title: Modulation of in vivo alloreactivity by inhibition of inducible nitric oxide synthase.
abstract: The role of nitric oxide in the immune response to allogeneic tissue was explored in an in vivo cardiac transplant model in the rat. Nitric oxide production during organ rejection was demonstrated by elevations in systemic serum nitrite/nitrate levels and by electron paramagnetic resonance spectroscopy. Messenger RNA for the inducible nitric oxide synthase enzyme was detected in the rejecting allografted heart, but not in the nonrejecting isografted heart. The enzyme was demonstrated to be biologically active by the in vitro conversion of L-arginine to L-citrulline and was immunohistochemically localized to the infiltrating inflammatory cells. Treatment with aminoguanidine, a preferential inhibitor of the inducible nitric oxide synthase isoform, prevented the increased nitric oxide production in the transplanted organ and significantly attenuated the pathogenesis of acute rejection. Aminoguanidine treatment prolonged graft survival, improved graft contractile function, and significantly reduced the histologic grade of rejection. These results suggest an important role for nitric oxide in mediating the immune response to allogeneic tissue. Inhibition of inducible nitric oxide synthase may provide a novel therapeutic modality in the management of acute transplant rejection and of other immune-mediated processes.
authors.affiliation: Department of Surgery (Division of Cardiothoracic Surgery), Washington University School of Medicine, Saint Louis, Missouri 63110.
authors.forename: N K
authors.initials: NK
authors.lastname: Worrall
authors.forename: W D
authors.initials: WD
authors.lastname: Lazenby
authors.forename: T P
authors.initials: TP
authors.lastname: Misko
authors.forename: T S
authors.initials: TS
authors.lastname: Lin
authors.forename: C P
authors.initials: CP
authors.lastname: Rodi
authors.forename: P T
authors.initials: PT
authors.lastname: Manning
authors.forename: R G
authors.initials: RG
authors.lastname: Tilton
authors.forename: J R
authors.initials: JR
authors.lastname: Williamson
authors.forename: T B
authors.initials: TB
authors.lastname: Ferguson
mesh_terms: D000594:Amino Acid Oxidoreductases / Q000037:antagonists & inhibitors*; D000595:Amino Acid Sequence; D000818:Animals; D001483:Base Sequence; D017931:DNA Primers / Q000737:chemistry; D004790:Enzyme Induction / Q000187:drug effects; D015870:Gene Expression; D006084:Graft Rejection; D006146:Guanidines / Q000494:pharmacology; D016027:Heart Transplantation; D008969:Molecular Sequence Data; D009569:Nitric Oxide / Q000502:physiology*; D019001:Nitric Oxide Synthase; D012333:RNA, Messenger / Q000235:genetics; D051381:Rats; D011912:Rats, Inbred ACI; D011917:Rats, Inbred Lew
chemical_list: D017931:DNA Primers; D006146:Guanidines; D012333:RNA, Messenger; D009569:Nitric Oxide; D019001:Nitric Oxide Synthase; D000594:Amino Acid Oxidoreductases; C004479:pimagedine