title: Nitration of proteins in bronchoalveolar lavage fluid from patients with acute respiratory distress syndrome receiving inhaled nitric oxide.
abstract: Inhaled nitric oxide (.NO) is used to improve gas exchange and reduce pulmonary vascular resistance (PVR) in patients with the acute respiratory distress syndrome (ARDS). Although controlled studies have shown no survival benefit, some investigators have suggested that inhaled.NO may have antiinflammatory properties under these circumstances. In contrast, others have speculated that.NO given by inhalation could be cytotoxic, as it combines with superoxide at near diffusion-limited rates to produce the highly reactive oxidant peroxynitrite (ONOO(-)). We therefore quantified levels of 3-nitrotyrosine, a marker for ONOO(-) formation, in bronchoalveolar lavage fluid (BAL) from patients with ARDS receiving inhaled.NO, and from patients with comparable lung injury who were not so treated. We also measured levels of 3-chlorotyrosine as an index of neutrophil activation to assess indirectly the effects of inhaled.NO on lung inflammation. Patients receiving .NO had increased levels of 3-nitrotyrosine (6.76 +/- 2.79 versus 0.4 +/- 0.15 nmol/mg of protein, p < 0.05) and 3-chlorotyrosine (7.97 +/- 2.74 versus 1. 53 +/- 1.09 nmol/mg of protein, p < 0.05) in BAL protein compared with controls. In patients with ARDS, inhaled.NO increases the formation of 3-nitrotyrosine and is accompanied by an increase in levels of 3-chlorotyrosine (a marker of neutrophil activation). The possible long-term consequences of these observations remain to be evaluated.
authors.affiliation: Unit of Critical Care, Imperial College School of Medicine, Royal Brompton Hospital, London, United Kingdom.
authors.forename: N J
authors.initials: NJ
authors.lastname: Lamb
authors.forename: G J
authors.initials: GJ
authors.lastname: Quinlan
authors.forename: S T
authors.initials: ST
authors.lastname: Westerman
authors.forename: J M
authors.initials: JM
authors.lastname: Gutteridge
authors.forename: T W
authors.initials: TW
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002452:Cell Count; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018375:Neutrophil Activation / Q000187:drug effects; D009569:Nitric Oxide / Q000008:administration & dosage*; D012128:Respiratory Distress Syndrome / Q000188:drug therapy* / Q000378:metabolism; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000032:analysis
chemical_list: D001993:Bronchodilator Agents; D009569:Nitric Oxide; C002744:3-nitrotyrosine; D014443:Tyrosine