title: Sepiapterin decreases acute rejection and apoptosis in cardiac transplants independently of changes in nitric oxide and inducible nitric-oxide synthase dimerization.
abstract: Tetrahydrobiopterin (BH(4)), a cofactor of inducible nitric-oxide synthase (iNOS), is an important post-translational regulator of NO bioactivity. We examined whether treatment of cardiac allograft recipients with sepiapterin [S-(-)-2-amino-7,8-dihydro-6-(2-hydroxy-1-oxopropyl)-4-(1H)-pteridinone], a precursor of BH(4), inhibited acute rejection and apoptosis in cardiac transplants. Heterotopic cardiac transplantation was performed in Wistar-Furth donor to Lewis recipient strain rats. Recipients were treated daily after transplantation with 10 mg/kg sepiapterin. Grafts were harvested on post-transplant day 6 for analysis of BH(4) (high-performance liquid chromatography), expression of inflammatory cytokines (reverse transcription- and real-time polymerase chain reaction), iNOS (Western blots), and NO (Griess reaction and NO analyzer). Histological rejection grade was scored, and graft function was determined by echocardiography. Apoptosis, protein nitration, and oxidative stress were determined by immunohistochemistry. Treatment of allografts with sepiapterin increased cardiac BH(4) levels by 3-fold without changing protein levels of GTP cyclohydrolase, the enzyme that regulates de novo BH(4) synthesis. Sepiapterin decreased inflammatory cell infiltrate and significantly inhibited histological rejection scores and apoptosis similar in magnitude to cyclosporine. Sepiapterin also decreased nitrative and oxidative stress. Sepiapterin caused a smaller increase in left ventricular mass versus untreated allografts but without improving fractional shortening. Sepiapterin did not alter tumor necrosis factor-alpha and interferon-gamma expression, whereas it decreased interleukin (IL)-2 expression. Sepiapterin did not change total iNOS protein or monomer levels, or plasma and tissue NO metabolites levels. It is concluded that the mechanism(s) of antirejection are due in part to decreased apoptosis, protein nitration, and oxidation of cardiomyocytes, which seems to be mediated at the immune level by limiting inflammatory cell infiltration via decreased IL-2-mediated T-lymphocyte expansion.
authors.affiliation: Division of Transplant Surgery, Medical College of Wisconsin, 9200 West Wisconsin Ave., Milwaukee, WI 53226, USA. gmpieper@mcw.edu
authors.forename: Galen M
authors.initials: GM
authors.lastname: Pieper
authors.forename: Irina A
authors.initials: IA
authors.lastname: Ionova
authors.forename: Brian C
authors.initials: BC
authors.lastname: Cooley
authors.forename: Raymond Q
authors.initials: RQ
authors.lastname: Migrino
authors.forename: Ashwani K
authors.initials: AK
authors.lastname: Khanna
authors.forename: Jennifer
authors.initials: J
authors.lastname: Whitsett
authors.forename: Jeannette
authors.initials: J
authors.lastname: Vásquez-Vivar
mesh_terms: D000447:Aldehydes / Q000378:metabolism; D000818:Animals; D017209:Apoptosis / Q000187:drug effects* / Q000276:immunology; D001119:Arginase / Q000235:genetics; D001708:Biopterins / Q000031:analogs & derivatives / Q000378:metabolism; D016572:Cyclosporine / Q000627:therapeutic use; D016207:Cytokines / Q000235:genetics; D004452:Echocardiography; D006136:GTP Cyclohydrolase / Q000378:metabolism; D015870:Gene Expression / Q000187:drug effects / Q000235:genetics; D006084:Graft Rejection / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D016027:Heart Transplantation / Q000276:immunology* / Q000473:pathology*; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use; D009206:Myocardium / Q000378:metabolism / Q000473:pathology; D009569:Nitric Oxide / Q000097:blood / Q000378:metabolism*; D052247:Nitric Oxide Synthase Type II / Q000378:metabolism*; D011499:Protein Processing, Post-Translational / Q000187:drug effects; D011622:Pterins / Q000494:pharmacology* / Q000627:therapeutic use; D051381:Rats; D011917:Rats, Inbred Lew; D011920:Rats, Inbred WF; D014184:Transplantation, Homologous / Q000473:pathology; D014185:Transplantation, Isogeneic; D014443:Tyrosine / Q000031:analogs & derivatives / Q000378:metabolism
chemical_list: D000447:Aldehydes; D016207:Cytokines; D007166:Immunosuppressive Agents; D011622:Pterins; D001708:Biopterins; D009569:Nitric Oxide; C002744:3-nitrotyrosine; D014443:Tyrosine; D016572:Cyclosporine; C016727:sepiapterin; D052247:Nitric Oxide Synthase Type II; C496318:Nos2 protein, rat; D001119:Arginase; D006136:GTP Cyclohydrolase; C003402:sapropterin; C027576:4-hydroxy-2-nonenal