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February 1, 1995Journal of Clinical Investigation248 citationsOpen Access

The lethal effects of cytokine-induced nitric oxide on cardiac myocytes are blocked by nitric oxide synthase antagonism or transforming growth factor beta.

DPDavid J. PinskyBCBolin CaiXYXiaochun Yang

Key Result

Cytokine-induced nitric oxide production caused significant cardiac myocyte death, which was completely prevented by the nitric oxide synthase inhibitor L-NMMA or transforming growth factor-beta.

Key Points

  • To evaluate the impact of inducible nitric oxide synthase on cardiac myocyte cytotoxicity induced by cytokines.
  • Exposed adult rat cardiac myocytes to cytokines and cocultured with activated J774 macrophages.
  • Assessed iNOS expression, NO synthesis, and myocyte death through nitrite production and CPK release.
  • Examined the effects of TGF-beta on iNOS expression and NO-mediated cytotoxicity.
  • Cytokine treatment increased myocyte death, indicated by elevated CPK levels and loss of membrane integrity.
  • L-NMMA treatment significantly reduced nitrite production and cytotoxicity in treated cultures.
  • TGF-beta treatment decreased iNOS expression and NO-mediated cytotoxicity in cardiac myocytes.

Structured PICO

Does NO synthase antagonism or TGF-beta prevent cytokine-induced NO-mediated cytotoxicity in adult rat cardiac myocytes?

P
Population
Adult rat cardiac myocytes exposed to either cytokines alone (TNF-alpha, IL-1 beta, and IFN gamma) or to activated J774 macrophages in coculture
I
Intervention
Competitive NO synthase inhibitor L-NMMA or transforming growth-factor beta (TGF-beta)
C
Comparator
Cytokine treatment or activated macrophages alone without inhibitors
O
Outcome
Cardiac myocyte cytotoxicity (measured by CPK release and trypan blue staining) and NO synthesis (nitrite production)surrogate

Cytokine-induced nitric oxide production causes cardiac myocyte cytotoxicity, which can be blocked by NO synthase antagonism or TGF-beta, suggesting a potential therapeutic target for cardiomyopathies.

Main Result

Absolute Event Rate: 59% vs 38%

p-value: p=<0.05

Limitations

  • In vitro experimental model using isolated rat myocytes and murine macrophages, which may not fully replicate in vivo human pathophysiology
  • The exact physiological role and multiple potential mechanisms of iNOS toxicity within cardiac myocytes remain to be fully identified

Abstract

Inducible nitric oxide (NO) produced by macrophages is cytotoxic to invading organisms and has an important role in host defense. Recent studies have demonstrated inducible NO production within the heart, and that cytokine-induced NO mediates alterations in cardiac contractility, but the cytotoxic potential of nitric oxide with respect to the heart has not been defined. To evaluate the role of inducible nitric oxide synthase (iNOS) on cardiac myocyte cytotoxicity, we exposed adult rat cardiac myocytes to either cytokines alone or to activated J774 macrophages in coculture. Increased expression of both iNOS message and protein was seen in J774 macrophages treated with IFN gamma and LPS and cardiac myocytes treated with TNF-alpha, IL-1 beta, and IFN gamma. Increased NO synthesis was confirmed in both the coculture and isolated myocyte preparations by increased nitrite production. Increased NO synthesis was associated with a parallel increase in myocyte death as measured by CPK release into the culture medium as well as by loss of membrane integrity, visualized by trypan blue staining. Addition of the competitive NO synthase inhibitor L-NMMA to the culture medium prevented both the increased nitrite production and the cytotoxicity observed after cytokine treatment in both the isolated myocyte and the coculture experiments. Because transforming growth-factor beta modulates iNOS expression in other cell types, we evaluated its effects on cardiac myocyte iNOS expression and NO-mediated myocyte cytotoxicity. TGF-beta reduced expression of cardiac myocyte iNOS message and protein, reduced nitrite production, and reduced NO-mediated cytotoxicity in parallel. Taken together, these experiments show the cytotoxic potential of endogenous NO production within the heart, and suggest a role for TGF-beta or NO synthase antagonists to mute these lethal effects. These findings may help explain the cardiac response to sepsis or allograft rejection, as well as the progression of dilated cardiomyopathies of diverse etiologies.

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Cite This Study

Pinsky et al. (1995) studied Cytokine-induced nitric oxide toxicity in cardiac myocytes. L-NMMA or Transforming Growth Factor-beta (TGF-β) vs. Cytokines alone (IFN-γ, TNF-α, IL-1β) or unstimulated controls was evaluated on Myocyte death at 24 hours (percentage of dead cells) (p=<0.05). Cytokine-induced nitric oxide production caused significant cardiac myocyte death, which was completely prevented by the nitric oxide synthase inhibitor L-NMMA or transforming growth factor-beta.

synapsesocial.com/papers/6a0f8e792badbc352afe5682https://doi.org/10.1172/jci117713
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