N(omega)-nitro-L-arginine methyl ester effects on neutrophil function and bacterial clearance

Shock. 2004 Aug;22(2):180-5. doi: 10.1097/01.shk.0000132487.89800.15.

Abstract

Nitric oxide synthase (NOS) inhibitors are considered promising as a therapeutic option in severe septic shock. The aim of this study was to investigate the effects of N-nitro-L-arginine methyl ester (L-NAME) application on neutrophil (PMN) respiratory burst, phagocytosis, and elimination of Escherichia coli from blood and tissue in rabbits. Twenty-eight female chinchilla rabbits were randomized to a treatment and control group. To quantify the bacterial clearance process, 10 colony forming units (CFU) of E. coli were injected intravenously into anesthetized rabbits. Animals in the L-NAME group had a significantly higher mortality compared with controls. NOS inhibition resulted in a significant delay of bacterial clearance (P < 0.001). These findings correlated with a significant augmentation of all organ E. coli findings (P = 0.002-0.035). PMN phagocytosis activity was notably reduced by L-NAME treatment during the experimental observation. Neutrophil burst, on the other hand, was amplified by NOS inhibition (P = 0.008). Our findings point to an interference with the PMN-dependent immune mechanisms after L-NAME treatment. The augmented PMN burst reaction could be a compensatory mechanism, potentially leading to tissue damage. Therefore, in this model, we find sufficient evidence pointing to a possible cause for the deleterious effect of early nonselective NOS inhibition in critically ill patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Pressure
  • Chinchilla
  • Endotoxins / metabolism
  • Enzyme Inhibitors / pharmacology
  • Escherichia coli / metabolism
  • Escherichia coli Infections / drug therapy*
  • Female
  • Hemodynamics
  • Humans
  • Kinetics
  • Lactates / metabolism
  • Leukocytes, Mononuclear / metabolism
  • Lipopolysaccharides / metabolism
  • Lung / metabolism
  • NG-Nitroarginine Methyl Ester / metabolism
  • NG-Nitroarginine Methyl Ester / pharmacology
  • Neutrophils / metabolism*
  • Nitrates / metabolism
  • Nitric Oxide Synthase / metabolism
  • Nitrites / metabolism
  • Organ Culture Techniques
  • Phagocytosis
  • Phenotype
  • Rabbits
  • Stem Cells
  • Time Factors
  • Tissue Distribution

Substances

  • Endotoxins
  • Enzyme Inhibitors
  • Lactates
  • Lipopolysaccharides
  • Nitrates
  • Nitrites
  • Nitric Oxide Synthase
  • NG-Nitroarginine Methyl Ester