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Differential Induction of Nitric Oxide Synthase in Hepatocytes During Endotoxemia and the Acute-Phase Response

David A. Geller, MD; Paul D. Freeswick, MD; Dan Nguyen; Andreas K. Nussler, PhD; Mauricio Di Silvio, MD; Richard A. Shapiro; Stewart C. Wang, MD; Richard L. Simmons, MD; Timothy R. Billiar, MD
Arch Surg. 1994;129(2):165-171. doi:10.1001/archsurg.1994.01420260061008.
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Objective:  Nitric oxide (NO) is a potent biologic mediator produced by hepatocytes following exposure to cytokines and lipopolysaccharide (LPS). These cytokines are also known to regulate induction of the hepatic acute-phase response. The objective of this study was to determine whether inducible nitric oxide synthase (iNOS), the enzyme that produces NO, is expressed as part of the hepatic acute-phase response.

Design:  The gene expression for inducible NOS (iNOS) as well as α1–acid glycoprotein (AGP), an established acute-phase reactant, was measured by Northern blot analysis in rat hepatocytes in vivo during endotoxemia (LPS injection) and during the acute-phase response produced by hindlimb turpentine injection. Hepatocyte iNOS messenger RNA (mRNA) levels were correlated with iNOS activity and circulating plasma nitrite and nitrate levels. In vitro, iNOS and AGP mRNA levels were determined in cultured hepatocytes stimulated with interleukin 6 (IL-6), interleukin 1β (IL-1β), tumor necrosis factor α (TNF-α), or dexamethasone.

Results:  The AGP mRNA levels were increased in vivo following both LPS and turpentine injection, while iNOS expression was induced only by LPS injection. Hepatocyte iNOS activity and plasma nitrite and nitrate levels also increased after LPS treatment. In vitro, the cytokine combination IL-6, IL-1β, and TNF-α induced hepatocyte iNOS expression but had minimal effects on AGP in the absence of dexamethasone. Addition of dexamethasone alone markedly increased AGP mRNA levels, with further increases seen with TNF-α or IL-1β addition. In contrast, dexamethasone decreased iNOS expression.

Conclusion:  The results show that hepatocyte iNOS expression is not part of the acute-phase response induced by remote inflammation and indicates that iNOS is differentially regulated from the acute-phase reactant, AGP.(Arch Surg. 1994;129:165-171)

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