Identification and Molecular Mechanism of Novel Two-Way Immunomodulatory Peptides from Ovalbumin: In Vitro Cell Experiments, De Novo Sequencing, and Molecular Docking.

The purpose of this study was to identify ovalbumin-derived immunomodulatory peptides by in vitro cell experiments, de novo sequencing, and molecular docking. Ovalbumin hydrolysates were prepared by two enzymes (alkaline protease and papain) individually, sequentially, or simultaneously, respectively. The simultaneous enzymatic hydrolysate (OVAH) had a high degree of hydrolysis (38.12 ± 0.48%) and exhibited immune-enhancing and anti-inflammatory activities. A total of 160 peptides were identified by LC-MS/MS in OVAH. Three novel peptides NVMEERKIK, ADQARELINS, and WEKAFKDE bound to TLR4-MD2 through hydrogen bonds and hydrophobic interactions with high binding affinity and binding energies of -181.40, -178.03, and -168.12 kcal/mol, respectively. These three peptides were synthesized and validated for two-way immunomodulatory activity. NVMEERKIK exhibiting the strongest immunomodulatory activity, increased NO and TNF-α levels by 128.69 and 38.01%, respectively, in normal RAW264.7 cells and reduced NO and TNF-α levels by 27.31 and 39.13%, respectively, in lipopolysaccharide-induced inflammatory RAW264.7 cells. Overall, this study first revealed that ovalbumin could be used as an immunomodulatory source for controlling inflammatory factor secretion.

IFN-γ-mediated control of SARS-CoV-2 infection through nitric oxide.

Introduction: The COVID-19 pandemic has highlighted the need to identify mechanisms of antiviral host defense against SARS-CoV-2. One such mediator is interferon-g (IFN-γ), which, when administered to infected patients, is reported to result in viral clearance and resolution of pulmonary symptoms. IFN-γ treatment of a human lung epithelial cell line triggered an antiviral activity against SARS-CoV-2, yet the mechanism for this antiviral response was not identified. Methods: Given that IFN-γ has been shown to trigger antiviral activity via the generation of nitric oxide (NO), we investigated whether IFN-γ induction of antiviral activity against SARS-CoV-2 infection is dependent upon the generation of NO in human pulmonary epithelial cells. We treated the simian epithelial cell line Vero E6 and human pulmonary epithelial cell lines, including A549-ACE2, and Calu-3, with IFN-γ and observed the resulting induction of NO and its effects on SARS-CoV-2 replication. Pharmacological inhibition of inducible nitric oxide synthase (iNOS) was employed to assess the dependency on NO production. Additionally, the study examined the effect of interleukin-1b (IL-1ß) on the IFN-g-induced NO production and its antiviral efficacy. Results: Treatment of Vero E6 cells with IFN-γ resulted in a dose-responsive induction of NO and an inhibitory effect on SARS-CoV-2 replication. This antiviral activity was blocked by pharmacologic inhibition of iNOS. IFN-γ also triggered a NO-mediated antiviral activity in SARS-CoV-2 infected human lung epithelial cell lines A549-ACE2 and Calu-3. IL-1ß enhanced IFN-γ induction of NO, but it had little effect on antiviral activity. Discussion: Given that IFN-g has been shown to be produced by CD8+ T cells in the early response to SARS-CoV-2, our findings in human lung epithelial cell lines, of an IFN-γ-triggered, NO-dependent, links the adaptive immune response to an innate antiviral pathway in host defense against SARS-CoV-2. These results underscore the importance of IFN-γ and NO in the antiviral response and provide insights into potential therapeutic strategies for COVID-19.

Oxidative stress and immune system analysis after cycle ergometer use in critical patients

OBJECTIVE: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients. METHODS: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães. The patients were divided into two groups: one group underwent cycle ergometer passive exercise for 30 cycles/min on the lower limbs for 20 minutes; the other group did not undergo any therapeutic intervention during the study and served as the control group. A total of 20 ml of blood was analysed, in which nitric oxide levels and some specific inflammatory cytokines (tumour necrosis factor alpha (TNF-α), interferon gamma (IFN-γ) and interleukins 6 (IL-6) and 10 (IL-10)) were evaluated before and after the study protocol. RESULTS: Regarding the demographic and clinical variables, the groups were homogeneous in the early phases of the study. The nitric oxide analysis revealed a reduction in nitric oxide variation in stimulated cells (p=0.0021) and those stimulated (p=0.0076) after passive cycle ergometer use compared to the control group. No differences in the evaluated inflammatory cytokines were observed between the two groups. CONCLUSION: We can conclude that the passive cycle ergometer promoted reduced levels of nitric oxide, showing beneficial effects on oxidative stress reduction. As assessed by inflammatory cytokines, the treatment was not associated with changes in the immune system. However, further research in a larger population is necessary for more conclusive results.

Does the effect of smoking on fractional exhaled nitric oxide vary by race in adults in a US National Survey?

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Asthma diagnosis and severity monitoring in primary school children: Essential role of sequential testing of exhaled nitric oxide

BACKGROUND: Chronic eosinophilic airway inflammation, airflow limitation, and airway hyper-responsiveness are the mainstays of asthma diagnosis. The increased levels of exhaled nitric oxide (FeNO) in asthma are closely related to the extent of airway inflammation. Sequential measurement of FeNO concentrations may accurately predict asthma severity and guide therapeutic decisions. METHODS: A total of 22,083 grade 1 students in Taipei city primary schools were screened for wheezing episodes using the International Study of Asthma and Allergies in Childhood questionnaire (ISAAC) questionnaires while their sero-atopic conditions were confirmed by Fluorescent Enzyme Immune Assay (FEIA). All students with allergies were tested by FeNO electrochemical test. 100 age-matched healthy students were used as control group (FeNO levels < 25 ppb). RESULTS: From the 2650 students (12%) initially included via the wheezing criteria, 2065 (78.0%) were confirmed to have allergy by FEIA (sensitisation to at least two common aero-allergens in Taiwan) and diagnosed by a paediatric allergologist. Among them, 1852 (89.6%) had elevated FeNO values (>25 ppb) and 266 (10%) had FeNO values < 25 ppb. Using the GINA guidelines, 140 mild-to-moderate asthma students who had received inhaled corticosteroids (ICS) with or without Singulair treatment completed serial FeNO testing every three months for one year. The FeNO levels decreased in 121 students (86.4%) and increased in 19 students (13.6%), which was compatible to changing childhood asthma control score and response to step-down treatment, respectively. CONCLUSION: FeNO is an easy, used non-invasive tool for the diagnosis of allergic asthma. Sequential FeNO testing can accurately reflect asthma severity and provide for successful stepwise therapy for asthmatic children

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The effects of nitric oxide on the immune response during giardiasis

Nitric oxide (NO) is a free radical synthesized from L-arginine by different isoforms NO-synthases. NO possesses multiple and complex biological functions. NO is an important mediator of homeostasis, and changes in its generation or actions can contribute or not to pathological states. The knowledge of effects of NO has been not only important to our understanding of immune response, but also to new tools for research and treatment of various diseases. Knowing the importance of NO as inflammatory mediator in diverse infectious diseases, we decided to develop a revision that shows the participation/effect of this mediator in immune response induced against Giardia spp. Several studies already demonstrated the participation of NO with microbicidal and microbiostatic activity in giardiasis. On the other hand, some works report that Giardia spp. inhibit NO production by consuming the intermediate metabolite arginine. In fact, studies in vitro showed that G. lamblia infection of human intestinal epithelial cells had reduced NO production. This occurs due to limited offer of the crucial substrate arginine (essential aminoacid for NO production), consequently reducing NO production. Therefore, the balance between giardial arginine consumption and epithelial NO production could contribute to the variability of the duration and severity of infections by this ubiquitous parasite.

Involvement of nitric oxide and its up/down stream molecules in the immunity against parasitic infections

Nitric oxide (NO) is a potent mediator with diverse roles in regulating cellular functions and signaling pathways. The NO synthase (NOS) enzyme family consists of three major isoforms, which convey variety of messages between cells, including signals for vasorelaxation, neurotransmission and cytotoxicity. This family of enzymes are generally classified as neuronal NOS (nNOS), endothelial NOS (eNOS) and inducible NOS (iNOS). Increased levels of NO are induced from iNOS during infection; while eNOS and nNOS may be produced at the baseline in normal conditions. An association of some key cytokines appears to be essential for NOS gene regulation in the immunity of infections. Accumulating evidence indicates that parasitic diseases are commonly associated with elevated production of NO. NO plays a role in the immunoregulation and it is implicated in the host non-specific defence in a variety of infections. Nevertheless, the functional role of NO and NOS isoforms in the immune responses of host against the majority of parasites is still highly controversial. In the present review, the role of parasitic infections will be discussed in the controversy related to the NO production and iNOS gene expression in different parasites and a variety of experimental models.

Immunoactivation and immunopathogeny during active visceral leishmaniasis / Imunoativação e imunopatogenia durante leishmaniose visceral ativa

Visceral leishmaniasis is caused by protozoan parasites of the Leishmania donovani complex. During active disease in humans, high levels of IFN-γ and TNF-α detected in blood serum, and high expression of IFN-γ mRNA in samples of the lymphoid organs suggest that the immune system is highly activated. However, studies using peripheral blood mononuclear cells have found immunosuppression specific to Leishmania antigens; this poor immune response probably results from Leishmania antigen-engaged lymphocytes being trapped in the lymphoid organs. To allow the parasites to multiply, deactivating cytokines IL-10 and TGF-β may be acting on macrophages as well as anti-Leishmania antibodies that opsonize amastigotes and induce IL-10 production in macrophages. These high activation and deactivation processes are likely to occur mainly in the spleen and liver and can be confirmed through the examination of organ samples. However, an analysis of sequential data from studies of visceral leishmaniasis in hamsters suggests that factors outside of the immune system are responsible for the early inactivation of inducible nitric oxide synthase, which occurs before the expression of deactivating cytokines. In active visceral leishmaniasis, the immune system actively participates in non-lymphoid organ lesioning. While current views only consider immunocomplex deposition, macrophages, T cells, cytokines, and immunoglobulins by diverse mechanism also play important roles in the pathogenesis.

A leishmaniose visceral é causada por protozoários do gênero do complexo Leishmania donovani. Durante a doença ativa no homem são detectados altos níveis de IFN-γ e de TNF-α no soro, e elevada expressão de mRNA de IFN-γ em amostras de órgãos linfóides sugerindo um estado intensamente ativado do sistema imunológico. A visão atual, no entanto, refere-se à imunossupressão específica aos antígenos de Leishmania com base em estudos utilizando células mononucleares do sangue periférico; a explicação para sua resposta deficiente seria provavelmente porque os linfócitos compometidos com antígeno de Leishmania são sequestrados nos órgãos linfóides. Para permitir a proliferação do parasito, citocinas desativadoras IL-10 e TGF-β atuariam nos macrófagos, bem como os anticorpos anti-Leishmania opsonizando amastigotas e induzindo a produção IL-10 pelos macrófagos. Estes processos de intensa ativação e desativação provavelmente ocorreriam no baço e fígado, principalmente, e confirmados com amostras de órgãos. No entanto, analisando dados seqüenciais obtidos na leishmaniose visceral no hamster, sugere-se provável presença de fatores fora do sistema imunológico como responsável pela inativação inicial de sintase induzível do óxido nítrico que ocorre antes da expressão de citocinas desativadoras. Na leishmaniose visceral ativa o sistema imunológico participa ativamente na lesão de órgãos não linfóides. Contrária à visão existente que considera somente mecanismos de deposição de imunocomplexos, observa-se na patogenia a participação de macrófagos, células T, citocinas e imunoglobulinas por mecanismo alternativo.

The effects of nitric oxide on the immune system during Trypanosoma cruzi infection

Trypanosoma cruzi infection triggers substantial production of nitric oxide (NO), which has been shown to have protective and toxic effects on the host's immune system. Sensing of trypomastigotes by phagocytes activates the inducible NO-synthase (NOS2) pathway, which produces NO and is largely responsible for macrophage-mediated killing of T. cruzi. NO is also responsible for modulating virtually all steps of innate and adaptive immunity. However, NO can also cause oxidative stress, which is especially damaging to the host due to increased tissue damage. The cytokines IFN-³ and TNF-±, as well as chemokines, are strong inducers of NOS2 and are produced in large amounts during T. cruzi acute infection. Conversely, TGF-² and IL-10 negatively regulate NO production. Here we discuss the recent evidence describing the mechanisms by which NO is able to exert its antimicrobial and immune regulatory effects, the mechanisms involved in the oxidative stress response during infection and the implications of NO for the development of therapeutic strategies against T. cruzi.

Proinflammatory Cytokine and Nitric Oxide Production by Human Macrophages Stimulated with Trichomonas vaginalis

Trichomonas vaginalis commonly causes vaginitis and perhaps cervicitis in women and urethritis in men and women. Macrophages are important immune cells in response to T. vaginalis infection. In this study, we investigated whether human macrophages could be involved in inflammation induced by T. vaginalis. Human monocyte-derived macrophages (HMDM) were co-cultured with T. vaginalis. Live, opsonized-live trichomonads, and T. vaginalis lysates increased proinflammatory cytokines, such as TNF-alpha, IL-1beta, and IL-6 by HMDM. The involvement of nuclear factor (NF)-kappaB signaling pathway in cytokine production induced by T. vaginalis was confirmed by phosphorylation and nuclear translocation of p65 NF-kappaB. In addition, stimulation with live T. vaginalis induced marked augmentation of nitric oxide (NO) production and expression of inducible NO synthase (iNOS) levels in HMDM. However, trichomonad-induced NF-kappaB activation and TNF-alpha production in macrophages were significantly inhibited by inhibition of iNOS levels with L-NMMA (NO synthase inhibitor). Moreover, pretreatment with NF-kappaB inhibitors (PDTC or Bay11-7082) caused human macrophages to produce less TNF-alpha. These results suggest that T. vaginalis stimulates human macrophages to produce proinflammatory cytokines, such as IL-1, IL-6, and TNF-alpha, and NO. In particular, we showed that T. vaginalis induced TNF-alpha production in macrophages through NO-dependent activation of NF-kappaB, which might be closely involved in inflammation caused by T. vaginalis.

Proinflammatory Cytokine and Nitric Oxide Production by Human Macrophages Stimulated with Trichomonas vaginalis

Trichomonas vaginalis commonly causes vaginitis and perhaps cervicitis in women and urethritis in men and women. Macrophages are important immune cells in response to T. vaginalis infection. In this study, we investigated whether human macrophages could be involved in inflammation induced by T. vaginalis. Human monocyte-derived macrophages (HMDM) were co-cultured with T. vaginalis. Live, opsonized-live trichomonads, and T. vaginalis lysates increased proinflammatory cytokines, such as TNF-alpha, IL-1beta, and IL-6 by HMDM. The involvement of nuclear factor (NF)-kappaB signaling pathway in cytokine production induced by T. vaginalis was confirmed by phosphorylation and nuclear translocation of p65 NF-kappaB. In addition, stimulation with live T. vaginalis induced marked augmentation of nitric oxide (NO) production and expression of inducible NO synthase (iNOS) levels in HMDM. However, trichomonad-induced NF-kappaB activation and TNF-alpha production in macrophages were significantly inhibited by inhibition of iNOS levels with L-NMMA (NO synthase inhibitor). Moreover, pretreatment with NF-kappaB inhibitors (PDTC or Bay11-7082) caused human macrophages to produce less TNF-alpha. These results suggest that T. vaginalis stimulates human macrophages to produce proinflammatory cytokines, such as IL-1, IL-6, and TNF-alpha, and NO. In particular, we showed that T. vaginalis induced TNF-alpha production in macrophages through NO-dependent activation of NF-kappaB, which might be closely involved in inflammation caused by T. vaginalis.

The role of nitric oxide in the regulation of adaptive immune responses

The immune system constitutes a set of effective host responses to pathogens. T lymphocytes orchestrate these responses through specific receptor recognition of pathogen-derived antigenic peptides on antigen presenting cells (APC). Extracellular stimuli (such as fungal and bacterial endotoxins) and cytokines (IFN-¦Ã, TNF-¦Á and IL-1¦Â)activate macrophages to express inducible nitric oxide synthase (iNOS)and inhibit pathogen replication by releasing a variety of effect ormolecules including nitric oxide (NO). However, the participation of NO in the resolution of immune responses is not an exclusive hallmark of iNOS from macrophages. Recent evidence indicates that constitutive NOS expression in other immune cells also plays an important role in the development of adaptive immune responses. This review summarizes recent reports indicating an important role for NO in immune responses, focusing on the unresolved controversies concerning the production and function of NO in T lymphocytes (AU)

Los linfocitos T juegan un papel central en la regulación de la respuesta inmune adaptativa generada por el huésped frente a la agresión por agentes patógenos, mediante el reconocimiento de péptidos antigénicos expuestos en la superficie de células presentadoras de antígeno (APC). La presencia de células necróticas, la infección por virus u hongos, ciertas endotoxinas bacterianas (como por ejemplo el LPS) o las citocinas proinflamatorias IFN-γ, TNFα e IL-1β activan la expresión de la forma inducible de óxido nítrico sintetasa (iNOS) en macrófagos y con ello la producción de altas concentraciones de óxido nítrico (NO) cuya función más reconocida en estas células es mantener una actividad microbicida e inhibir la proliferación de agentes infecciosos. Sin embargo, la producción de NO y su participación en la resolución de la respuesta inmune no es una característica exclusiva de la expresión de iNOS en macrófagos. Evidencias recientes indican que la expresión de las isoformas constitutivas de NOS (cNOS: NOS endotelial y NOS neuronal) por parte de otras células inmunitarias también juega un importante papel en el desarrollo de la respuesta inmune adaptativa. La presente revisión trata de integrar los hallazgos iniciales y otros estudios más recientes en los cuales el NO ha sido considerado un mediador químico con una importante función reguladora para el desarrollo de la respuesta inmune adaptativa, centrándonos en la controversia suscitada entorno a su producción y función en los linfocito (AU)

Macrófagos e inducción de arginasa como mecanismo de evasión de parásitos / Macrophages and arginase induction as a mechanism for parasite escape

Aunque existen varios mecanismos inmunológicos para eliminar a los patógenos intracelulares, éstos han elaborado una variedad de estrategias para escapar de la respuesta del sistema inmune y asegurarse su supervivencia y replicación en el huésped. Algunos parásitos modulan la producción de numerosas moléculas tóxicas sintetizadas por el sistema inmune. Varios parásitos son altamente sensibles al óxido nítrico (ON) y sus derivados. El ON es producido en macrófagos (MΦ) luego de la estimulación con productos microbianos o con citoquinas. En el pasado, los MΦ se identificaban como células puramente inflamatorias (MΦ activados en forma clásica), capaces de secretar mediadores inflamatorios, actuar como células presentadoras de antígenos y matar patógenos intracelulares. Sin embargo, los MΦ activados representan un grupo más heterogéneo de células con distintos marcadores biológicos que pueden llevar a cabo diferentes funciones inmunológicas. Los MΦ activados alternativamente, fallan en producir ON en virtud de la inducción de la enzima arginasa y consecuentemente tienen disminuida su capacidad para matar patógenos intracelulares. Se ha comunicado la inducción de arginasa por parte de varios parásitos, por lo tanto este mecanismo podría favorecer su supervivencia en el huésped. En un modelo de infección con Trypanosoma cruzi, en nuestro grupo estudiamos la participación de arginasa y de las señales intracelulares involucradas en su inducción, durante la replicación de este parásito en los MΦ. La información obtenida a partir de nuestros trabajos permitiría comprender algunos mecanismos por los cuales distintas células del sistema inmune pueden ser programadas para favorecer el establecimiento de infecciones parasitarias crónicas.

Although there are several immunological mechanisms to eliminate the intracellular pathogens, they have elaborated a variety of strategies to escape of the immune response and to make possible their survival and replication in the host. Some parasites modulate the production of several toxic molecules synthesized by the immune system. Several parasites are highly sensitive to nitric oxide (ON) and their derivatives. ON is produced in macrophages (MΦ) after stimulation with microbial products or cytokines. In the past, M Φ were defined as inflammatory cells (classically activated MΦ), able to produce inflammatory mediators, to act like antigens presenting cells and to kill intracellular pathogens. Nevertheless, activated MΦ involve a more heterogeneous group of cells with different biological markers that can carry out different immunological functions. Alternatively activated MΦ fail to produce ON due to the arginase induction and consequently they have diminished their capacity to kill intracellular pathogens. It has been reported the induction of arginase by different parasites; therefore this mechanism could favor their survival in the host. In our group, we studied the participation of arginase in a model of Trypanosoma cruzi infection and the intracellular signals involved in the replication of this parasite in MΦ. The data obtained from our works would allow the understanding of some mechanisms by which cells can be programmed to favor the establishment of chronic parasitic infections.

Immune effector mechanisms of the nitric oxide pathway in malaria: cytotoxicity versus cytoprotection

Nitric oxide (NO) is thought to be an important mediator and critical signaling molecule for malaria immunopathology; it is also a target for therapy and for vaccine. Inducible nitric oxide synthase (iNOS) is synthesized by a number of cell types under inflammatory conditions. The most relevant known triggers for its expression are endotoxins and cytokines. To date, there have been conflicting reports concerning the clinical significance of NO in malaria. Some researchers have proposed that NO contributes to the development of severe and complicated malaria, while others have argued that NO has a protective role. Infection with parasites resistant to the microbicidal action of NO may result in high levels of NO being generated, which could then damage the host, instead of controlling parasitemia. Consequently, the host-parasite interaction is a determining factor for whether the parasite is capable of stimulating NO production; the role of NO in resistance to malaria appears to be strain specific. It is known that NO and/or its related molecules are involved in malaria, but their involvement is not independent of other immune events. NO is an important, but possibly not an essential contributor to the control of acute-phase malaria infection. The protective immune responses against malaria parasite are multifactorial; however, they necessarily involve final effector molecules, including NO, iNOS and RNI.

Sepsis: emerging role of nitric oxide and selectins

Sepse – um estado de infecção bacteriana sistêmica – frequentemente leva à falência múltipla de órgãos e associa-se a altos índices de mortalidade, apesar de progressos recentes no manejo de pacientes em unidades de terapia intensiva. Muitos dos efeitos maléficos associados à sepse são atribuídos a uma resposta inflamatória patologicamente ampliada que leva a recrutamento neutrofílico e ativação das moléculas de adesão do grupo das selectinas, durante as fases iniciais do processo . O óxido nítrico e sua diversas isoformas também foram implicados nas diversas manifestações vasculares da sepse como participantes diretos da toxicidade celular. Esta revisão descreve o papel das selectinas e do óxido nítrico em situações clínicas e experimentais de sepse, bem como os respectivos efeitos de processos terapêuticos de bloqueio.

Regulation of nitric oxide induced by mycobacterial lipoarabinomannan in murine macrophages: effects of interferon-B and taurine-chloramine

We examined the effects of interferon beta (IFN-beta) on the production of liporabinomannan (LAM)-induced nitric oxide (NO) in peritoneal macrophages from low-responder and high-responder (C3H/HeJ and C3H/OuJ) mice. NO was produced in a dose response when induced by lipo-polysaccharide (LPS) or LAM plus interferon gamma (IFN-gamma) or IFN-beta in both high- and low-responder mice. In contrast to IFN-gamma, both high- and low-responder mice failed to induce nitrite production when IFN-beta was added, except at a high concentration of IFN-beta. Tau-Cl (0.5 mM) inhibited NO production about 50% in the high-responder strain when cells were activated with LPS or LAM in combination with either IFN-beta or IFN-gamma, and almost abolished NO production at 1.0 mM. In the low-responder strain, Tau-Cl (0.5 mM) significantly inhibited NO production when cells were activated with IFN-gamma or IFN-beta in addition to LPS or LAM, but did not completely inhibit NO production at 1.0 mM. Tau-Cl appears to play a potent role in regulating inflammatory reaction-induced bacterial or mycobacterial organisms. These data indicate a pivotal role for IFN-gamma and IFN-beta for the production of LPS and LAM initiated NO in peritoneal macrophages from low-responder (C3H/HeJ) mice.

Oxido nítrico exhalado como marcador de inflamación en niños con asma / The exhaled nitric oxide is a inflammatory response

El óxido nítrico es un gas reactivo que se produce de manera endógena por enzimas óxido nítrico sintetasa. Existe una gran producción de óxido nítrico inducida por la isoforma de la enzima óxido nítrico sintetasa, que da como resultado la formación de productos citotóxicos, que son importantes mediadores de los mecanismo de defensa y de la respuesta inflamatoria normal. El óxido nítrico puede detectarse en el aire exhalado en humanos, sus concentraciones están incrementadas en pacientes con asma, y después de la exposición a alergenos. La medición del óxido nítrico exhalado se efectúa por métodos sencillos, no invasivos, para valorar el grado de inflamación de la vía aérea y la respuesta al tratamiento con esteroides en pacientes pediátricos

Oxido nítrico en el Síndrome de Sjögren: posible participación en el bloqueo de la apoptosis linfocitaria

Objetivo: evaluar el papel del óxido nítrico (NO) en el síndrome de sjögren primario (SSp) y su relación con la apoptosis tisular en glándulas salivares menores (GSM). Métodos. Las GSM correspondieron a sialoadenitis focal propia del SSp, sialoadenitis crónica (SAC) y a GSM histológicamente normales. El progreso del SSp fue evaluado mediante el puntaje por focos inflamatorios en GSM. Los niveles salivares y séricos de nitrito (NO2) fueron medidos mediante la reacción de Griess. La expresión de la óxido nitrico sintetasa tipo 2 (NOS2) y de la cistatina C (Cis-C), un inhibidor fisiológico de proteasas, fue examinada en GSM por inmunohistoquímica, y analizada de manera semicuantitativa. La apoptosis tisular fue evaluada determinando la fragmentación del ADN mediante la incorporación de nucleótidos marcados. Resultados. Los niveles de NO2 en saliva fueron mayores en pacientes con SSp (n=17) que en controles sanos (n=17) (71.1ñ20.6 vs 3.7 uM, p=0.02), mientras que en suero fueron similares (22.3ñ3.8 vs 17ñ1.4 uM). En el infiltrado inflamatorio la expresión de NOs2 fue mayor en pacientes con SSp que con SAC (n=4) (94 por ciento vs 7 por ciento). La NOS2 fue observada también en células epiteliales canaliculares, células acinares y fibroblastos de pacientes (SSp y SAC), y de controles normales (n=5). En GSM de pacientes con SSp la expresión de NOS2 fue mayor en aquellas con focos inflamatorios <4(78 por ciento vs 17 por ciento, p=0.04) y con menor número de células apoptóticas en el inflitrado inflamatorio (0.6ñ0.2 vs 1.66ñ0.3, p=0.02). La expresión de Cls-C fue observada en los tres grupos estudiados, principalamente en células epiteliales canaliculares, en algunos plasmocitos y células acinares de pacientes con SSp. No se observó asociación entre la expresión de Cls-C y la apoptosis tisular. Conclusión. Este estudio confirma el aumento de la síntesis de NO en el SS primario, producido localmente en el sitio inflamatorio, principalamente durante las fases tempranas de la enfermedad, y sugiere su participación en el bloqueo de la apoptosis linfocitaria, la cual no es regulada por la Cis-C. el mecanismo de esta inhibición apoptótica podría estar asociada a la S-nitrosilación de caspasas