Kilbourn R G, Gross S S, Lodato R F, Adams J, Levi R, Miller L L, Lachman L B, Griffith O W
Department of Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston 77030.
J Natl Cancer Inst. 1992 Jul 1;84(13):1008-16. doi: 10.1093/jnci/84.13.1008.
Interleukin-1-alpha (IL-1) is a cytokine with potentially therapeutic immunoproliferative and tumoricidal activities. Preliminary clinical studies suggest that use of IL-1 may be restricted by dose-limiting hypotension.
The purpose of this study was to investigate the role of nitric oxide (NO.) as a possible mediator of this hypotension.
Cytokine-treated rat aortic smooth muscle cells were assayed for nitrite production, a stable breakdown product of nitric oxide. Nitric oxide synthase from smooth muscle cells was partially characterized in cytosol preparations using a novel Fe(2+)-myoglobin method to test for nitric oxide production. To determine the role of NO. on the immunorestorative and antineoplastic activity of IL-1, N omega-amino-L-arginine (NAA) or N omega-monomethyl-L-arginine (NMA), inhibitors of nitric oxide synthase, were added to either cultures of IL-1-dependent T cells or A375 melanoma cells exposed to IL-1. To investigate the effects of NAA in vivo, pentobarbital anesthetized dogs, which were made hypotensive by administration of IL-1, received a single intravenous bolus dose of NAA. The effects of NAA were then reversed by the administration of L-arginine.
Our results show that cultured IL-1-activated rat aortic smooth muscle cells synthesize nitric oxide, a potent vasodilator. Induction of nitric oxide synthase is augmented by interferon-gamma and blocked by IL-1 receptor antagonist and by inhibitors of RNA or protein synthesis. Nitric oxide synthesis by IL-1-activated smooth muscle cells is inhibited by NAA, NMA, and N omega-nitro-L-arginine (NNA) with ED50 (i.e., effective dose for 50% inhibition) values of 20, 60, and 1000 microM, respectively; this rank order of inhibition is characteristic of an agonist-unregulated, inducible isoform of nitric oxide synthase. In smooth muscle cells, inhibition of NO. synthesis by NAA is reversed by excess L-arginine. Consistent with the induction of unregulated NO. synthesis in vascular smooth muscle in vivo, administration of IL-1 (50 micrograms/kg) to dogs caused a 33.5% decrease in systemic vascular resistance and a 28% decrease in blood pressure within 3 hours. Subsequent administration of NAA (20 mg/kg) rapidly and completely reversed the hypotension and increased systemic vascular resistance; these effects of NAA were reversed by L-arginine. Neither the immunoproliferative nor the tumoricidal activity of IL-1 was diminished by NAA.
Our results indicate that (a) vascular smooth muscle is a likely source as well as a target of IL-1-induced NO. synthesis, causing vasodilatation and hypotension, (b) nitric oxide synthase inhibitors can fully reverse this hypotension, and (c) the therapeutically useful properties of IL-1 are not diminished by nitric oxide synthase inhibitors.
Administration of inhibitors of nitric oxide synthase can reverse the pathological cardiovascular effects of IL-1 at concentrations that do not interfere with the potentially useful immunoproliferative or tumoricidal effects of this cytokine. In the context of the current clinical trials of IL-1, this finding would represent a very significant advantage.
白细胞介素 -1α(IL -1)是一种具有潜在治疗性免疫增殖和杀肿瘤活性的细胞因子。初步临床研究表明,IL -1的使用可能受到剂量限制性低血压的限制。
本研究的目的是探讨一氧化氮(NO.)作为这种低血压可能的介质所起的作用。
检测细胞因子处理的大鼠主动脉平滑肌细胞中亚硝酸盐的产生,亚硝酸盐是一氧化氮的一种稳定分解产物。使用一种新型的Fe(2 +)-肌红蛋白方法在胞质溶胶制剂中对平滑肌细胞中的一氧化氮合酶进行部分特性分析,以检测一氧化氮的产生。为了确定NO.对IL -1的免疫恢复和抗肿瘤活性的作用,将一氧化氮合酶抑制剂Nω-氨基 -L -精氨酸(NAA)或Nω-单甲基 -L -精氨酸(NMA)添加到依赖IL -1的T细胞培养物或暴露于IL -1的A375黑色素瘤细胞培养物中。为了研究NAA在体内的作用,给戊巴比妥麻醉的狗静脉注射单次大剂量NAA,这些狗通过给予IL -1而出现低血压。然后通过给予L -精氨酸来逆转NAA的作用。
我们的结果表明,培养的IL -1激活的大鼠主动脉平滑肌细胞合成一氧化氮,一种强效血管扩张剂。一氧化氮合酶的诱导被干扰素 -γ增强,并被IL -1受体拮抗剂以及RNA或蛋白质合成抑制剂阻断。IL -1激活的平滑肌细胞产生的一氧化氮被NAA、NMA和Nω-硝基 -L -精氨酸(NNA)抑制,其半数有效剂量(ED50,即50%抑制的有效剂量)值分别为20、60和1000 microM;这种抑制的排序顺序是一氧化氮合酶的一种激动剂非调节性、诱导性同工型的特征。在平滑肌细胞中,过量的L -精氨酸可逆转NAA对NO.合成的抑制。与体内血管平滑肌中诱导产生非调节性NO.合成一致,给狗注射IL -1(50微克/千克)在3小时内导致全身血管阻力降低33.5%,血压降低28%。随后注射NAA(20毫克/千克)迅速且完全逆转了低血压并增加了全身血管阻力;NAA的这些作用被L -精氨酸逆转。NAA既没有降低IL -1的免疫增殖活性也没有降低其杀肿瘤活性。
我们的结果表明,(a)血管平滑肌可能是IL -1诱导的NO.合成的来源以及靶点,导致血管扩张和低血压,(b)一氧化氮合酶抑制剂可以完全逆转这种低血压,并且(c)一氧化氮合酶抑制剂不会降低IL -1的治疗有用特性。
给予一氧化氮合酶抑制剂可以在不干扰这种细胞因子潜在有用的免疫增殖或杀肿瘤作用的浓度下逆转IL -1的病理性心血管作用。在当前IL -1的临床试验背景下,这一发现将代表一个非常显著的优势。