Selective iNOS inhibition attenuates acetylcholine- and bradykinin-induced vasoconstriction in lipopolysaccharide-exposed rat lungs

Background: Nonselective nitric oxide synthase (NOS) inhibition has detrimental effects in sepsis because of inhibition of the physiologically important endothelial NOS (eNOS). The authors hypothesized that selective inducible NOS (iNOS) inhibition would maintain eNOS vasodilation but prevent acetylcholine- and bradykinin-mediated vasoconstriction caused by lipolysaccharide-induced endothelial dysfunction. Methods: Rats were administered intraperitoneal lipopolysaccharide (15 mg/kg) with and without the selective iNOS inhibitors L-N6-(1-iminoethyl)-lysine (L-NIL, 3 mg/kg), dexamethasone (1 mg/kg), or the nonselective NOS inhibitor N-omega-nitro-L-arginine methylester (L-NAME, 5 mg/kg), Six hours later, the lungs were isolated and pulmonary vasoreactivity was assessed with hypoxic vasoconstrictions (3% O-2), acetylcholine (1 mu g), Biochemical Engineering, and bradykinin (3 mu g). In additional lipopolysaccharide experiments, L-NIL (10 mu M) or 4-Diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP, 100 mu M), a selective muscarinic M-3 antagonist, was added into the perfusate, Results: Exhaled nitric oxide was higher in the lipopolysaccharide group (37.7 +/- 17.8 ppb) compared with the control group (0.4 +/- 0.7 ppb), L-NIL and dexamethasone decreased exhaled nitric oxide in lipopolysaccharide mts by 83 and 79%, respectively, whereas L-NAME had no effect. In control lungs, L-NAME significantly decreased acetylcholine- and bradykinin-induced vasodilation by 75% and increased hypoxic vasoconstrictions, whereas L-NIL and dexamethasone had no effect. In lipopolysaccharide lungs, acetylcholine and bradykinin both transiently increased the pulmonary artery pressure by 8.4 +/- 2.0 mmHg and 35.3 +/- 11.7 mmHg, respectively, immediately after vasodilation, L-NIL and dexamethasone both attenuated this vasoconstriction by 70%, whereas L-NAME did not. The acetylcholine vasoconstriction was dose-dependent (0.01-1.0 mu g), unaffected by L-NIL added to the perfusate, and abolished by 4-DAMP. Conclusions: In isolated perfused lungs, acetylcholine and bradykinin caused vasoconstriction in Lipopolysaccharide-treated rats. This vasoconstriction was attenuated by administration of the iNOS inhibitor L-NIL but not with L-NAME. Furthermore, L-NIL administered with lipopolysaccharide preserved endothelium nitric oxide-dependent vasodilation, whereas L-NAME did not.