3-nitrotyrosine and Bronchiolitis-Obliterans

Chronic rejection is the major leading cause of morbidity and mortality after lung transplantation. Bronchiolitis obliterans syndrome (BOS), a fibroproliferative disorder of the small airways, is the main manifestation of chronic lung allograft rejection. We investigated, using transgenic mice, the mechanisms through which the deficiency of IL-1β/IL-18, Casp-1, or Fpr-1 genes could be protective in an experimental model of BOS, induced in mice by allogeneic heterotopic tracheal transplantation. Fpr-1 KO mice showed a marked reduction in histological markers of BOS and of mast cell numbers compared to other groups. Molecular analyses indicated that the absence of the Fpr-1 gene was able to decrease NF-κB nuclear translocation and modulate NLRP3 inflammasome signaling and the mitogen-activated protein kinase (MAPK) pathway in a more significant way compared to other groups. Additionally, Fpr-1 gene deletion caused a reduction in resistance to the apoptosis, assessed by the TUNEL assay. Immunohistochemical analyses indicated changes in nitrotyrosine, PARP, VEGF, and TGF-β expression associated with the pathology, which were reduced in the absence of the Fpr1 gene more so than by the deletion of IL-1β/IL-18 and Casp-1. We underline the importance of the NLRP3 inflammasome and the pathogenic role of Fpr-1 in experimental models of BOS, which is the result of the modulation of immune cell recruitment together with the modulation of local cellular activation, suggesting this gene as a new target in the control of the pathologic features of BOS.

Topics: Animals; Apoptosis; Bronchiolitis Obliterans; Caspase 1; Cell Count; Enzyme Activation; Inflammasomes; Intercellular Signaling Peptides and Proteins; Interleukin-18; Interleukin-1beta; Male; Mast Cells; Mice, Inbred C57BL; Mice, Knockout; Mitogen-Activated Protein Kinases; Molecular Targeted Therapy; Nitric Oxide Synthase Type II; NLR Family, Pyrin Domain-Containing 3 Protein; Poly(ADP-ribose) Polymerases; Receptors, Formyl Peptide; Signal Transduction; Syndrome; Tyrosine

Obliterative bronchiolitis (OB) affects over half of all survivors following lung or heart-lung transplantation. Respiratory epithelial cell injury, peribronchial inflammation, and proliferation of fibrovascular tissue causing airway occlusion characterize the lesion. While peroxynitrite is known to participate in other models of acute lung injury, its role in the evolution of OB is unclear. Using a rat model of experimental OB, tracheas from Brown-Norway or Lewis rats were transplanted into Lewis recipients. Treated animals received FP-15, a peroxynitrite decomposition catalyst, at 1 mg/kg/day intraperitoneal for 14 days. Luminal obstruction, epithelial loss, and inflammatory infiltrate were examined, as was nitrotyrosine staining by immunohistochemistry in explanted tracheas. By postoperative day 14, control allografts demonstrated marked peribronchial inflammation, near complete loss of respiratory epithelium and extensive intraluminal proliferation of fibrovascular connective tissue, with a mean 83% reduction in airway cross-sectional area. Allograft recipients treated with FP-15 showed reduced nitrotyrosine formation, preservation of respiratory epithelium, limited peribronchial inflammation, and only 14% (P <.001) reduction in airway cross-sectional area. Peroxynitrite therefore appears to play a role in the development of obliterative bronchiolitis in rats. The peroxynitrite decomposition catalyst, FP-15, is protective when administered daily and warrants investigation into its potential clinical utility.

Topics: Animals; Bronchiolitis Obliterans; Image Processing, Computer-Assisted; Immunohistochemistry; Male; Metalloporphyrins; Models, Animal; Peroxynitrous Acid; Rats; Rats, Inbred BN; Rats, Inbred Lew; Respiratory Mucosa; Trachea; Transplantation, Homologous; Transplantation, Isogeneic; Tyrosine

Inflammation, epithelial cell injury, and development of fibrosis and airway obliteration are the major histological features of posttransplant obliterative bronchiolitis (OB). The expression of inducible nitric oxide synthase (iNOS) in the damaged epithelium, accompanied by peroxynitrite, suggests that endogenous nitric oxide (NO) mediates the epithelial destruction preceding obliteration. To elucidate the role of NO in this cascade, heterotopic bronchial allografts were studied in pigs.. Allografts or autografts were harvested serially 3-90 days after transplantation and processed for histology and immunocytochemistry for iNOS, nitrotyrosine, a marker of peroxynitrite formation, and superoxide dismutase (SOD).. During initial ischemic damage to the epithelium, iNOS, nitrotyrosine, and SOD were found to be strongly expressed in the epithelium of all implants as well as later, after partial recovery, parallel to onset of epithelial destruction and subsequent airway obliteration in allografts. The levels of expression of iNOS in fibroblasts during the early phase of obliteration paralleled the onset of fibrosis. Constant expression of iNOS and SOD, but not nitrotyrosine, occurred in autografts and allografts with blocked alloimmune response.. These findings suggest that an excessive amount of NO promotes posttransplant obliterative bronchiolitis by destroying airway epithelium and stimulating fibroblast activity. SOD may provide protection by binding reactive molecules and preventing peroxynitrite formation.

Topics: Animals; Bronchi; Bronchiolitis Obliterans; Cell Division; Disease Models, Animal; Fibroblasts; Lung Transplantation; Nitric Oxide; Nitric Oxide Synthase; Nitric Oxide Synthase Type II; Peroxynitrous Acid; Respiratory Mucosa; Superoxide Dismutase; Swine; Tyrosine

This study investigated nitration and chlorination of epithelial lining fluid (ELF) proteins in patients (n = 29) who had undergone lung allotransplantation. We assayed lung lavage nitrotyrosine (NT) and chlorotyrosine (CT) by HPLC. We measured NT, nitrate (NO(3)(-)), and nitrate (NO(2)(-)) in bronchoalveolar lavage fluid (BALF) and total nitrite (NO(2)(-) + NO(3)(-)) in serum of another group of lung transplant patients (n = 82). In the first group (n = 29), percent nitration of tyrosines (Tyr) (NT/total Tyr x 100) in BALF proteins was: patients, 0.01 (0.00-0.12)%; median (25th-75th% confidence interval), and control subjects 0.01 (0.00-0.02)%. CT (CT/ total Tyr x 100) occurred only in the patients' BALF: 0.01 (0. 00- 0.02)%. In the second group (n = 82), nitrotyrosine (NT) was detected by ELISA in the BALF of patients: 9 (0-41) pmol/mg pro and control subjects: 28 (26-33). Total nitrite (NO(2)(-) + NO(3)(-)) in BALF of the patients: 3.3 (1.9-5.1) microM significantly exceeded that in control subjects: 1.3 (0.8-1.3) microM; p = 0.0133. Serum nitrite also was significantly higher in patients: 37 (26-55) microM than control subjects: 19 (17-20) microM; p = 0.0037. Airway inflammation in transbronchial biopsies (B score) correlated with NT in BALF (p = 0.0369). Lung transplants have increased airway concentrations of reactive nitrogen species (RNS) metabolites. NT, a marker of peroxynitrite (ONOO(-)), is related to the degree of airway inflammation in lung transplants.

Topics: Adult; Bronchiolitis Obliterans; Bronchoalveolar Lavage Fluid; Chromatography, High Pressure Liquid; Female; Forced Expiratory Volume; Graft Rejection; Humans; Lung; Lung Transplantation; Male; Nitrates; Nitrites; Postoperative Complications; Prognosis; Tyrosine