Increased nitric oxide formation in recurrent thrombotic microangiopathies: A possible mediator of microvascular injury

M. Noris, P. Ruggenenti, M. Todeschini, M. Figliuzzi, D. Macconi, C. Zoja, S. Paris, F. Gaspari, G. Remuzzi

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

The term thrombotic microangiopathy (TMA) has been used extensively to encompass hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, two syndromes of hemolytic anemia, and thrombocytopenia associated with renal or brain involvement or both. There is evidence that endothelial damage is a crucial feature in the sequence of events that precedes the development of microvascular lesions. More recent studies would suggest that endothelial dysfunction could be a consequence of neutrophil activation. Activated neutrophils generate superoxide anions (O2 -) that, combining with endothelial-derived nitric oxide (NO), form the highly cytotoxic hydroxyl radical. Seven patients with recurrent forms of TMA and seven healthy volunteers were studied. Plasma concentrations of the NO metabolites, nitrites/nitrates, were elevated in the acute phase of TMA, indicating an increased NO synthesis in vivo. In addition, elevated serum concentrations of tumor necrosis factor, a potent inducer of endothelial NO synthase, were found in acute TMA. Serum from patients with acute TMA induced NO synthesis in cultured endothelial cells more than normal serum. Enhanced stimulatory activity was no longer found in the recovery phase. Release of O2 - by neutrophils ex vivo was higher than normal in patients with acute TMA, but decreased in the recovery phase. Exactly the same trend was observed for plasma malondialdehyde and conjugated dienes, indicating that excessive oxygen radical formation in acute TMA is associated with increased lipid peroxidation. Thus, in recurrent forms of TMA, NO formation was increased as compared with controls. This was associated with signs of lipid peroxidation, likely the consequence of the interaction of NO with neutrophil-derived oxygen products.

Original languageEnglish
Pages (from-to)790-796
Number of pages7
JournalAmerican Journal of Kidney Diseases
Volume27
Issue number6
Publication statusPublished - 1996

Fingerprint

Thrombotic Microangiopathies
Nitric Oxide
Wounds and Injuries
Neutrophils
Lipid Peroxidation
Serum
Thrombotic Thrombocytopenic Purpura
Neutrophil Activation
Hemolytic-Uremic Syndrome
Nitric Oxide Synthase Type III
Hemolytic Anemia
Nitrites
Malondialdehyde
Superoxides
Thrombocytopenia
Hydroxyl Radical
Nitrates
Cultured Cells
Reactive Oxygen Species
Healthy Volunteers

Keywords

  • endothelial cells
  • hemolytic uremic syndrome
  • neutrophils
  • Nitric oxide
  • oxygen radicals
  • peroxynitrite
  • thrombotic microangiopathy
  • thrombotic thrombocitopenic purpura

ASJC Scopus subject areas

  • Nephrology

Cite this

Increased nitric oxide formation in recurrent thrombotic microangiopathies : A possible mediator of microvascular injury. / Noris, M.; Ruggenenti, P.; Todeschini, M.; Figliuzzi, M.; Macconi, D.; Zoja, C.; Paris, S.; Gaspari, F.; Remuzzi, G.

In: American Journal of Kidney Diseases, Vol. 27, No. 6, 1996, p. 790-796.

Research output: Contribution to journalArticle

@article{42857a948d6f489294b27b3736c7e982,
title = "Increased nitric oxide formation in recurrent thrombotic microangiopathies: A possible mediator of microvascular injury",
abstract = "The term thrombotic microangiopathy (TMA) has been used extensively to encompass hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, two syndromes of hemolytic anemia, and thrombocytopenia associated with renal or brain involvement or both. There is evidence that endothelial damage is a crucial feature in the sequence of events that precedes the development of microvascular lesions. More recent studies would suggest that endothelial dysfunction could be a consequence of neutrophil activation. Activated neutrophils generate superoxide anions (O2 -) that, combining with endothelial-derived nitric oxide (NO), form the highly cytotoxic hydroxyl radical. Seven patients with recurrent forms of TMA and seven healthy volunteers were studied. Plasma concentrations of the NO metabolites, nitrites/nitrates, were elevated in the acute phase of TMA, indicating an increased NO synthesis in vivo. In addition, elevated serum concentrations of tumor necrosis factor, a potent inducer of endothelial NO synthase, were found in acute TMA. Serum from patients with acute TMA induced NO synthesis in cultured endothelial cells more than normal serum. Enhanced stimulatory activity was no longer found in the recovery phase. Release of O2 - by neutrophils ex vivo was higher than normal in patients with acute TMA, but decreased in the recovery phase. Exactly the same trend was observed for plasma malondialdehyde and conjugated dienes, indicating that excessive oxygen radical formation in acute TMA is associated with increased lipid peroxidation. Thus, in recurrent forms of TMA, NO formation was increased as compared with controls. This was associated with signs of lipid peroxidation, likely the consequence of the interaction of NO with neutrophil-derived oxygen products.",
keywords = "endothelial cells, hemolytic uremic syndrome, neutrophils, Nitric oxide, oxygen radicals, peroxynitrite, thrombotic microangiopathy, thrombotic thrombocitopenic purpura",
author = "M. Noris and P. Ruggenenti and M. Todeschini and M. Figliuzzi and D. Macconi and C. Zoja and S. Paris and F. Gaspari and G. Remuzzi",
year = "1996",
language = "English",
volume = "27",
pages = "790--796",
journal = "American Journal of Kidney Diseases",
issn = "0272-6386",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - Increased nitric oxide formation in recurrent thrombotic microangiopathies

T2 - A possible mediator of microvascular injury

AU - Noris, M.

AU - Ruggenenti, P.

AU - Todeschini, M.

AU - Figliuzzi, M.

AU - Macconi, D.

AU - Zoja, C.

AU - Paris, S.

AU - Gaspari, F.

AU - Remuzzi, G.

PY - 1996

Y1 - 1996

N2 - The term thrombotic microangiopathy (TMA) has been used extensively to encompass hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, two syndromes of hemolytic anemia, and thrombocytopenia associated with renal or brain involvement or both. There is evidence that endothelial damage is a crucial feature in the sequence of events that precedes the development of microvascular lesions. More recent studies would suggest that endothelial dysfunction could be a consequence of neutrophil activation. Activated neutrophils generate superoxide anions (O2 -) that, combining with endothelial-derived nitric oxide (NO), form the highly cytotoxic hydroxyl radical. Seven patients with recurrent forms of TMA and seven healthy volunteers were studied. Plasma concentrations of the NO metabolites, nitrites/nitrates, were elevated in the acute phase of TMA, indicating an increased NO synthesis in vivo. In addition, elevated serum concentrations of tumor necrosis factor, a potent inducer of endothelial NO synthase, were found in acute TMA. Serum from patients with acute TMA induced NO synthesis in cultured endothelial cells more than normal serum. Enhanced stimulatory activity was no longer found in the recovery phase. Release of O2 - by neutrophils ex vivo was higher than normal in patients with acute TMA, but decreased in the recovery phase. Exactly the same trend was observed for plasma malondialdehyde and conjugated dienes, indicating that excessive oxygen radical formation in acute TMA is associated with increased lipid peroxidation. Thus, in recurrent forms of TMA, NO formation was increased as compared with controls. This was associated with signs of lipid peroxidation, likely the consequence of the interaction of NO with neutrophil-derived oxygen products.

AB - The term thrombotic microangiopathy (TMA) has been used extensively to encompass hemolytic uremic syndrome and thrombotic thrombocytopenic purpura, two syndromes of hemolytic anemia, and thrombocytopenia associated with renal or brain involvement or both. There is evidence that endothelial damage is a crucial feature in the sequence of events that precedes the development of microvascular lesions. More recent studies would suggest that endothelial dysfunction could be a consequence of neutrophil activation. Activated neutrophils generate superoxide anions (O2 -) that, combining with endothelial-derived nitric oxide (NO), form the highly cytotoxic hydroxyl radical. Seven patients with recurrent forms of TMA and seven healthy volunteers were studied. Plasma concentrations of the NO metabolites, nitrites/nitrates, were elevated in the acute phase of TMA, indicating an increased NO synthesis in vivo. In addition, elevated serum concentrations of tumor necrosis factor, a potent inducer of endothelial NO synthase, were found in acute TMA. Serum from patients with acute TMA induced NO synthesis in cultured endothelial cells more than normal serum. Enhanced stimulatory activity was no longer found in the recovery phase. Release of O2 - by neutrophils ex vivo was higher than normal in patients with acute TMA, but decreased in the recovery phase. Exactly the same trend was observed for plasma malondialdehyde and conjugated dienes, indicating that excessive oxygen radical formation in acute TMA is associated with increased lipid peroxidation. Thus, in recurrent forms of TMA, NO formation was increased as compared with controls. This was associated with signs of lipid peroxidation, likely the consequence of the interaction of NO with neutrophil-derived oxygen products.

KW - endothelial cells

KW - hemolytic uremic syndrome

KW - neutrophils

KW - Nitric oxide

KW - oxygen radicals

KW - peroxynitrite

KW - thrombotic microangiopathy

KW - thrombotic thrombocitopenic purpura

UR - http://www.scopus.com/inward/record.url?scp=0030008624&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030008624&partnerID=8YFLogxK

M3 - Article

C2 - 8651242

AN - SCOPUS:0030008624

VL - 27

SP - 790

EP - 796

JO - American Journal of Kidney Diseases

JF - American Journal of Kidney Diseases

SN - 0272-6386

IS - 6

ER -