1 An enhanced production of nitric oxide (NO) from L-arginine, related to the di use expression of an inducible NO synthase (iNOS), contributes to the pathogenesis of endotoxic shock. Since iNOS activity depends on extracellular L-arginine, we hypothesized that limiting cellular L-arginine uptake would reduce NO production in endotoxic shock. We investigated the e ects of L-lysine, an inhibitor of Larginine uptake through system y + , on NO production, multiple organ dysfunction and lactate levels, in normal and endotoxaemic rats. 2 Anaesthetized rats challenged with intravenous lipopolysaccharide (LPS, 10 mg kg 71 ) received a 5 h infusion of either L-lysine (500 mmol kg 71 h 71 , n=12) or isotonic saline (2 ml kg 71 h 71 , n=11). In rats treated with saline, LPS produced a large increase in plasma nitrate and L-citrulline concentrations at 5 h, both markers of enhanced NO production. LPS also caused severe hypotension, low cardiac output and marked hyperlactataemia. All these changes were signi®cantly reduced by L-lysine administration.3 Endotoxaemia also caused a signi®cant rise in the plasma levels of alanine aminotransferase (ALAT), lipase, urea and creatinine, and hence, liver, pancreatic and renal dysfunction. These changes tended to be less pronounced in rats treated with L-lysine, although the di erences did not reach statistical signi®cance. 4 Similar experiments were conducted in 10 rats challenged with LPS vehicle in place of LPS and then treated with L-lysine (500 mmol kg 71 h 71 , n=5) or saline (2 ml kg 71 h 71 , n=5) for 5 h. In these animals, all the haemodynamic and metabolic variables remained stable and not statistically di erent between both treatment groups, except for a slight rise in ALAT, which was comparable in L-lysine and saline-treated rats. 5 In conclusion, L-lysine, an inhibitor of cellular L-arginine uptake, reduces NO production and exerts bene®cial haemodynamic e ects in endotoxaemic rats. L-lysine also reduces hyperlactataemia and tends to blunt the development of organ injury in these animals. Contrastingly, L-lysine has no e ects in the absence of endotoxin and thus appears to act as a selective modulator of iNOS activity.