Objective-To investigate the role of neuronal nitric oxide synthase (NOS1) in murine polymicrobial peritonitis and sepsis.
Design-Randomized experimental trial.Setting-Animal research facility. NIH-PA Author Manuscript NIH-PA Author Manuscript
Subjects-B6129S
NIH-PA Author ManuscriptInterventions-NOS1 +/+ and NOS1 -/-animals underwent cecal ligation and puncture (CLP) or sham surgery and received the NOS1 inhibitor 7-nitroindazole (7-NI) or vehicle.Measurements and main results-After CLP, genetic deficiency and pharmacologic inhibition of NOS1 significantly increased risk of mortality [8.69 (3.27, 23.1), p < 0.0001 and 1.71 (1.00, 2.92) p = 0.05, hazard ratio of death (95% confidence interval) for NOS1 -/-and 7-NItreated NOS1 +/+ respectively] compared with NOS1 +/+ animals. In 7-NI-treated NOS1 +/+ animals, there were increases (6 h) and then decreases (24 h), whereas in NOS -/-animals persistent increases in blood bacteria counts (p = 0.04 for differing effects of 7-NI and NOS1 -/-) were seen compared with NOS1 +/+ animals. After CLP, NOS1 -/-had upregulation of inducible NOS and proinflammatory cytokines and greater increases in serum tumor necrosis factor-α and interleukin-6 levels compared with NOS1 +/+ mice (all p < 0.05). Following CLP, there were similar significant decreases in circulating leukocytes and lung lavage cells (p ≤ 0.0008) and significant increases in peritoneal lavage cells (p = 0.0045) in all groups. Over 6 h and 24 h following CLP, compared with NOS1 +/+ , NOS -/-mice had significantly higher peritoneal cell concentrations {respectively 0.40 ± 0.09 vs 0.79 ± 0.15 [log(× 10 4 cells/ml)] averaged over both times p = 0.038}.Conclusions-Deficiency and inhibition of NOS1 increases mortality, possibly by increasing proinflamma-tory cytokine response and impairing bacterial clearance after CLP. These data suggest that NOS1 is important for survival, bacterial clearance, and regulation of cytokine response during infection and sepsis.