Urinary Nitrate Excretion Is a Noninvasive Indicator of Acute Cardiac Allograft Rejection and Nitric Oxide Production in the Rat

Ds, Winlaw; Cg, Schyvens; Ga, Smythe; Zy, Du; Sp, Rainer; Am, Keogh; Ja, Mundy; Lord, RS; Pm, Spratt; Macdonald, P.

doi:10.1097/00007890-199411150-00010

Cited by 45 publications

(18 citation statements)

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“…Only nitrate as a by-product of NO has been examined. Winlaw et al found elevated nitrate concentrations shortly after transplantation in the urine of rats with later rejection episodes [9]. Also, Albrecht et al could show these finding days before an acute rejection after renal transplantation in humans.…”

Section: Discussionmentioning

confidence: 97%

Inducible NO synthase expression in endomyocardial biopsies after heart transplantation in relation to the postoperative course

Koch

Burgschweiger²,

Herpel

et al. 2007

European Journal of Cardio-Thoracic Surgery

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Objective: Ischemia and reperfusion during heart transplantation cause damage to cardiomyocytes and endothelial cells and may initiate later acute rejection. Free oxygen radicals generated by iNOS are widely accepted to be responsible for ischemic injury. Increased iNOS expression on cardiac tissue may represent a more intensive tissue injury during ischemia and reperfusion in heart transplantation. The aim of this study was, therefore, to test the hypothesis that increased iNOS expression in early postoperative endomyocardial biopsies correlates with rejection or infection episodes in the later postoperative course. Patients and methods: Right ventricular endomyocardial biopsies were obtained from heart transplantation recipients at transplantation and during the first 2 weeks postoperatively. The recipients were divided into three groups depending on the postoperative course during the first year after transplantation: patients in group 1 had an uncomplicated postoperative course, patients in group 2 developed significant signs of postoperative infection, while patients in group 3 presented with acute rejection ( grade 2R ISHLT). The expression was analyzed in a semi-quantitative score. Results: iNOS expression was found in cardiomyocytes, endothelial cells, infiltrating cells, and vascular smooth muscle cells. At the time of heart transplantation, the expression was significantly increased in the rejection group compared to the other groups. This increase was even more pronounced in week 2. Conclusions: The present study shows that an increased iNOS expression at the time of heart transplantation could precede an acute rejection in the later postoperative course. Thus, measurements of iNOS expression may be of predictive value for an increased rejection risk and therefore offer the possibility of earlier therapeutic intervention. #

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Section: Discussionmentioning

confidence: 97%

Inducible NO synthase expression in endomyocardial biopsies after heart transplantation in relation to the postoperative course

Koch

Burgschweiger²,

Herpel

et al. 2007

European Journal of Cardio-Thoracic Surgery

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“…In cardiac allograft rejection, an increased NO production was detected by a rise in the excretion of nitrate as a stable metabolite of NO in an experimental study [21]. Plasma nitrite and nitrate have been reported to increase with allograft rejection and decrease with successful antirejection therapy in both experimental models and patients [2,7,13,20].…”

Section: Discussionmentioning

confidence: 97%

“…Langrehr et al have demonstrated that plasma nitrate levels increased in host-versus-graft and graft-versus-host responses in rats [13]. Wjnlaw et al have documented increased urinary nitrate excretion in cardiac allograft rejection in an experimental study [21]. In this study, we investigate the kinetics of urinary nitrate excretion in orthotopic liver transplantation under conditions of acute cellular rejection in an experimental rat model.…”

Section: Introductionmentioning

confidence: 88%

Increased urinary nitrate excretion associated with hepatic allograft rejection in experimental rat models and clinical cases

et al. 2000

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Increased urinary nitrate excretion associated with hepatic allograft rejection in experimental rat models and clinical casesAbstract In this study, we investigated the relationship between excretion of urinary nitrate as a stable end-product of nitric oxide (NO) metabolism and hepatic allograft rejection. In experimental rat models, hepatic allograft rejection was associated with increased nitrate excretion with a peak on postoperative day 5. The severity of the hepatic allograft rejection was dependent on the increased urinary nitrate excretion. No significant increase in urinary nitrate excretion was observed in cases in which effective immunosuppression was achieved. Inducible nitric oxide synthase mRNA expression was upregulated parallel to interferon-y gene expression in the graft-infiltrating mononuclear cells and spleen cells from the recipients. In clinical cases, urinary nitrate excretion increased parallel to increased serum cytosolic enzymes that accompanied rejection. These results suggest that urinary nitrate excretion is a useful indicator for the surveillance of graft rejection and the monitoring of therapeutic effects of antirejection treatments.

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“…18,36 Urinary nitrate excretion has also been shown to increase eight-fold in untreated rejection compared to that seen in isografts. 37 Only three studies have been performed in human allografts, with contradictory results. One showed serum nitrate to be significantly increased in acute rejection and that serum nitrate concentration correlated closely with the grade of rejection.…”

Section: Acute Rejectionmentioning

confidence: 99%

Role of nitric oxide following cardiac transplantation

Chester

Birks

1998

J Hum Hypertens

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Urinary Nitrate Excretion Is a Noninvasive Indicator of Acute Cardiac Allograft Rejection and Nitric Oxide Production in the Rat

Cited by 45 publications

References 0 publications

Inducible NO synthase expression in endomyocardial biopsies after heart transplantation in relation to the postoperative course

Inducible NO synthase expression in endomyocardial biopsies after heart transplantation in relation to the postoperative course

Increased urinary nitrate excretion associated with hepatic allograft rejection in experimental rat models and clinical cases

Role of nitric oxide following cardiac transplantation

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