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J Am Coll Cardiol, 2003; 42:1299-1305, doi:10.1016/S0735-1097(03)00992-6 © 2003 by the American College of Cardiology Foundation |




* Department of Thoracic and Cardiovascular Surgery, Tel-Aviv University, Tel-Aviv, Israel
Department of Nephrology, Tel-Aviv Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Felsenstein Medical Research Center, Petah-Tikva, Israel
Manuscript received February 3, 2003; revised manuscript received May 19, 2003, accepted June 4, 2003.
* Reprint requests and correspondence: Dr. Inna Frolkis, Department of Thoracic and Cardiovascular Surgery, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 64239, Israel.
frolkisi{at}tasmc.health.gov.il
OBJECTIVES: The present study aimed to investigate the influence of endogenous tumor necrosis factor-alpha (TNF-
) that was synthesized during ischemia and exogenous TNF-
on endothelial and inducible nitric oxide synthase (eNOS and iNOS) messenger ribonucleic acid (mRNA) expression and nitric oxide (NO) production in the isolated rat heart.
BACKGROUND: Tumor necrosis factor-
is recognized as being a proinflammatory cytokine with a significant cardiodepressant effect. One of the proposed mechanisms for TNF-
-induced cardiac contractile dysfunction is increased NO production via iNOS mRNA upregulation, but the role of NO in TNF-
-induced myocardial dysfunction is highly controversial.
METHODS: Isolated rat hearts studied by a modified Langendorff model were randomly divided into subgroups to investigate the effect of 1-h global cardioplegic ischemia or the effect of 1-h perfusion with exogenous TNF-
on the expression of eNOS mRNA and iNOS mRNA and on NO production.
RESULTS: After 1 h of ischemia, there were significant increases in TNF levels in the effluent (from hearts), and eNOS mRNA expression had declined (from 0.91 ± 0.08 to 0.68 ± 0.19, p < 0.001); but there were no changes in iNOS mRNA expression, and NO was below detectable levels. Perfusion of isolated hearts with TNF-
had a cardiodepressant effect and decreased eNOS mRNA expression to 0.67 ± 0.04 (p < 0.002). Inducible nitric oxide synthase mRNA was unchanged, and NO was below detectable levels.
CONCLUSIONS: We believe this is the first study to directly show that TNF-
does not increase NO synthesis and release but does downregulate eNOS mRNA in the ischemic and nonischemic isolated rat heart.
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