The Journal of Immunology, 1998, 161: 1422-1427.
Copyright © 1998 by The American Association of Immunologists
Covalent Cross-Linking of Immune Complexes by Oxygen Radicals and Nitrite1
Masaaki Uesugi*,
Takeshi Hayashi
and
Hugo E. Jasin2,*
*
Division of Rheumatology and Clinical Immunology, University of Arkansas for Medical Sciences and John L. McClellan Veterans Administration Center, Little Rock, AR 72205; and
Department of Orthopedic Surgery, Yokohama City University School of Medicine, Yokohama, Japan
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Abstract
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We have shown that polymorphonuclear neutrophils mediate the
covalent cross-linking of immune complexes (ICs) using
H2O2 and myeloperoxidase (MPO). Moreover,
activated superficial chondrocytes produce large amounts of nitric
oxide (NO), suggesting that high concentrations of these radicals may
interact at the cartilage surface in rheumatoid arthritis. We describe
the effects of the interaction of NO and its decay product,
NO2, with H2O2 and MPO on IC
cross-linking. Cross-linking was measured by resistance to the
guanidine extraction of plastic-bound ICs. The combination of
H2O2, MPO, and NO in the absence of
O2 did not alter the magnitude of cross-linking. The
addition of O2 resulted in a significant enhancement of
cross-linking (p < 0.004), suggesting that nitrite
was responsible for the increase observed. Indeed, NaNO2
greatly increased H2O2-dependent cross-linking
(control: 29.2 ± 3.8; 1 mM NaNO2: 58.4 ± 9.9;
10 mM: 60.4 ± 4.2% cross-linking, p < 0.0002).
Sodium azide, which is an inhibitor of MPO, completely inhibited
cross-linking. These results indicated that the product of interaction
of H2O2 and NO2 mediated by MPO may
be responsible for the increase in cross-linking. The generation of
nitrotyrosine was demonstrated when NO2 was added to the
cross-linking system. Cross-linking was also shown with an
O2--generating system and NO. Peroxynitrite
alone mediated cross-linking (100 µM ONOO-: 40.3 ±
1.9% cross-linking; p < 0.002), and the addition of
MPO significantly enhanced this effect (100 µM: 57.7 ± 6.0%;
p < 0.0002 with respect to no nitrite control).
Oxygen radicals and NO are likely to interact at the cartilage surface
in inflammatory arthritis, resulting in an increase in oxidative damage
within the joint cavity.
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Introduction
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Highly
reactive
oxygen-derived species (ROS)3
play important roles in defense mechanisms against infections (1) and
in tissue injury in inflammatory reactions (2, 3). One of the main
reactive products generated by activated phagocytic cells is
hypochlorous acid (HOCl), which is formed by the enzyme myeloperoxidase
(MPO) acting on H2O2 in the presence of
chloride ion. This oxidant is mainly responsible for the intracellular
killing of phagocytosed bacteria (1); it also plays a role in tissue
injury because it mediates the oxidative modification of tissue
macromolecules, the deamination and decarboxylation of proteins with
the formation of aldehydes, sulfhydryl oxidation, and covalent
cross-linking (4, 5, 6, 7, 8, 9, 10). We have shown previously that HOCl is
responsible for the covalent cross-linking of proteins, namely IgG,
resulting in the generation of immune complex (IC)-like aggregates with
phlogogenic capacity (10, 11). Moreover, IgG aggregates with
evidence of oxidative modification have been found in the synovial
fluids of patients with rheumatoid arthritis (12). Previous work in our
laboratory also indicated that the majority of articular cartilage
specimens obtained from patients with rheumatoid arthritis contained
ICs and complement that were tightly bound and sequestered on the
pannus-free articular surface (13). It was suggested that these
complexes gave rise to the phenomenon of frustrated phagocytosis (14, 15) on the cartilage surface, resulting in the egestion of noxious
neutrophil granular component such as ROS and proteases. Indeed, there
is abundant evidence that a variety of neutrophil products are present
at the cartilage surface and at the cartilage-pannus junction (16, 17, 18, 19).
Articular chondrocytes generate large amounts of nitric oxide (NO) when
appropriately stimulated with cytokines or bacterial products (20, 21).
We and others have recently shown that most of the oxidant gas is
secreted by the chondrocytes located close to the articular surface
(22, 23). Moreover, recent data indicate that the human neutrophil is
also able to secrete NO when appropriately stimulated (24). Chemical
data suggest that NO reacts with O2- and other
reactive molecules to form stronger oxidant molecules such as
peroxynitrite (25, 26) and nitryl chloride (27). Similarly, the
dismutation of O2- by superoxide
dismutase and the subsequent generation of H2O2
reacting with nitrite in the presence of MPO may give rise to another
strong oxidant, nitrogen dioxide (NO·2) (28). Since the
considerations discussed above indicate that high concentrations of
ROS, neutrophil granular material such as MPO, and NO may interact at
the articular surface in inflammatory arthritis, the present studies
were conducted to study the effects of NO and its decay products on the
protein cross-linking activity of neutrophil-derived ROS.
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Materials and Methods
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Reagents
Sodium hypochlorite and 5,5'-dithiobis(2-nitrobenzoic acid) were
purchased from Sigma (St. Louis, MO). Rabbit anti-BSA Ab was
purified as described previously (10, 29). Purified human MPO was a
gift from Dr. Isaac Ginsburg (Hebrew University, Hadassah School of
Dental Medicine, Jerusalem, Israel) (10). NO gas (10% concentration)
was purchased from Matheson (Montgomeryville, PA). HOCl was obtained by
vacuum distillation of a 5% solution of sodium hypochlorite (pH 7.5)
(30). The resulting product was stored at -80°C.
Concentrations were determined by spectrophotometric analysis
(
235 = 100 M-1 cm-1) (31)
(Beckman Instruments, Fullerton, CA). Mouse monoclonal
anti-nitrotyrosine IgG was purchased from Upstate Biotechnology
(Waltham, MA). Affinity-purified goat anti-mouse Ig was purchased
from Biosource International (Camarillo, CA).
Preparation of NO-saturated HBSS
HBSS was saturated with NO gas as described by Harry et al. (32)
with modifications. A total of 10 ml of HBSS without phenol red was
bubbled for 15 min with nitrogen gas and subsequently with 10% NO gas
followed by air for 15 min in studies in which the presence of
O2 was required. NO-HBSS was prepared freshly before use.
NO2 concentrations were determined by the Griess reaction
(33). Briefly, 100 µl of diluted NO-saturated HBSS or standard
solution was mixed with 50 µl of 0.1% naphthalene diamine
dihydrochloride and 50 µl of 1% sulfanilamide, 5% phosphoric acid.
Standards were prepared with 10 to 250 µM sodium nitrite. After a
5-min incubation, the OD at 540 nm was measured with a microplate
reader (400ATC, SLT Labs, Triangle Park, NC).
Synthesis of 5-thio-2-nitrobenzoic acid (TNB)
The synthesis of TNB was conducted according to Ching et al.
(34). A total of 20 mM of sodium borohydride was added to a 1 mM
solution of 5,5'-dithiobis(2-nitrobenzoic acid) in 50 mM potassium
phosphate buffer (pH 6.6) plus 5 mM EDTA. The solution was
incubated at 37°C for 30 min. The concentrations were determined by
spectrophotometric analysis (
412 = 13,600
M-1 cm-1) (35).
Synthesis of peroxynitrite
Peroxynitrite was synthesized from sodium nitrite and hydrogen
peroxide according to Rakesh and Victor (36). Two syringes containing 6
ml of 2 M cold NaNO2 and 6.6 ml of 30% cold
H2O2 plus 5% HNO3 were used to mix
the two solutions rapidly before neutralization with 6 ml of 4.2 M NaOH
solution that had been stirred and kept in an ice bath. Residual
H2O2 was removed by passing the solution
through a column of granular MnO2 that had been rinsed with
0.5 M NaOH and kept at 4°C. The concentration of peroxynitrite was
determined spectrophotometrically (
302 = 1670
M-1 cm-1).
Cross-linking of plastic-bound ICs
We have described previously the methodology for the generation
of cross-linked ICs on plastic plates (10). Round-bottom, flexible,
polyvinyl chloride 96-well microtiter plates (Dynatech Laboratories,
Chantilly, VA) were coated with 50 µl BSA 20 µg/ml in saline
solution. After a 2-h incubation, the wells were washed twice with 100
µl of PBS and blocked twice with 100 µl of PBS containing 10%
heat-inactivated rabbit serum (PBS-RS) for 10 min. ICs were generated
by 2 h of incubation with 50 µl of a 1:100 dilution of
affinity-purified 125I-labeled rabbit-anti-BSA
Ab in PBS-RS at room temperature. The cross-linking of ICs was achieved
by incubation with MPO, glucose oxidase (GO), and glucose as a source
of hydrogen peroxide. The wells contained 22 mU/ml of MPO, 0.1 U/ml of
GO with or without NaNO2, or 0.01 to 1 mM of NO-saturated
HBSS in a total volume of 50 µl. Additional experiments were
conducted with 10 µM HOCl, MPO, and GO or with 0.1 and 1.0 mU/ml
xanthine oxidase (XO) and 1.5 mM hypoxanthine with or without 2.0 mM
sodium nitroprusside (SNP). After incubation with MPO, HOCl, or XO at
37°C for 1 h, the reaction was terminated by removing the HBSS
and washing twice with 100 µl of PBS-RS. Sextuplicate wells were
divided into two groups. The first group of triplicate wells was washed
twice with 100 µl of 0.1 N HCl containing 10% rabbit serum and twice
with 100 µl of 4 M guanidine solution (4 M guanidine, 0.1 M EDTA, 0.1
M NaCl, 0.05 M Tris, and 0.01 M sodium azide) for 10 min each to remove
noncovalently bound IgG. The other group of wells was washed four times
with PBS-RS for 10 min. Controls consisted of wells incubated without
MPO. Plastic-bound radioactivity was measured in a Cobra-2 autogamma
scintillation spectrometer (Packard Instrument Company, Meriden, CT).
The quantification of the cross-linking of ICs was calculated as the
percent radioactivity bound = cpm/well washed with HCl and 4 M
guanidine/cpm/well washed with PBS x 100; net percent bound
= percent bound with MPO - percent bound without MPO.
Colorimetric assay for oxidative activity
The oxidative activity of MPO or polymorphonuclear neutrophils
(PMNs) was measured as described by Ching et al. (34). The wells
containing 250 mU/ml of MPO, 0.01 U/ml of GO, or 5 x
105 PMN/ml, and 70 µM of TNB in HBSS with or without 0.1
to 10 mM NaNO2 were incubated for 1 h at 37°C. The
OD was measured at 412 nm.
Colorimetric assay for H2O2
Hydrogen peroxide was measured as described by Pick and Keisari
(37). The method is based on the colorimetric measurement of oxidized
phenol red. Concentrations were calculated from a standard curve using
serial dilutions of an H2O2 solution.
Purification of blood leukocytes
PMNs were purified from 15 ml of heparinized blood from healthy
donors by isopicnic centrifugation using Polymorphoprep (Accurate
Chemical and Scientific, Westbury, NY). PMNs were washed twice with
large amounts of HBSS without phenol red; contaminating E were lysed
with 0.2% NaCl solution. After further washing with HBSS, the cell
suspension was adjusted to 106 cells/ml. As a rule, cell
viability was >99% as determined by the trypan blue dye exclusion
test.
Detection of nitrotyrosine
The nitrosation of the tyrosine residues of BSA mediated by
H2O2, MPO, and nitrite was detected by
radioimmunoassay as described by Crow et al. with some modifications
(38). We coated 96-well polyvinyl chloride plates with 50 µl BSA
solution, 20 µg/ml for 2 h at room temperature. The
coated wells were incubated with 44 mU/ml of MPO, 0.1 U/ml of GO, and
0.1 to 10 mM NaNO2 in chloride-free buffer (0.02 M
KH2PO4, 0.08 M Na2HPO4,
10 mg/dl MgSO4, and 100 mg/dl glucose (pH 7.4)) for 1
h at 37°C in the presence of increasing concentrations of sodium
nitrite or sodium nitrate as control. Additional controls consisted of
wells in which MPO was omitted. The wells were then washed twice with
chloride-free phosphate buffer, twice with PBS, and twice with PBS and
0.05% Tween 20 for 10 min. Next, the wells were incubated with 50 µl
of a 1:500 dilution of anti-nitrotyrosine Ab in PBS and 0.05%
Tween 20 for 2 h at room temperature. After washing twice with PBS
and blocking twice with PBS and 0.05% Tween 20, the wells were
incubated with 50 µl of a 1:100 dilution of 125I-labeled
goat anti-mouse Ig in PBS and 0.05% Tween 20 for 2 h.
Subsequently, the wells were washed twice and counted with an autogamma
scintillation spectrometer.
Statistics
The number of experiments (n) refers to the number of
separate experiments, where the results for each experiment were the
mean value of triplicate wells. The results were analyzed by ANOVA.
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Results
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Incubating ICs with GO-glucose as a source of
H2O2 and also with MPO resulted in covalent
cross-linking of high magnitude as shown previously (Fig. 1
) (10). Incubating ICs with GO, MPO, and
NO-saturated HBSS in the presence of O2, however, almost
doubled cross-linking at an initial concentration of 1 mM (no NO:
31.7 ± 5.2%; 0.01 mM NO: 25.1 ± 5.2%; 0.1 mM NO:
43.6 ± 4.0; 1 mM NO: 67.3 ± 5.9%; p
< 0.0002) (Fig. 1
). In the absence of O2, no increase in
covalent cross-linking was detected (data not shown).

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FIGURE 1. Effect of NO gas in air-saturated HBSS on the
H2O2-MPO-mediated covalent cross-linking of
ICs. Plastic-bound BSA/anti-BSA complexes were incubated for 1
h with 22 mU/ml of MPO and 0.1 U/ml GO ± NO gas.
*p < 0.0002; n = 4.
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The above results suggested that the oxidative product of NO,
NO2, was responsible for the increase in IC cross-linking.
Indeed, the H2O2-dependent cross-linking of
plastic-bound ICs in the presence of MPO was significantly increased by
1 and 10 mM NaNO2 (no NO2: 29.2 ± 3.8%;
1 mM NaNO2: 58.4 ± 9.9%; p < 0.008;
10 mM NaNO2: 60.4 ± 4.2%) (Fig. 2
). Sodium nitrate in concentrations as
high as 10 mM did not affect cross-linking (data not shown). Moreover,
when NaNO2 was added to an optimal dilution of purified
HOCl, the salt inhibited protein cross-linking in a dose-dependent
fashion (Fig. 3
). As previously shown
(10), H2O2 and MPO in the absence of chloride
resulted in insignificant cross-linking. However, the absence of
chloride did not affect nitrite-dependent cross-linking (Fig. 4
). These findings reinforced the
suggestion that nitrite was able to mediate this phenomenon in the
presence of H2O2 and MPO. This conclusion was
supported by the observation that sodium azide, which is an inhibitor
of MPO, also inhibited nitrite-dependent cross-linking (Fig. 5
). The aggregate of these results
indicated that a nitrite-mediated enhancement of protein cross-linking
required the presence of MPO and H2O2; HOCl was
not required, and its cross-linking capacity was inhibited by nitrite.

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FIGURE 2. Effect of sodium nitrite on the
H2O2-MPO-mediated cross-linking of ICs. For
experimental details, see Figure 1 . *p < 0.008;
**p < 0.006; n = 4.
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FIGURE 3. Effect of sodium nitrite on the HOCl-mediated cross-linking of ICs.
Plastic-bound ICs were incubated with 10 µM freshly distilled
HOCl ± sodium nitrite. *p < 0.02;
**p < 0.004; n = 3.
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FIGURE 4. Effect of sodium nitrite on the chloride-free
H2O2-MPO-mediated cross-linking of ICs.
*p < 0.01; **p < 0.0001;
n = 3.
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FIGURE 5. Effect of sodium azide on the H2O2-MPO-mediated
cross-linking of ICs. Control: no sodium nitrite or azide (100%); Open
bars: with sodium azide; stippled bars: no sodium azide.
*p < 0.04 with respect to an absence of azide control;
n = 3.
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The next series of experiments was designed to investigate the effects
of nitrite on MPO activity. The activity of MPO, as measured by the
oxidation of TNB, was significantly enhanced by nitrite in a
dose-dependent manner (Fig. 6
).
Similarly, the addition of increasing concentrations of nitrite to
stimulated PMNs resulted in a significant increase in oxidative
activity as measured with TNB as a substrate (Fig. 7
). To rule out the possibility that the
nitrite effects observed may have been due to increased
H2O2 production by GO, the enzyme activity was
measured in the presence or absence of sodium nitrite. As shown in
Figure 8
, 1 mM of sodium nitrite did not
affect the production of H2O2; 10 mM of sodium
nitrite partially reduced its production in the face of a concomitant
increase in protein cross-linking, as shown previously (Fig. 2
).

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FIGURE 7. Effect of sodium nitrite on the oxidative activity of PMNs as measured
by TNB oxidation. *p < 0.003; n =
4.
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Since the nitrosation of tyrosine can be generated by the product of
H2O2 and nitrite (28), experiments were
conducted to examine this possibility. Plastic-bound BSA was incubated
with the H2O2-generating system in the presence
or absence of nitrite. As shown in Figure 9
, easily detectable nitrosation was seen
after a 1-h incubation with 0.1 mM nitrite, reaching a maximal increase
in nitrotyrosine at a nitrite concentration of 1 mM. No nitrosation was
detected with nitrate or when MPO was omitted; this observation
supports our previous findings, which indicated that
H2O2 and nitrite were necessary and sufficient
for the generation of nitrotyrosine and protein cross-linking.

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FIGURE 9. Effect of sodium nitrite on the
H2O2-MPO-mediated generation of nitrotyrosine.
Plastic-bound BSA was incubated with increasing concentrations of
sodium nitrite in the presence or absence of MPO. Open bars: no MPO;
stippled bars: with MPO. *p < 0.0001;
n = 3.
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The aggregate of these results suggested that the product of
interaction between NO2 and H2O2
that was catalyzed by MPO may have been responsible for the increase in
IC cross-linking observed. Since activated PMNs generate
O2-, an alternative pathway may involve the
product of the interaction of this radical with NO, namely
peroxynitrite. The next series of experiments were designed to explore
this possibility. Adding increasing concentrations of NaNO2
to the O2- generated by XO and hypoxanthine
did not result in any detectable cross-linking or nitrotyrosine
generation (data not shown). However, significant protein cross-linking
was obtained (O.1 mU/ml XO: 4.1 ± 0.9%, p <
0.02; 1.0 mU/ml XO: 5.2 ± 1.4%, p < 0.05,
crosslinking over control without SNP) when a NO donor (SNP, 1 mM) was
added to the O2--generating system, suggesting
that the resulting peroxynitrite was responsible for these results.
Indeed, increasing concentrations of freshly synthesized peroxynitrite
alone mediated cross-linking (1.0 µM ONOO-: 2.2 ±
3.7%; 10 µM ONOO-: 0.7 ± 3.7%; 100 µM
ONOO-: 40.3 ± 1.9% cross-linking; p
< 0.002) and the addition of MPO significantly enhanced this effect
(1.0 µM ONOO-: 6.0 ± 5.1%; 10 µM
ONOO-: 7.1 ± 5.5%; 100 µM ONOO-:
55.7 ± 6.0%; p = 0.05 vs no MPO) (Fig. 10
).

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FIGURE 10. Effect of peroxynitrite on the cross-linking of ICs. Open bars: no MPO;
stippled bars: with MPO. *p = 0.05 vs no MPO;
n = 4.
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Discussion
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There is considerable evidence that in inflammatory foci such as
the involved joint in rheumatoid arthritis, ROS and NO-derived reactive
products play important pathogenic roles in tissue damage (39). Thus,
evidence of oxidative damage of rheumatoid synovial fluid proteins has
been reported by us (12) and others (40); in addition, increased
concentrations of nitrite (41) and the presence of nitrotyrosine (42)
in synovial fluids indicate that NO-derived products also play a
significant role. There is also abundant evidence that a variety of
neutrophil components are present at the cartilage surface and at the
cartilage-pannus junction (16-19). We have previously shown that one of
the major oxidative products of PMNs, namely HOCl, is responsible for
the covalent cross-linking of ICs (10). Moreover, we have also obtained
evidence that superficial articular chondrocytes generate large amounts
of NO when appropriately stimulated with cytokines or bacterial
products (23). Recent data by other investigators indicate that the
human neutrophil is also able to secrete NO when appropriately
stimulated (24). Chemical data suggest that NO reacts with
O2- and other reactive molecules to form
strong oxidant molecules such as peroxynitrite (25, 26) and nitryl
chloride (27). Alternatively, O2--derived
H2O2 reacting with nitrite also gives rise to
another strong oxidant, probably
NO2· (28). However, NO has been
shown to have both deleterious and protective effects in pathologic
states. The considerations discussed above suggest that high
concentrations of ROS, PMN granular products, and NO may interact at
the articular surface in inflammatory arthritis; this finding prompted
the present studies dealing with the effects of NO and its decay
products on the oxidizing activity of PMN-derived ROS.
The results obtained indicated that NO gas under anaerobic conditions
did not interfere with HOCl-mediated protein cross-linking. However, NO
significantly enhanced cross-linking in the presence of O2,
suggesting that the oxidation end-product of NO, namely nitrite, may
have been responsible for this enhancement. Additional experiments
clearly indicated that NO2 and not NO3 was able
to increase MPO-mediated cross-linking in the absence of chloride ion.
Indeed, NO2 was shown to partially quench HOCl-mediated
protein cross-linking, suggesting that cross-linking was solely the
result of the interaction of NO2 with MPO and
H2O2. The enhanced oxidative capacity of MPO in
the presence of NO2 was also evident when an alternative
substrate (TNB) was used, and, more pertinent to biology, when PMNs
were the source of ROS. These findings are also in accordance to
previous work showing that MPO reacts directly both with
NO2 (28, 43) and ONOO- (44).
Finally, the covalent cross-linking of ICs was demonstrated with a
source of O2- and a NO donor, and in addition
with a low concentration of freshly synthesized ONOO- that
was further enhanced by the addition of MPO. The modest increase in
cross-linking observed when MPO was added suggests that
ONOO- was able to mediate this reaction by itself, since
most of the cross-linking observed took place with the oxidant alone.
The chemical pathways resulting in the modification of macromolecules
as found in inflammatory foci in vivo are complicated and have not been
completely clarified. The t1/2 of NO is probably
very short in inflammatory fluids (45), reacting with various
substrates and decaying to its oxidized byproduct, NO2,
which has been found to be increased in inflammatory synovial fluids
(41). Since NO is generated intracellularly, it may react with
O2- to form ONOO-, which is a
well-known nitrosating and cross-linking species (38, 39). Moreover,
O2- generated by inflammatory cells would
readily dismutate to H2O2 in the presence of
the superoxide dismutase found in inflammatory cells and rheumatoid
synovial fluids (46, 47). This oxidant may mediate the same effects in
conjunction with nitrite and MPO as shown in these studies. To
complicate things even further, tyrosine chlorination and nitrosation
may also occur as a result of the interaction of HOCl and NO, giving
rise to nitryl chloride or similar chloride- and NO-derived free
radicals (27, 48). Finally, ONOO- can decay spontaneously
to form hydroxyl radical and nitrogen dioxide (25), another molecule
which is thought to mediate tyrosine nitrosation (28). The presence of
the inhibitors of these reactions (chloride, as shown here, or
bicarbonate (49) in body fluids) introduces yet another complicating
factor. At the present time, it is not possible to determine which or
how many of these pathways may be operative in inflammation.
The relatively large concentrations of nitrite that are required to
mediate protein cross-linking in our experiments raise questions as to
the biologic significance of the results, since the nitrite
concentrations measured in inflammatory fluids are lower by at least
two orders of magnitude. Several factors may help explain this
requirement. The nitrite "accumulation" measured in biologic fluids
probably represents a gross underestimation, taking into account its
rapid equilibration with the vascular compartment, the removal of
nitrite by locally produced HOCl (27), and the real concentration
probably achieved within the inflammatory cell phagosomes in which
H2O2, MPO, and NO synthase are known to
coexist. Moreover, higher nitrite concentrations were required to
prevent protein fragmentation mediated by strong oxidative attack,
because we used limiting amounts of MPO and GO in our experiments.
Regardless of the relative importance of each of the reactions outlined
above, one of the possible corollaries of the results presented stems
from our previous observations that both in the superficial layers of
cartilage obtained from an experimental model of rheumatoid arthritis
(50) and in superficial cartilage from patients with this disease (13),
we found large amounts of ICs tightly bound to the tissue, so that even
exposure to high molar guanidine solutions was not sufficient to
extract them. Extraction could only be achieved with a dissolution of
the tissue using bacterial collagenase (51), suggesting that the
ICs were covalently bound to the underlying cartilage
macromolecules. Ongoing studies in our laboratory may help clarify some
of the unresolved issues discussed above.
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Footnotes
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1 This work was supported by U.S. Public Health Service Grant AR-16209. 
2 Address correspondence and reprint requests to Dr. Hugo E. Jasin, UAMS-Mail Slot 509, 4301 W. Markham, Little Rock, AR 72205. 
3 Abbreviations used in this paper: ROS, reactive oxygen-derived species; IC, immune complex; GO, glucose oxidase; MPO: myeloperoxidase; XO: xanthine oxidase; PMN, polymorphonuclear neutrophil; NO, nitric oxide; TNB, 5-thio-2-nitrobenzoic acid; PBS-RS, PBS containing 10% heat-inactivated rabbit serum; SNP, sodium nitroprusside. 
Received for publication August 18, 1997.
Accepted for publication March 30, 1998.
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