The Journal of Immunology, 2000, 165: 3592-3598.
Copyright © 2000 by The American Association of Immunologists
Prolonged Exposure to Lipopolysaccharide Inhibits Macrophage 5-Lipoxygenase Metabolism Via Induction of Nitric Oxide Synthesis1
Michael J. Coffey2,
Susan M. Phare and
Marc Peters-Golden
Division of Pulmonary and Critical Care Medicine, University of Michigan Medical Center, Ann Arbor, MI 48109
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Abstract
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LPS from bacteria can result in the development of sepsis syndrome
and acute lung injury. Although acute exposure to endotoxin primes
leukocytes for enhanced synthesis of leukotrienes (LT), little is known
about the effect of chronic exposure. Therefore, we determined the
effect of prolonged LPS treatment on 5-lipoxygenase (5-LO) metabolism
of arachidonic acid in alveolar macrophages (AM) and in peripheral
blood monocytes. Pretreatment of AM with LPS caused time- and
dose-dependent suppression of LT synthetic capacity. LPS pretreatment
failed to inhibit arachidonic acid (AA) release. The fact that LPS
inhibited LT synthesis from endogenous AA more than from exogenous AA
suggested an effect on 5-LO-activating protein (FLAP). In addition, an
inhibitory effect of LPS treatment on AM 5-LO activity was suggested by
cell-free 5-LO enzyme assay. No effect on the expression of either 5-LO
or FLAP proteins was observed. New protein synthesis was necessary for
LPS-induced reduction of 5-LO metabolism in AM, and immunoblotting
demonstrated marked induction of NO synthase (NOS). Inhibition by LPS
was reproduced by an NO donor and was abrogated by inhibitors of
constitutive and inducible NOS. Compared with AM, peripheral blood
monocytes exhibited no suppression by LPS of 5-LO metabolism and no
induction of inducible NOS. We conclude that prolonged exposure to LPS
impairs AM 5-LO metabolism by NO-mediated suppression of both 5-LO and
FLAP function. Because LT contribute to antimicrobial defense, this
down-regulation of 5-LO metabolism may contribute to the increased
susceptibility to pneumonia in patients following
sepsis.
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Introduction
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Gram-negative
bacterial sepsis is an important cause of morbidity and mortality
(1, 2). Acute complications include multiorgan failure and
acute lung injury. Patients who survive sepsis have a high incidence of
subsequent infections, including pneumonia (3, 4). LPS
endotoxin, a component of the bacterial cell wall, is thought to be
responsible for many of these manifestations of sepsis. It has also
been shown to regulate mediator production from host immune cells, most
notably mononuclear phagocytic cells. One group of mediators whose
synthesis is regulated by LPS is the eicosanoids, biologically active
metabolites of arachidonic acid
(AA).3 Prolonged
incubation with LPS increases the capacity for synthesis of PGs by
transcriptional up-regulation of the macrophage cyclo-oxygenase-2
(COX-2) enzyme (5, 6). LPS stimulation over a 2-h period
has been shown to prime peripheral blood monocytes (PBM) for increased
AA release and metabolism via the 5-lipoxygenase (5-LO) pathway to
leukotrienes (LT) (7, 8). However, macrophages are
long-lived immune effector cells resident in tissues, and the effect of
longer intervals of LPS exposure on macrophage 5-LO metabolism has not
been adequately examined.
The LT are proinflammatory mediators that play an important role in
disease states such as asthma (9, 10, 11). They are also
produced in high levels in pneumonia (12) and acute lung
injury (13). Recently, LT have been implicated as having a
role in host defense against microbial infection (14). LT
synthesis from AA is initiated by the
Ca2+-dependent activation of 5-LO, acting in
concert with the AA-binding protein, 5-LO-activating protein
(FLAP) (15), to form LTA4.
LTA4 is the precursor for formation of the two
major groups of LT, LTB4 and the
peptidoleukotrienes LTC4,
D4, and E4
(16).
Among the other macrophage mediators stimulated by LPS is NO. This is
formed from the amino acid L-arginine by NO synthase (NOS).
An inducible form of NOS (iNOS) is well known to be transcriptionally
up-regulated by LPS (17, 18). NO is an important
endogenous regulator of pro- and anti-inflammatory processes
(19, 20). It has been shown to modulate COX activity in a
complex manner, either up-regulating (21, 22) it or
down-regulating (23) it in various systems. Although NO
activation is stimulated by 5-LO products (24, 25), little
is known about the effect of NO on 5-LO metabolism.
In this study we evaluated the effects of prolonged exposure to LPS on
LT synthesis by alveolar macrophages (AM). AM are the resident
inflammatory cell of the pulmonary alveolar space and have a greater
capacity for LT synthesis than do other mononuclear phagocytic
populations (26). We now report that, in contrast to the
reported effects of short term LPS exposure, prolonged LPS treatment of
AM in vitro suppressed LT synthesis. The mechanism of LPS suppression
involved reduced activity of both 5-LO and FLAP. Most of the
down-regulatory effect of LPS on LT synthesis was accounted for by the
generation of NO following induction of iNOS by LPS. By comparison, PBM
failed to exhibit induction of iNOS following LPS treatment, and they
showed substantially less suppression of LT synthesis than did AM.
These effects of prolonged LPS exposure and the effect of NO on LT
synthesis provide novel and clinically relevant insights into the
regulation of LT synthesis.
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Materials and Methods
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Cell isolation and culture of rat AM and human PBM
The rat AM was studied because it is a good model of human AM
5-LO metabolism and has been well characterized in our laboratory
(27). AM were obtained from 150-g specific pathogen-free
female Wistar rats as previously described (26). Lavaged
cells were >90% AM; they were >98% AM following adherence, as
determined by differential staining. Viability was >95%, as assessed
by trypan blue exclusion. PBM were isolated from whole blood by
Ficoll-Hypaque centrifugation and adherence as previously described
(28). Cells were >90% PBM by differential staining, and
viability was >95% by trypan blue exclusion. Isolated AM and PBM were
resuspended in LPS-free DMEM at 0.5 x
106/ml and were plated as follows: 0.2 ml/well in
96-well plates for enzyme immunoassay (EIA), 1 ml/well in 24-well
plates for [3H]AA release studies, and 5
ml/50-mm culture plate for immunoblot analysis. Cells adhered for
1 h at 37°C in a humidified atmosphere of 5%
CO2/95% O2. Nonadherent
cells were removed by washing twice with DMEM, and adherent cells were
cultured in DMEM containing 10% FCS, with or without various
concentrations of LPS (Escherichia coli serotype 0111:4B,
Sigma, St. Louis, MO) for various time periods.
Quantitation of 5-LO metabolism in intact cells
The maximal capacity for 5-LO metabolism in intact cells was
measured by EIA (Cayman Chemicals, Ann Arbor, MI) determination in
cell-free supernatants of the predominant 5-LO product,
LTB4. Following incubation with or without LPS,
the cells were washed three times in DMEM and subsequently incubated
with the Ca2+ ionophore A23187 (1 µM) to
stimulate the release and metabolism of endogenous AA or exogenous AA
(50 µM). This high concentration of AA has been shown to activate
5-LO enzyme activity as well as providing substrate for LT synthesis
(28, 29). The EIA results were confirmed by reverse phase
HPLC analysis. Briefly, cells were prelabeled overnight with
[3H]AA in the presence or the absence of LPS.
There was no effect of LPS on cellular uptake of radioactivity (data
not shown). The eicosanoid profile was determined by HPLC analysis of
3H-radiolabeled eicosanoids (thromboxane
B2, PGE2,
LTB4, and 5-hydroxyeicosatetraenoic acid
(5-HETE)) released from A23187-stimulated cells as previously described
(30). To assess total AA release, cells were stimulated in
the presence of 0.1% BSA, which binds AA and prevents both metabolism
and reacylation.
5-LO cell-free assay
The 5-LO activity of cell lysates (100 µg of total protein) or
of purified recombinant 5-LO (gift from Denis Riendeau, Merck Frosst,
Montreal, Canada) was determined in reaction mixtures containing 20
µM AA (Cayman Chemicals; including
100,000 dpm of
[3H]AA (DuPont-New England Nuclear, Boston,
MA)) and 10 µM
13(S)-hydroperoxy-9-cis-11-trans-octadecadienoic
acid (Cayman Chemicals) as activator in 1 ml of 50 mM Tris, 0.3 mM
CaCl2, 0.6 mM EDTA, 0.1 mM ATP, and 12 µg/ml
phosphotidylcholine (Avanti Polarlipids, Alabaster, AL) as previously
described (31, 32). After a 30-min reaction at room
temperature the reaction was stopped by adding 1 ml of ether/MeOH/1 M
citric acid (30/4/1, v/v/v) and centrifuging at 3500 rpm for 5 min. The
upper phase was removed, evaporated under nitrogen, and stored at
-70°C. Lipid residues were dissolved in 250 µl of acetonitrile and
analyzed by HPLC on a 5-µm Bondapak C18 column
(30 x 0.4 cm; Waters Associates, Milford, MA) using a mobile
phase of acetonitrile/water/trifluoroacetic acid at a flow rate of 2
ml/min as previously described (27). Radioactivity in 1 ml
of eluate fractions was quantitated by on-line radioactivity detection.
5-LO specific activity was calculated based on conversion of AA to
5-HPETE/5-HETE plus
LTB4/LTB4 isomers, and was
expressed as nanomoles per milligrams of protein per 10 min.
Immunoblot analysis of 5-LO, FLAP, and iNOS
The relative quantities of cellular 5-LO, FLAP, and iNOS
proteins were determined by Western blot analysis. Crude lysates were
prepared as previously described (27) and subjected to
SDS-PAGE by the method of Laemmli on 10% acrylamide gels. Proteins
were transferred overnight to nitrocellulose membranes, and probed with
rabbit polyclonal Abs against human leukocyte 5-LO (1/3000 dilution),
amino acid residues 4152 of the human FLAP sequence (1/5000 dilution;
both provided by Dr. J. Evans, Merck Frosst) (28), or iNOS
(1/2000 dilution; Biomol, Plymouth Meeting, PA). After washing, blots
were incubated for 1 h with HRP-conjugated anti-rabbit IgG
(Amersham) at a dilution of 1/5000. Membranes were then washed and
incubated for 1 min with ECL chemiluminescence detection reagents
(Amersham) and exposed to film for varying time periods to ensure that
densitometric quantitation was performed under conditions in which band
density and exposure time were linearly related. Video densitometry was
performed using NIH Image software (Scion, Frederick, MD).
Modulation of NO
The levels of NO in cell cultures were modulated by a number of
reagents. Exogenous NO was provided by addition of the NO donor
S-nitroso-N-acetylpenicillamine (SNAP)
(33). Inhibition of NO generation was accomplished by the
addition of an analogue of L-arginine,
N-monomethyl-L-arginine
(L-NMMA) (34). Finally, specific
inhibition of iNOS-dependent NO generation was accomplished using the
specific iNOS inhibitor
L-N6-(1-iminoethyl)-lysine
(L-NIL) (35).
Data analysis
Where indicated, data were expressed as the mean ± SEM.
Intergroup differences were analyzed by ANOVA, with statistical
significance assessed by Scheffes test; p < 0.05 was
considered significant.
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Results
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Reduced 5-LO metabolism in cultured AM, and not PBM, following LPS
treatment
AM treated with LPS overnight consistently demonstrated a marked
decline in LTB4 synthesis from endogenous AA.
This suppression of 5-LO metabolism was dose dependent (Fig. 1
A). A dose of 1 µg/ml
suppressed LT synthesis by 81.3 ± 6.3% (n = 6;
p < 0.001) compared with that in untreated cells (Fig. 1
B). A 1-h incubation with LPS at any dose failed to
suppress LTB4 synthesis. In fact, consistent with
literature reports, such short term LPS pretreatment increased AA
release (data not shown). A modest decrease in
LTB4 synthesis was also seen in PBM treated
overnight with LPS (69.4 ± 9.5% of untreated cells;
n = 4; p = 0.02), but this difference
reached statistical significance only when comparing relative (data
expressed as a percentage of the value in untreated cells), as shown
above, and not absolute levels of LTB4 (as shown
in Fig. 1
B).

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FIGURE 1. Prolonged LPS treatment suppresses 5-LO metabolism in AM. AM and PBM
were incubated for 16 h with or without LPS in LPS-free DMEM
containing 10% FCS. The cells were then stimulated with A23817 (1
µM) for 30 min at 37°C, and the medium was analyzed for
LTB4 by EIA. A, Dose-dependent suppression
of LT synthesis by LPS treatment in AM. B, Suppression
of LTB4 synthesis by LPS (1 µg/ml) in AM, but not in PBM.
*, p < 0.001 (n = 6).
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LT synthesis from endogenous AA requires both phospholipase
A2-mediated deacylation of AA and FLAP-dependent
binding and presentation of AA to 5-LO. We next examined the effect of
LPS pretreatment on LT synthesis from exogenous AA. Exogenous AA
bypasses the necessity for AA release by cytosolic phospholipase
A2 and also reduces the reliance on FLAP by
presenting large amounts of the substrate AA directly to the 5-LO
enzyme (28). Interestingly, this suppressive effect of
overnight LPS treatment of AM was much less marked when
LTB4 synthesis from exogenously supplied AA was
analyzed (56.0 ± 4.9% of cells untreated with LPS;
n = 3; p = 0.05). PBM demonstrated no
inhibitory effect of overnight LPS on LT synthesis from exogenous AA
(98.2 ± 8.5% of cells untreated with LPS; n = 4;
not significant).
LPS has no effect on AA release in macrophages
We next wished to specifically examine the effects of LPS
pretreatment on AA release. AM phospholipids were prelabeled overnight
with [3H]AA and then stimulated with A23187.
Although all the 5-LO products were diminished following LPS treatment
(Fig. 2
), the synthesis of
[3H]COX products (predominantly thromboxane)
and of 12-HETE was unchanged. This argues against a reduction in AA
release being responsible for the decrease in LT synthesis. This was
confirmed in experiments conducted to conclusively measure deacylation
of AA by stimulating cells in the presence of 0.1% albumin. Release of
AA from macrophages was not affected by LPS treatment (untreated cells,
1.64 ± 0.27% of incorporated radioactivity; LPS-treated cells,
1.93 ± 0.61%; n = 3), indicating that this was
not a mechanism for limiting LT synthesis.

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FIGURE 2. Reduced 3H-labeled 5-LO products in AM incubated with LPS.
Prelabeled cells incubated for 16 h with (solid line) or without
(dotted line) LPS were stimulated with A23187 (1 µM) for 30 min, and
[3H]AA metabolites were identified by HPLC. Peaks were
identified by coelution with authentic standards, and the products were
expressed as a percentage of incorporated radioactivity. A
representative profile of three separate experiments is shown.
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LPS treatment reduces 5-LO cell-free activity
The reduction in LT synthesis from exogenous AA, albeit less
pronounced than that observed with endogenous AA, suggested an
inhibitory effect of LPS on the activity of the 5-LO enzyme itself. We
further tested this possibility by performing cell-free 5-LO assays on
crude cellular lysates of AM following treatment with or without LPS.
Treatment of AM with LPS indeed resulted in reduced 5-LO activity in
crude cell lysates (33.5 ± 11.5% of cells untreated with LPS;
n = 2). The extent of this suppression of 5-LO activity
by LPS treatment was greater than that of LT synthesis by intact AM
incubated with exogenous AA, and not as great as that seen with A23187
stimulation of intact AM. These observations indicate that in addition
to possible effects on FLAP function, LPS probably has a direct
inhibitory effect on the 5-LO enzyme itself.
No effect of LPS on 5-LO and FLAP expression
A reduction in 5-LO metabolism that is slow in onset could
theoretically be explained by reduced 5-LO and/or FLAP protein
expression. The data presented to date suggested impairment of both
these components of 5-LO metabolism in LPS-treated cells. However,
Western blot analysis did not demonstrate any reduction in 5-LO or FLAP
expression in AM upon overnight treatment with LPS (Fig. 3
). Therefore, the mechanism of the LPS
effect is likely to involve impaired 5-LO and FLAP actions.

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FIGURE 3. No effect of LPS treatment on 5-LO and FLAP expression. AM were
incubated for 16 h with or without LPS (1 µg/ml). Equal amounts
(20 µg of protein) of crude cellular lysate from AM were subjected to
immunoblot analysis for 5-LO and FLAP, as described in Materials
and Methods. Shown are representative autoradiographs of
Western blots from a total of three independent experiments
demonstrating the amounts of 5-LO (top) and FLAP
(bottom) in AM (left) and PBM
(right) from control and LPS-treated cells.
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New protein synthesis is necessary for inhibition of 5-LO
metabolism by LPS
We next investigated whether new protein synthesis was necessary
for the suppression of LT synthesis in AM treated with LPS overnight.
Treatment with the protein synthesis inhibitor cycloheximide overnight
blocked the inhibitory effect of LPS on 5-LO metabolism (169.5 ±
10.31% of LPS-treated AM; n = 3; p =
0.003). These observations suggested that LPS treatment induced de novo
synthesis of a protein that, in turn, was responsible for reduced 5-LO
metabolism in AM.
COX metabolism plays only a modest role in inhibition of 5-LO
metabolism by LPS
One plausible candidate for such a newly synthesized protein is
COX-2, because LPS is known to induce COX-2 in AM (5, 6),
and PGE2 is known to inhibit LT synthesis
(36, 37). Although A23187-stimulated
PGE2 synthesis was indeed increased after LPS
treatment (696.7 ± 196.6 vs 259.3 ± 59.5 pg/ml;
n = 3; p = 0.01), relatively less of an
increase was observed in cells incubated with exogenous AA (1629
± 59.3 vs 1296.0 ± 138.2 pg/ml; n = 3;
p = 0.09). Thus, there was dissociation between
LPS-induced enhancement of PGE2 synthesis and
inhibition of 5-LO metabolism under the two experimental conditions.
Furthermore, the COX inhibitor indomethacin failed to abrogate the
LPS-induced inhibition of LT synthesis (LPS-treated cells, 24% of
untreated cells; LPS plus indomethacin-treated cells, 26% of untreated
cells), conclusively demonstrating that enhanced PG synthesis did not
play a significant role in the suppression of 5-LO metabolism.
Suppression of 5-LO metabolism in LPS-treated AM involves NO
generation
Because LPS also enhances NO production, we examined the effect of
this reactive nitrogen intermediate on 5-LO metabolism. When
L-NMMA, an analogue of L-arginine that
suppresses cellular NO synthesis, was coincubated overnight with
LPS-treated AM, it dose-dependently increased LT synthesis (Fig. 4
). At L-NMMA doses
>10 µg/ml, LPS-induced suppression was completely overcome, and at
doses >100 µg/ml, LTB4 synthesis far exceeded
that in the cells untreated with LPS. The effect of treatment of
LPS-untreated AM with L-NMMA showed a trend
toward an increase in 5-LO metabolism, but this did not reach
statistical significance (Fig. 4
).

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FIGURE 4. Nonselective NO inhibitor prevents the suppression of 5-LO metabolism
by LPS. AM were incubated with or without 1 µg/ml LPS in LPS-free
DMEM containing 10% FCS in the presence or the absence of increasing
concentrations of L-NMMA (1, 10, 100, and 500 µg/ml). The
cells were stimulated with A23817 (1 µM) for 30 min at 37°C, and
medium was analyzed for LTB4 by EIA. Representative data
from three separate experiments are shown.
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The ability of L-NMMA treatment to overcome the reduction
in 5-LO metabolism in LPS-treated AM suggested an important role for NO
in regulating LT synthesis under these conditions. Therefore, we added
exogenous NO, in the form of the donor compound SNAP, and examined its
effect on L-NMMA-treated cells. SNAP reversed the effect of
L-NMMA on 5-LO metabolism, further confirming a role for NO
in suppressing LT synthesis in LPS-treated AM (Fig. 5
A). Furthermore, overnight
treatment of rat AM with SNAP alone in the absence of LPS was able to
significantly suppress 5-LO metabolism (Fig. 5
A). Finally,
when purified 5-LO enzyme was incubated for 5 min with the NO donor,
SNAP, there was a decrease in cell-free enzymatic activity (Fig. 5
B). These observations confirm a role for NO in the
suppression of 5-LO metabolism by LPS, and indicate that this
suppression involves at least in part a direct effect on 5-LO.
In view of the involvement of NO and the dependence on new protein
synthesis of the LPS suppression of 5-LO metabolism, we hypothesized
that LPS acted via induction of iNOS. Indeed, LPS treatment of AM
resulted in markedly increased expression of iNOS (Fig. 6
A). Consistent with the fact
that suppression of 5-LO metabolism was much more modest in PBM than in
AM, PBM failed to demonstrate iNOS induction by LPS (Fig. 6
A). Furthermore, in view of the controversy on the
elaboration of NO by human AM, we examined the effect of LPS overnight
on 5-LO metabolism and NO generation. LPS treatment of human AM for
16 h did not suppress LT synthesis and was not associated with
iNOS induction (data not shown). However, exogenous NO, in the form of
SNAP, suppressed human AM 5-LO product formation.

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FIGURE 6. iNOS plays a role in the suppression of 5-LO metabolism in AM, but not
in PBM. A, AM and PBM were incubated for 16 h with
or without LPS (1 µg/ml). Crude cell lysates were prepared, and equal
amounts (20 µg) of crude cellular lysate were subjected to immunoblot
analysis for iNOS as described in Materials and Methods.
Shown is a representative autoradiograph from three separate
experiments. B, AM were incubated for 16 h with or
without LPS (1 µg/ml) in the presence or the absence of the selective
iNOS inhibitor L-NIL. Cells were then stimulated with
A23817 (1 µM) for 30 min at 37°C, and medium was analyzed for
LTB4 by EIA. Data shown are from a representative
experiment of three performed.
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We next used a selective iNOS inhibitor to examine the role of NO
derived from this synthase isoform in LPS-treated rat AM. Like
L-NMMA, L-NIL treatment dose-dependently
overcame the inhibitory effect of LPS on AM 5-LO metabolism (Fig. 6
B). Selective iNOS inhibitors had no effect on LT synthesis
in LPS-treated PBM (data not shown). These data suggest that iNOS was
an important source of NO, which resulted in reduced 5-LO metabolism in
LPS-treated AM.
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Discussion
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In this study we examined the effect of prolonged LPS treatment on
5-LO metabolism in macrophages, and now report a number of novel
findings: 1) overnight LPS treatment resulted in marked suppression of
LT synthesis in AM, but only a modest degree of suppression in PBM; 2)
the suppressive effect of LPS treatment on 5-LO metabolism in
macrophages entails reductions in both 5-LO and FLAP activity; 3) the
LPS effect is independent of changes in AA release as well as 5-LO and
FLAP expression; 4) the reduction in 5-LO metabolism is largely
explained by LPS-induced synthesis of NO by increased iNOS. Considering
their important pathophysiologic roles in inflammatory states,
synthesis of LTs must be tightly regulated. The observations that LPS
and NO can both suppress 5-LO metabolism provide crucial new insights
into the control of this pathway.
LPS is present on the outer membrane of Gram-negative bacteria and
plays an important role in inflammatory reactions that occur in
response to these infections (1). It is well known that
LPS activates macrophages to release proinflammatory mediators,
including superoxide (38), cytokines (39), NO
(17), and AA metabolites (40). Short term
(2-h) treatment with LPS has been reported to prime PBM for increased
AA release and enhanced LT synthesis following stimulation with FMLP
(41). However, this priming effect waned after 2 h.
Other investigators have demonstrated that i.v. LPS increased ex vivo
synthesis of LTB4 by rat AM on day 1, but this
returned to control levels on day 3 (42). LPS for 12 h
in vitro primed human AM for A23187-stimulated
LTB4 synthesis (8, 43).
Our data suggest that multiple mechanisms underlie the reduced 5-LO
metabolism by LPS. As discussed above, the effect is not at the
phospholipase A2 level, because there was no
reduction in AA release itself or in the synthesis of eicosanoids
derived from AA via the COX and 12-LO pathways with LPS treatment. LPS
globally suppressed the formation of all 5-LO metabolites, but did not
affect the expression of 5-LO or FLAP. Separate effects on the function
of these two proteins appear to be involved. First, cell-free 5-LO
activity was reduced. NO has been proposed to inactivate lipoxygenases
by reducing the ferric enzyme to the ferrous form, which is inactive
(33, 44). This also explains why LT synthesis is reduced
in intact cells incubated with exogenous AA. An additional inhibition
by LPS of FLAP activity was suggested by the observation that a
reduction in LT synthesis was less marked when the cells were incubated
under conditions that are relatively FLAP independent (exogenous AA)
than when they were stimulated under conditions that are highly FLAP
dependent (endogenous AA mobilized by A23187).
Induction of COX-2-dependent synthesis of PGE2 by
LPS treatment represented one possible mechanism by which LT synthesis
was suppressed in AM. However, a number of lines of evidence argue
against such a mechanism. First, the degree of
PGE2 augmentation by LPS was quite modest,
consistent with previous observations in AM from the rat
(45). Second, PG production was greater in LPS-treated AM
incubated with exogenous AA, whereas the suppressive effect of LPS was
more pronounced in A23187-treated cells. Finally, inhibition of PG
production with indomethacin did not restore LT synthetic capacity in
LPS-treated AM. The nature of the interaction of NO with COX has proven
controversial. NO has been reported to both augment (21, 22) and suppress (23) COX activity in various
systems. In our studies inhibition of NO induction tended to augment
COX product synthesis to a minor degree.
There is less information available about the interactions of NO and
5-LO, and the information that is available is derived from complex
experimental models. In platelet-neutrophil cocultures, exogenous
nitroprusside had opposing effects on 5-LO-derived products, reducing
LT synthesis and increasing lipoxin synthesis (46). Others
have shown in a rabbit leukocyte-perfused heart model that treatment
with L-arginine reduced cysteinyl-LT levels, which was
associated with reduced coronary perfusion pressure (34).
Our work extends the observation that endogenous NO inhibits
lipoxygenase metabolism (47). Although the above studies
suggest that NO may inhibit lipoxygenase metabolism, other
investigators have noted that NO up-regulates the activity of
lipoxygenases (48, 49), including 5-LO (50),
in different models.
What are the clinical implications of our findings? Although human AM
may not elaborate NO under normal conditions, there is evidence that NO
is produced in AM in inflammatory states, e.g., acute lung injury
(51), emphysema (52), and idiopathic
pulmonary fibrosis (53). In addition, we have demonstrated
that exogenous NO suppresses 5-LO metabolism in human AM. Furthermore,
in the human lung other cell types, e.g., epithelial and endothelial
cells, elaborate large amounts of NO, which, in turn, may suppress AM
LT synthesis. The reduction in the synthesis of proinflammatory, smooth
muscle constrictive, and edemagenic LTs may help to explain the
salutary effects of inhaled NO in various models. These effects include
relaxation of airway tone in asthmatics (54, 55) and of
pulmonary vascular tone in pulmonary hypertension (56, 57), and inhibition of neutrophil migration (58)
and endothelial permeability in models of acute lung injury
(59). Therefore, exogenous treatment with NO may be a
method of suppressing excessive 5-LO product formation that contributes
to the pathogenesis of asthma (60), idiopathic pulmonary
fibrosis (61), and acute lung injury (62). In
contrast, prolonged exposure of macrophages to LPS is relevant in
patients who survive the acute phase of sepsis secondary to
Gram-negative bacteria (63). Our data predict that the
macrophages capacity to elaborate LT would be compromised under these
circumstances. This, in turn, might be expected to impair host defense
mechanisms, because LT enhance the phagocytosis and killing of
micro-organisms (14, 64, 65).
In summary, we have demonstrated for the first time that exposure of AM
to LPS for a prolonged period suppresses LT synthesis in vitro via an
NO-dependent mechanism. The induction of iNOS with associated NO
generation results in reduced 5-LO and FLAP activity. This reduction in
5-LO metabolism in the setting of prolonged LPS exposure may represent
an endogenous means to limit the inflammatory response, but may at the
same time increase susceptibility to infection. iNOS inhibitors may
have utility in restoring LT synthetic capacity and thereby enhancing
host defense capabilities in subjects surviving sepsis.
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Footnotes
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1 This work was supported by National Institutes of Health Grant R01-HL02810 (to M.J.C.), a grant from the General Clinical Research Center at University of Michigan (M01-RR00042), and National Institutes of Health Grants RO1-HL58897 and P50-HL56402 (to M.P.-G.). 
2 Address correspondence and reprint requests to Dr. Michael J. Coffey, 6301 MSRB III, 1150 West Medical Center Drive, Ann Arbor, MI 48109-0642. 
3 Abbreviations used in this paper: AA, arachidonic acid; AM, alveolar macrophage; COX, cyclo-oxygenase; EIA, enzyme-linked immunoassay; 5-HETE, 5-hydroxyeicosatetraenoic acid; iNOS, inducible NO synthase; 5-LO, 5-lipoxygenase; FLAP, 5-LO-activating protein; LT, leukotriene; L-NMMA, N-monomethyl-L-arginine; L-NIL, L-N6-(1-iminoethyl)-lysine; PBM, peripheral blood monocyte; SNAP, S-nitroso-N-acetylpenicillamine. 
Received for publication January 21, 2000.
Accepted for publication July 7, 2000.
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References
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