Participação do óxido nítrico na expressão de vasopressina e ocitocina durante sepse polimicrobiana experimental / Involvement of nitric oxide in vasopressin and oxytocin expression during experimental polymicrobial sepsis.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Sepsis induces massive production of inflammatory mediators, such as nitric oxide (NO), and causes cardiovascular, neuroendocrine and body temperature (Tb) alterations. In the late phase of sepsis there is a basal vasopressin (AVP) release despite the persisting hypotension. One reason could be the inhibition of AVP synthesis by the increase in NO production. Our aim was to investigate the possible involvement of NO, produced centrally by NO synthase (NOS) isoforms, on AVP and oxytocin (OT) expression, cardiovascular response and Tb during experimental sepsis. Male Wistar rats received an i.c.v. injection of the non-selective NOS inhibitor L-NAME (250g/L), or of aminoguanidine (AG,250g/L), a selective inhibitor of its inducible isoform (iNOS). Another group received soluble guanylate cyclase inhibitor (ODQ,0.25µg/L). Control groups received vehicles (saline or DMSO1%). Thirty minutes after the injections, sepsis was induced by cecal ligation and puncture (CLP), or the rats were sham operated. The animals were divided into 4 groups for: 1) assessment of survival, 2) determination of Tb, 3) measurement of blood pressure (MAP) and heart rate (HR), and 4) evaluation of hydroelectrolytic parameters and AVP and OT secretion. The CLP promoted high mortality and progressive increase in NO levels. It also decreased MAP and increased HR. The AVP plasma concentration (AVPp) increased in the early phase of sepsis and its antipyretic effect may have contributed to the observed hypothermia. The expression ratio of both hormones was reduced in the supraoptic (SON) and paraventricular (PVN) nuclei. In the late phase, AVPp was basal and its expression decreased in both nuclei more than in the initial phase. The OT expression decreased only in the SON. L-NAME pretreatment increased the survival and reduced the NO production until 20h. MAP and Tb were increased, while HR remained similar to that observed in the vehicle control group. AVPp increased simultaneously to the decrease of its expression ratio in both nuclei. In the late phase, the L-NAME group showed NO levels increased and decreased AVP expression, apparently contributing to basal AVPp and hypotension. The L-NAME decreased OT expression ratio in the initial phase, but increased in the late phase. Inhibition of iNOS by AG further increased the survival and Tb. Even though AG did not block NO production, it increased AVP and OT expression and kept AVPp constant and above the baseline. AG pretreatment increased MAP only in the initial phase of sepsis. The ODQ pretreatment was more efficient to increase survival and Tb after CLP. However it neither altered the progressive NO increase nor the decrease in AVP and OT expression ratio. The basal AVPp after ODQ contributed to hypotension observed during the studied period. These results show that the increased central NO levels observed after CLP inhibit cGMP-independent hormone expression in the SON and partially dependent in the PVN. Inhibition of AVP expression, in the late phase of sepsis, results in basal concentrations of this hormone further contributing to hypotension. In our experiments the control of body temperature during polymicrobial sepsis had greater contribution in survival than the neuroendocrine and/or cardiovascular regulation.

ASSUNTO(S)

l-name aminoguanidine hypotension aminoguanidina l-name odq. odq hipotensão hipotálamo hypothalamus

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