Evidence for cytokine-inducible nitric oxide synthesis from L-arginine in patients receiving interleukin-2 therapy
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An interferon-gamma, tumor necrosis factor, and interleukin-1-inducible, high-output pathway synthesizing nitric oxide (NO) from L-arginine was recently identified in rodents. High-dose interleukin-2 (IL-2) therapy is known to induce the same cytokines in patients with advanced cancer. Therefore, we examined renal cell carcinoma (RCC; n = 5) and malignant melanoma (MM; n = 7) patients for evidence of cytokine-inducible NO synthesis. Activity of this pathway was evaluated by measuring serum and urine nitrate (the stable degradation product of NO) during IL-2 therapy. IL-2 administration caused a striking increase in NO generation as reflected by serum nitrate levels (10- and 8-fold increase [P less than 0.001, P less than 0.003] for RCC and MM patients, respectively) and 24-h urinary nitrate excretion (6.5- and 9-fold increase [both P less than 0.001] for RCC and MM patients, respectively). IL-2-induced renal dysfunction made only a minor contribution to increased serum nitrate levels. Metabolic tracer studies using L-[guanidino-15N2]arginine demonstrated that the increased nitrate production was derived from a terminal guanidino nitrogen atom of L-arginine. Our results showing increased endogenous nitrate synthesis in patients receiving IL-2 demonstrate for the first time that a cytokine-inducible, high-output L-arginine/NO pathway exists in humans.
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During inflammatory reactions or infection involving increased iNOS expression, large amounts of NO are produced resulting in significant increases in plasma nitrate and nitrite.
“Importantly, during inflammatory reactions or infection involving increased iNOS expression large amounts of NO are produced resulting in significant increases in plasma nitrate and nitrite [42–44].”
From Inorganic nitrite therapy: historical perspective and future directions (2011) · cites this paper as [43]
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- Authors
- Hibbs, J. B., Westenfelder, C., Taintor, R., Vavrin, Z., Kablitz, C., Baranowski, R. L., Ward, J. H., Menlove, R. L., McMurry, M. P., & Kushner, J. P.
- Affiliations
- Veterans Health Administration (US)
- University of Utah (US)
- ORCID
- Westenfelder, C
- Venue
- Journal of Clinical Investigation
- Published
- 1992-03-01
- Volume
- 89
- Issue
- 3
- Pages
- 867-877
- ISSN
- 0021-9738 (ISSN-L)
- PMC
- PMC442932
- OpenAlex
- W2120872446
- Cited by
- 485
- References
- 80
- Citations by year
- 2026: 3 · 2025: 1 · 2023: 4 · 2022: 5 · 2021: 3 · 2020: 3 · 2019: 1 · 2018: 3 · 2017: 5 · 2016: 1 · 2015: 10 · 2014: 7 · 2013: 4 · 2012: 2
- FWCI
- 36.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Veterans Affairs
- American Heart Association
- National Institutes of Health
- National Cancer Institute (CA42014, P30CA042014)
- National Center for Research Resources (RR 00064)
- Topics
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Life Sciences › Immunology and Microbiology › Immunology › Immune cells in cancer
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Angiogenesis and VEGF in Cancer
- Keywords
- nitric oxide production, L-arginine, interleukin-2 therapy, interferon-gamma, TNF-α, interleukin-1, nitrate, urinary nitrate excretion, renal cell carcinoma, melanoma, renal dysfunction, arginine metabolism
- MeSH terms
- Adult, Arginine, Carcinoma, Renal Cell, Female, Humans, Interferon-gamma, Interleukin-2, Kidney Neoplasms, Kidney Tubules, Male, Melanoma, Middle Aged, Nitric Oxide, Vascular Resistance
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