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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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“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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Metadata
- 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 (medical) › 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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