Análise da concentração de nitrato no líquido cefalorraquidiano e da atividade enzimática das óxido nítrico sintases no hipotálamo de ratos submetidos à sepse experimental / Analysis of nitrate concentration in the cerebrospinal fluid and of the enzymatic activity of nitric oxide synthase in the hypothalamus of rats submitted to experimental sepsis.

Fábio Alves Aguila

Sepsis is defined as a systemic inflammatory response to an infectious stimulus. In the initial phase of the disease the secretion of vasopressin (AVP) is increased and late is observed a reduction, although high levels of inflammatory mediators and worsening of the hypotension, which are stimuli for the hormone secretion. Nitric oxide (NO) produced by the enzyme nitric oxide synthase (NOS), appears to modulate the secretion of AVP depending on the pathophysiological context. During experimental sepsis our group demonstrated that the plasma nitrate concentrations, which serve as an index of NO production, increase gradually during the course of the disease. However, there is no evidence that this also occurs at the central level. Our aim was to evaluate the temporal nitrate concentration in the cerebrospinal fluid (CSF) and the enzymatic activity of NOS in the hypothalamus of rats submitted to sepsis by cecal ligation and puncture (CLP). The procedures, approved by the Ethics Committee on Animal Use of the Campus of Ribeirão Preto (CEUA - USP, Protocol nº10.1.294.53.7) were performed with Wistar rats weighing 250 ± 30 grams, which were divided into two groups: CLP and Sham operation. After 0, 2, 6 and 24 hours of surgery, CSF was collected for determining the nitrate concentration by the chemiluminescence NO/ozone method. Immediately after, the animals were decapitated, blood was collected and used for hematocrit, serum sodium, protein, interleukin (IL)-1?, nitrate and plasma AVP determination. The neurohypophysis was removed for AVP content determinations and hypothalamus for NOS activity analysis by the method of citrulline. In septic animals, plasma concentrations of AVP showed the expected pattern, an increase at 2h and 6h and returning to basal levels at 24h. The AVP neurohypophyseal stocks decreased at 2h and 6h returning to basal levels at 24h. The sodium serum and plasma proteins decreased 2h, 6h and 24h after CLP, and the hematocrit increased at the same periods. The plasma concentration of IL-1? and nitrate increased 6h and remained elevated 24h after CLP. However, in the cerebrospinal, nitrate increased at 6h but returned to basal level in 24h. The total and constitutive NOS activities were fifty to one hundred times higher than inducible NOS and were increased 6h and 24h after CLP. These results suggest that the activity of NOS observed in the hypothalamus ex vivo of rats septic indicates the presence of viable forms of enzymes, and that the constitutive isoform is the most relevant for the NO production in this brain region. Moreover the temporal alterations of the nitrate concentrations in the CSF differ from the plasma nitrate, showing a different profile of the central and peripheral NO production, which may be related to biphasic AVP secretion in the sepsis.

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