Cytokine-induced intestinal epithelial hyperpermeability: role of nitric oxide

Crit Care Med. 1999 Oct;27(10):2246-51. doi: 10.1097/00003246-199910000-00030.


Objective: Incubation of enterocytic monolayers with interferon (IFN)-gamma increases nitric oxide (NO) production and permeability, but NO synthesis inhibitors ameliorate the development of IFN-gamma-induced hyperpermeability. Induction of inducible nitric oxide synthase (iNOS), an isoform of the enzyme responsible for NO biosynthesis, is often enhanced by the synergistic effects of multiple cytokines. Moreover, many of the cytopathic effects of NO are mediated by peroxynitrite, which is produced by the reaction of NO with superoxide radical anion. In the present study, we sought to determine whether combinations of several proinflammatory cytokines, including IFN-gamma, interleukin-1beta, and tumor necrosis factor-alpha, have synergistic effects on the induction of iNOS expression and/or hyperpermeability to hydrophilic solutes in cultured enterocytic monolayers. We also assessed the effects of aminoguanidine (a relatively selective iNOS inhibitor), L-N(G)-monomethyl arginine (an isoform-nonselective NO synthase inhibitor), and Tiron (a superoxide radical anion scavenger) on the development of cytokine-induced hyperpermeability.

Design: Caco-2 monolayers were incubated under control conditions or with IFN-gamma, interleukin-1beta, or tumor necrosis factor-alpha alone, pairwise combinations of these cytokines, or all three cytokines together (cytomix; CM). iNOS messenger RNA (mRNA) expression was assessed using Northern blot analysis. The permeability of Caco-2 monolayers growing on permeable supports in bicameral chambers was assessed by measuring the apical-to-basolateral flux of fluorescein disulfonic acid. The concentration of nitrate plus nitrite in culture supernatants, an indirect measure of NO production, was determined using the Griess reaction.

Results: After 24 hrs of incubation, up-regulation of iNOS mRNA expression was evident only in cells exposed to IFN-gamma-containing formulations. Expression of iNOS mRNA was far greater in cells incubated with CM than in cells treated with IFN-gamma alone or either of the two-component IFN-gamma-containing cytokine combinations. Compared with IFN-gamma, CM resulted in a higher rate of NO production over 48 hrs of incubation. The permeability of Caco-2 monolayers increased by approximately six-fold and approximately 20-fold after incubation for 48 hrs with IFN-gamma alone and CM, respectively. The increase in permeability induced by incubation with CM was significantly ameliorated by the addition of aminoguanidine, L-N(G)-monomethyl arginine, or Tiron.

Conclusions: IFN-gamma-containing combinations of cytokines are potent inducers of iNOS in cultured enterocytic monolayers. Peroxynitrite may be an important mediator of cytokine-induced gut epithelial hyperpermeability.

Publication types

  • Comparative Study

MeSH terms

  • 1,2-Dihydroxybenzene-3,5-Disulfonic Acid Disodium Salt / pharmacology
  • Blotting, Northern
  • Caco-2 Cells / drug effects
  • Caco-2 Cells / metabolism
  • Cell Membrane Permeability / drug effects*
  • Culture Media / pharmacology
  • Enterocytes / drug effects
  • Enterocytes / metabolism*
  • Enterocytes / pathology
  • Enzyme Inhibitors / pharmacology
  • Guanidines / pharmacology
  • Humans
  • Indicators and Reagents / pharmacology
  • Interferon-gamma / pharmacology*
  • Interleukin-1 / pharmacology*
  • Membrane Proteins / biosynthesis
  • Membrane Proteins / genetics
  • Nitric Oxide / physiology*
  • Nitric Oxide Synthase / antagonists & inhibitors
  • Nitric Oxide Synthase / biosynthesis
  • Nitric Oxide Synthase / genetics
  • Nitric Oxide Synthase Type II
  • RNA, Messenger / genetics
  • RNA, Neoplasm / genetics
  • Tumor Necrosis Factor-alpha / pharmacology*
  • omega-N-Methylarginine / pharmacology


  • Culture Media
  • Enzyme Inhibitors
  • Guanidines
  • Indicators and Reagents
  • Interleukin-1
  • Membrane Proteins
  • RNA, Messenger
  • RNA, Neoplasm
  • Tumor Necrosis Factor-alpha
  • omega-N-Methylarginine
  • Nitric Oxide
  • 1,2-Dihydroxybenzene-3,5-Disulfonic Acid Disodium Salt
  • Interferon-gamma
  • NOS2 protein, human
  • Nitric Oxide Synthase
  • Nitric Oxide Synthase Type II
  • pimagedine