The onset of liver injury is a,pivotal event during endotoxemia. Lipopolysa
ccharide (LPS) activates the Kupffer cells (KC), the resident macrophages o
f the liver, to generate an abundance of inflammatory substances, including
nitric oxide (NO). Elevated levels of NO are thought to contribute to the
propagation of liver injury during sepsis. Calcium, a major second messenge
r in several cellular signaling events, is required by the KC for the gener
ation of inducible nitric oxide synthase (iNOS). The purpose of this study
was to determine whether calcium channel antagonists limit hepatic injury a
nd iNOS expression in vivo following LPS exposure and to evaluate their eff
ects on the regulation of iNOS expression in cultured KC. In rats subjected
to LPS for 6 h, the serum alanine aminotransferase (ALT) level was elevate
d significantly; this response was accompanied by an increase in iNOS mRNA
formation in the intact liver. Pretreatment of rats with calcium channel an
tagonists (i.e., diltiazem, nifedipine, or verapamil) before LPS exposure a
ttenuated the serum ALT level and iNOS mRNA expression in the liver. Pretre
atment of cultured KC with calcium channel antagonists for 1 h followed by
the addition of LPS markedly repressed iNOS protein and mRNA expression. Ti
me-course studies revealed that calcium channel antagonists were most effec
tive at inhibiting LPS-induced iNOS mRNA formation by KC when added before
LPS. Treatment of KC with calcium channel antagonists prior to the addition
of LPS decreased nuclear levels of the p65 subunit of nuclear factor-kappa
B and prevented the LPS-dependent degradation of the inhibitory protein I
kappa B alpha. Thus our findings indicate that under endotoxemic conditions
calcium channel antagonists limit hepatocellular injury that is accompanie
d by an inhibition of LPS-mediated iNOS expression in rat liver KC.