Inhibition of NF-kappa B activation by pyrrolidine dithiocarbamate prevents in vivo expression of proinflammatory genes

Background-The inability to inhibit multiple mediators of septic shock repr esents a major hurdle in the treatment of septic shock. In vivo inhibition of nuclear factor (NF)-kappa B activation, a transcription factor regulatin g expression of many proinflammatory genes, could provide a useful strategy for the treatment of septic shock. Methods and Results-In rats challenged with lipopolysaccharide (LPS) 8 mg/k g IV, we determined the time course of NF-kappa B activation and expression of multiple inflammatory signals: tumor necrosis factor-alpha (TNF-alpha), cyclooxygenase-2 (COX-2), cytokine-inducible neutrophil chemoattractant (C INC), and intercellular adhesion molecule-1 (ICAM)-1. We studied the effect s of in vivo inhibition of NF- kappa B activation using pyrrolidine dithioc arbamate (PDTC) on the expression of these mediators. NF-kappa B activation preceded the induction of TNF-alpha, COX-2, CINC, and ICAM-1 mRNAs, PDTC p revented the LPS-induced NF-kappa B activation but did not inhibit activati on of the transcription factors AP-1, Sp-1, and CREB, PDTC inhibited the LP S-induced expression of TNF-alpha, COX-2, CINC, and ICAM-1 mRNA and protein s and reduced the LPS-induced increases in plasma TNF-alpha, 6-keto-prostag landin F-1 alpha, and CINC concentrations. Inhibition of expression of thes e mediators prevented the increases in myeloperoxidase activity (a measure of neutrophil sequestration) in the heart, lungs, and liver. Conclusions-NF-kappa B activation correlates with LPS-induced expression of TNF-alpha, COX-2, CINC, and ICAM-I genes in vivo. PDTC inhibits NF-kappa B activation and expression of these proinflammatory genes and their product s. Thus, blocking NF-kappa B activation may be an effective strategy in the treatment of septic shock.