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Nitric oxide (NO) formed by the action of inducible form of nitric oxide
synthase (iNOS), reacts with oxygen radical forming reactive nitrogen
intermediate (RNI). NO and related RNI have been reported to possess
antimycobacterial activity. Macrophages can inhibit the proliferation of
Mycobacterium tuberculosis by producing NO. In murine models, the ability of
macrophages to produce NO can determine the susceptibility of the host to M.
tuberculosis and the virulence of M. tuberculosis. However, it is still not
clear whether NO is involved in the defense mechanism against M. tuberculosis in
humans. We have demonstrated that human peripheral blood mononuclear cells
(PBMC) and airway epithelial cells can express iNOS mRNA expression and produce
NO production in response to tubercle bacilli stimulation. Furthermore, H37Ra,
avirulent strain of M. tuberculosis, induces a larger amount of NO in cultured
PBMC than H37Rv, virulent strain, does. There was no difference in NO production
between healthy volunteers and patients with tuberculosis. NO production in
airway epithelial cells is closely related with IFN gamma concentration. The
balance of stimulatory cytokines and inhibitory cytokines for NO production may
play a critical role in the defense mechanism against M. tuberculosis
considering that NO production is upregulated by IFN gamma, TNF alpha, and IL-1
beta and downregulated by IL-10 and TGF beta. The study of immune response to M.
tuberculosis including NO production may give us a better understanding of the
pathogenesis of tuberculosis.