Harbrecht BG, Nweze I, Smith JW, Zhang B. Insulin inhibits hepatocyte iNOS expression induced by cytokines by an Akt-dependent mechanism. Am J Physiol Gastrointest Liver Physiol 302: G116-G122, 2012. First published October 28, 2011 doi:10.1152/ajpgi.00114.2011.-Hepatocyte inducible nitric oxide synthese (iNOS) expression is a tightly controlled pathway that mediates hepatic inflammation and hepatocyte injury in a variety of disease states. We have shown that cyclic adenosine monophosphate (cAMP) regulates cytokine-induced hepatocyte iNOS expression through mechanisms that involve protein kinase B/Akt. We hypothesized that insulin, which activates Akt signaling in hepatocytes, as well as signaling through p38 and MAPK p42/p44, would regulate iNOS expression during inflammation. In primary rat hepatocytes, insulin inhibited cytokine-stimulated nitrite accumulation and iNOS expression in a dose-dependent manner. Inhibition of MAPK p42/p44 with PD98059 had no effect on iNOS activation, whereas SB203580 to block p38 reversed insulin's inhibitory effect. However, insulin did not increase p38 activation and inhibition of p38 signaling with a dominant negative p38 plasmid had no effect on cytokine-or insulin-mediated effects on iNOS. We found that SB203580 blocked insulin-induced Akt activation. Inhibition of Akt signaling with LY294002 or a dominant negative Akt plasmid increased cytokine-stimulated nitrite production and iNOS protein expression and blocked the inhibitory effects of insulin. NF-B induces iNOS expression and can be regulated by Akt, but insulin had no effect on cytokine-mediated IB␣ levels or NF-B p65 translocation. Our data demonstrate that insulin inhibits cytokine-stimulated hepatocyte iNOS expression and does so through effects on Aktmediated signaling. nitric oxide; nitric oxide synthase; sepsis; inflammation; liver HEPATIC DYSFUNCTION WAS IDENTIFIED decades ago as a component of the multiple organ failure syndrome (10). Liver dysfunction can be manifested in a variety of ways and is associated with increased morbidity and mortality in critically ill patients (13,18,25). Nitric oxide synthesis is an important pathway in the host's response to inflammation and mediates hepatic dysfunction and hepatic injury in models of shock and organ failure (19,28). Proinflammatory cytokines stimulate hepatic nitric oxide production, and we have shown that glucagon and cyclic AMP inhibit hepatocyte inducible nitric oxide synthase (iNOS) expression (14 -16). The role of other counterregulatory mediators produced in shock and sepsis on iNOS regulation remain incompletely studied (8). Glucagon and cAMP regulate hepatocyte iNOS expression through intracellular signaling pathways involving 20,44). Our laboratory and others have demonstrated that cAMP activates protein kinase B/Akt in hepatocytes (9,27,43,45). Akt-mediated signaling changes have profound effects on hepatocyte function and physiology (9, 27, 43), and we have shown that the cAMP-induced changes in iNOS expression are mediated in part through Akt-induce...