Background. Lactoferrin (LF) and its effects on airway macrophages (M phi) are poorly characterized. Since LF binds lipopolysaccharide (LPS), and nitric oxide (NO) production by M phi is induced with LPS, M phi-related responses to both molecules were studied. Methods. Rat lung M phi were treated with LF and/or LPS for 24 h, and thereafter the NO metabolite nitrite was measured in culture supernatants. At 24 h, M phi-related expression of inducible NO synthase (iNOS) was determined by Northern analysis. To understand how LF might alter iNOS expression, nuclear factor kappa B (NF-kappa B) activation was studied in M phi. Results. LF did not stimulate M phi-related nitrite production at concentrations present in bronchial mucus. An excess of LF increased M phi-related nitrite production, but NO generation was less than that initiated by LPS. The LPS-binding peptide, polymyxin B, reduced LF and LPS responses to basal levels. After 24 h, mRNA expression of iNOS was lower in M phi treated with LF or LF + LPS vs. LPS alone. M phi had markedly increased NF-kappa B activation when treated with LPS or LPS + LF, while LF minimally increased NF-kappa B nuclear binding compared to untreated cells. Conclusions. M phi responses to LF may be induced by the LF-LPS complex rather than LF alone. Molecular responses of M phi to LPS differ from those of M phi stimulated by LF or the LF-LPS complex. These findings are likely important in the control of lung inflammation and injury.