Key result
Continuous nitroglycerin increases aortic PDE1A1 expression ~2.3-fold, suggesting a mechanism for nitrate tolerance.
Why the study?
The development of nitrate tolerance limits the efficacy of nitroglycerin as a vasodilator, and the underlying molecular mechanisms remain to be fully elucidated.
Effect estimate: 2.3-fold increase
Upregulation of PDE1A1 is a potential mechanism for nitrate tolerance, suggesting PDE1A1 inhibition as a novel therapeutic approach.
Suggests PDE1A inhibition as potential strategy against nitrate tolerance; leaves open translation from animal models to patients.
BACKGROUND: The efficacy of nitroglycerin (NTG) as a vasodilator is limited by tolerance, which develops shortly after treatment begins. In vascular smooth muscle cells (VSMCs), NTG is denitrated to form nitric oxide (NO), which activates guanylyl cyclase and generates cGMP. cGMP plays a key role in nitrate-induced vasodilation by reducing intracellular Ca(2+) concentration. Therefore, one possible mechanism for development of nitrate tolerance would be increased activity of the cGMP phosphodiesterase (PDE), which decreases cGMP levels. METHODS AND RESULTS: To test this hypothesis, rats were made tolerant by continuous infusion of NTG for 3 days (10 microgram kg(-1). min(-1) SC) with an osmotic pump. Analysis of PDE activities showed an increased function of Ca(2+)/calmodulin (CaM)-stimulated PDE (PDE1A1), which preferentially hydrolyzes cGMP after NTG treatment. Western blot analysis for the Ca(2+)/CaM-stimulated PDE revealed that PDE1A1 was increased 2.3-fold in NTG-tolerant rat aortas. Increased PDE1A1 was due to mRNA upregulation as measured by relative quantitative reverse transcription-polymerase chain reaction. The PDE1-specific inhibitor vinpocetine partially restored the sensitivity of the tolerant vasculature to subsequent NTG exposure. In cultured rat aortic VSMCs, angiotensin II (Ang II) increased PDE1A1 activity, and vinpocetine blocked the effect of Ang II on decrease in cGMP accumulation. CONCLUSIONS: Induction of PDE1A1 in nitrate-tolerant vessels may be one mechanism by which NO/cGMP-mediated vasodilation is desensitized and Ca(2+)-mediated vasoconstriction is supersensitized. Inhibiting PDE1A1 expression and/or activity could be a novel therapeutic approach to limit nitrate tolerance.
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Kim et al. (2001) studied Nitrate tolerance. Continuous infusion of nitroglycerin was evaluated on PDE1A1 expression and activity (2.3-fold increase). Continuous infusion of nitroglycerin in rats increased PDE1A1 expression 2.3-fold in aortas, suggesting a mechanism for nitrate tolerance.
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