The potential of stimulating nitric oxide formation in the treatment of hypertension

Introduction: Hypertension is a leading cause of morbidity and mortality worldwide. A major pathophysiological factor contributing to hypertension is reduced nitric oxide (NO) bioavailability. Strategies to address this pathophysiological mechanism could offer significant advantages.

Areas covered: In this review we aimed at examining a variety of drugs (statins, beta-adrenergic receptor blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin II type-1 receptor blockers) used to treat hypertension and other cardiovascular diseases, particularly with respect to their potential of increasing NO bioavailability and activity in the cardiovascular system. There is now evidence supporting the notion that many cardiovascular drugs activate NO signaling or enhance NO bioavailability as a contributing mechanism to their beneficial cardiovascular effects. Moreover, other drugs may attenuate NO inactivation by superoxide and other reactive oxygen species by exerting antioxidant effects. More recently, the NO oxidation products nitrite and nitrate have been acknowledged as sources of NO after recycling back to NO. Activation of the nitrate-nitrite-NO pathway is an alternate pathway that may generate NO from both anions and exert antihypertensive effects.

Expert opinion: In this review, we provide an overview of the possible mechanisms by which these drugs enhance NO bioavailability and help in the therapy of hypertension.     

Putative role of nitric oxide synthase isoforms in the changes of nitric oxide concentration in rat brain cortex and cerebellum following sevoflurane and isoflurane anaesthesia

We have previously observed an increase in nitric oxide (NO) content in rat brain cortex following halothane, sevoflurane or isoflurane anaesthesia. This study was undertaken in order to determine whether isoform-specific nitric oxide synthase (NOS) inhibitors and inducers could modify these increases in NO contents. Rats were subjected to isoflurane and sevoflurane anaesthesia with concomitant administration of neuronal nitric oxide synthase (nNOS) inhibitor 7-Nitro-indazole (7-NI), inducible nitric oxide synthase (iNOS) inhibitor 2-amino-5,6-dihydro-6-methyl-4H-1,3-thiazine (AMT) or lipopolysaccharide. NO concentration in different organs was measured by electron paramagnetic resonance (EPR) spectroscopy. 7-NI significantly decreased NO concentration in cerebellum but not in brain cortex, whereas AMT decreased NO in all the organs studied. Anaesthesia significantly increased NO concentration in brain cortex and decreased that in cerebellum. AMT abolished the NO increase in brain cortex. Anaesthesia enhanced the drastic increase in NO concentration in brain cortex after intraventricular lipopolysaccharide administration. Isoflurane was found to inhibit recombinant nNOS and iNOS activities at high concentrations (EC50=20 mM). Our data suggest a putative role for iNOS in the increase in NO levels produced by isoflurane and sevoflurane, whereas nNOS activity is probably inhibited during anaesthesia.     

Increase in gastric intramucosal hydrogen ion concentration following endotoxin challenge in the rat and the actions of nitric oxide synthase inhibitors

1. Cardiovascular events and outcome in septic shock may be predicted by monitoring the fall in intramural pH (pHi), as an index of splanchnic perfusion and mucosal ischaemia. In the present study, a small animal model for monitoring the changes of gastric pHi or intramucosal [H+] following challenge with the endotoxin lipopolysaccharide (LPS) was developed in the rat. The role of nitric oxide (NO) in these events in this model was evaluated using the non-selective NO synthase (NOS) inhibitors N(G)-nitro-L-arginine methyl ester (L-NAME) and N(G)-monomethyl-L-arginine (L-NMMA). 2. The pHi and intramucosal [H+] were evaluated in omeprazole-pretreated rats (30 mg/kg, i.p.) using the Henderson equation after estimating the PCO2 and the bicarbonate concentration in gastric wall. To measure gastric wall PCO2, the oesophagus was intubated and the pylorus ligated. The PCO2 was measured by a blood gas analyser in 2 mL saline instilled for 30 min in the gastric lumen to equilibrate with the gastric wall. The pHi was measured under basal conditions and 3 and 5 h after LPS (3 mg/kg) administration. Separate groups received treatment with L-NMMA (25-50 mg/kg) or L-NAME concomitantly or 2.5 h after administration of LPS. 3. Intravenous administration of Escherichia coli LPS provoked a significant fall in gastric pHi from 7.37 to 7.18 (median values; n =10-19) determined after 5 h. In groups treated concurrently with LPS and L-NAME (5 mg/kg; n = 19), there was a similar increase in intramucosal [H+] as that induced by LPS alone (n = 15) in those animals that survived. In contrast, L-NAME (5 mg/kg; n = 12), given 2.5 h after LPS challenge, at a time at which inducible NOS is known to be significantly expressed, prevented the increase in intramucosal [H+] at 3 and 5 h after LPS challenge. Similarly, L-NMMA (25-50 mg/kg; n = 23), given 2.5 h after LPS challenge, dose-dependently inhibited the increase in intramucosal [H+] at 3 and 5 h. 4. In conclusion, these findings indicate that this rat model could be useful in exploring the pathophysiology of acute endotoxin shock. Delayed administration of L-NAME and L-NMMA abolished the increase in gastric intramucosal [H+], supporting the involvement of excess NO in the tissue dysfunction associated with endotoxin shock. This suggests the potential value of this small animal model in evaluating the therapeutic activity of novel agents for use in septic shock.     

香菇多糖对巨噬细胞一氧化氮和一氧化氮合酶活性的影响

目的研究香菇多糖(LTN)诱导巨噬细胞的一氧化氮(NO)生成和一氧化氮合酶(iNOS)的活性,探讨LTN的免疫调节作用机理.方法采用Griess反应和荧光法测定不同剂量的LTN作用小鼠腹腔巨噬细胞后NO的生成量和iNOS活性.观察mRNA转录抑制剂、蛋白质合成抑制剂和iNOS抑制剂对巨噬细胞NO的生成和iNOS活性的影响.结果LTN能使小鼠腹腔巨噬细胞NO生成增加,iNOS活性增高,并呈作用剂量依赖关系.3种抑制剂均能抑制LTN诱导的小鼠腹腔巨噬细胞N0的生成和iNOS活性.结论LTN能刺激小鼠腹腔巨噬细胞提高iNOS活性和NO的生成.提示LTN的免疫调节作用机制可能与LTN刺激巨噬细胞NO生成有关.     

花色素苷诱导小鼠巨噬细胞一氧化氮生成及其机制

目的研究花色素苷对小鼠腹腔巨噬细胞一氧化氮(NO)合成的诱导作用及其机制。方法用CCK-8试剂检测花色素苷对小鼠脾细胞增殖的影响;硝酸盐还原酶法检测小鼠腹腔巨噬细胞NO含量;荧光法检测一氧化氮合酶(NOS)活性;RT-PCR检测iNOS mRNA的表达。结果花色素苷可促进小鼠脾细胞增殖,诱导小鼠腹腔巨噬细胞合成NO,提高NOS活性,其中矢车菊素-3-葡萄糖苷能够诱导iNOS mRNA的表达。结论花色素苷能够促进脾细胞的增殖,诱导小鼠腹腔巨噬细胞合成NO,使巨噬细胞激活,具有一定的免疫调节活性。     

一氧化氮合酶抑制剂的研究进展

一氧化氮（ｎｉｔｒｉｃｏｘｉｄｅ,ＮＯ）是一种能调节细胞多种功能的信息分子,它参与心血管、外周和中枢神经以及免疫等系统生理过程和生物信号的调节。体内组织中的ＮＯ由ＮＯ合酶（Ｎｉｔｒｉｃｏｘｉｄｅｓｙｎｔｈａｓｅ,ＮＯＳ）催化左旋精氨酸而合成,合成后的ＮＯ迅速跨膜扩散释放。各种调节ＮＯ释放的因素均作用于ＮＯＳ催化的化学反应过程,而体内影响该反应的ＮＯＳ在各组织的表达不同。特异性ＮＯＳ抑制剂通过调控ＮＯ的合成,对ＮＯＳ表达相关的各种疾病的预防和治疗具有重要的临床意义。本文对近年来ＮＯＳ抑制剂的研究进展作一概述。     

Constitutive nitric oxide synthases in the heart from hypertrophy to failure

1. Endogenous myocardial nitric oxide (NO) may modulate the transition from adaptive to maladaptive hypertrophy leading to heart failure. This review summarizes the information on the interrelations between the precise localization of NO synthases (NOS) and their regulatory functions within different compartments of the heart. 2. In rodent models of pressure overload or myocardial infarction, the three NOS isoforms (NOS1, NOS2, NOS3) were shown to play a neutral, protective, or even adverse role in myocardial remodelling, depending on the NOS activity, the location of each NOS and their regulators. 3. The analysis of conditions that modulate the expression of NOS1 and NOS3 in the heart according to physiopathological situations, indicated that, beside the level of total NOS activity, unique changes in NO compartmentation secondary to NOS1 or NOS3 subcellular location might be involved in the development of cardiac hypertrophy and failure. 4. Thus, different circuits in NO-signalling pathways in myocardium might be activated and this principle is a key to understand contradictions existing in NO biology in the heart. Unravelling the mechanisms behind the NO, NOS and cardiac function is still an ongoing challenge.     

Cardiovascular responses and nitric oxide production in cerebral ischemic rats

We investigated that the role of nitric oxide (NO) on ischemic rats in brain and heart. Ischemia was induced by both common carotid arteries (CCA) occlusion for 24h following reperfusion. Then tissue samples were removed and measured NOx. In brain, NOx was increased by about 40% vs. normal and it was significantly inhibited by aminoguanidine, selective iNOS inhibitor. This result showed that NOx concentration was increased by iNOS. We investigated the role of Ca2+ during ischemia. Nimodipine, L-type calcium channel blocker, didn't inhibit the increases of NOx concentration during ischemia. It suggested that increased NOx was due to calcium-independent NOS. MK-801, which N-methyl-D-aspartate (NMDA) receptor antagonist, didn't significantly prevent the increases of NOx. In heart, ischemia caused NOx decrease and it is inconsistent with NOx increase in brain. Aminoguanidine and nimodipine didnt affect on NOx decrease. But MK-801 more lowered NOx concentration than those of ischemia control group. It seemed that Ca2+ influx in heart partially occurred via NMDA receptor and inhibited by NMDA receptor antagonist. The mean arterial pressure (MAP) in ischemic rats after 24h of CCA occlusion was decreased when compared to normal value, whereas the heart rates (HR) was not different between two groups. Aminoguanidine or MK801 had no effect on MAP or HR, but nimodipine reduced MAP. There was no difference the effects of aminoguanidine, nimodipine, or MK-801, on MAP and HR between normal rats and ischemic rats. In summary, ischemic model caused an increase of NOx concentration, suggesting that this may be produced via iNOS, which is calcium independent in brain. However in heart, ischemia decreased NOx concentration and NMDA receptor was partially involved. The basal MAP was decreased in ischemic rats but HR was not different from normal control, suggesting that increased NOx in brain of ischemic rat may result in the hypotension.     

戊四唑癫痫大鼠脑组织一氧化氮含量和一氧化氮合酶活性变化

探讨一氧化氮在戊四唑癫病发机制中的作用。方法每天注射戊四唑建立在鼠癫痫模型,测定癫病发作后大鼠大脑皮质,海马一氧化氮和一氧化氮合酶活性变化,结果癫痫发作后海马ＮＯ含量和ＮＯＳ活性显著升高,结 戊四唑诱导的癫痫中具有致痫性。     

罗红霉素通过诱导型一氧化氮合酶/一氧化氮途径抑制哮喘大鼠气道炎症

目的探讨罗红霉素对哮喘大鼠支气管诱导型一氧化氮合酶(iNOS)及一氧化氮(NO)的影响。方法24只成年哮喘大鼠随机分成对照组、哮喘组以及罗红霉素组。对支气管肺泡灌洗液(BALF)细胞总数及嗜酸性粒细胞计数,免疫组织化学检测大鼠支气管上皮细胞iNOS蛋白表达,RT-PCR检测肺组织iNOS mRNA表达,分光光度计检测肺组织iNOS活性及NO含量。双抗体夹心法检测肺组织白细胞介素-4(IL-4)及干扰素-γ(IFN-γ)。结果哮喘组大鼠BALF细胞总数及嗜酸性粒细胞分类分别为(7.28±1.65)×108.L-1、(7.73±1.54)%,均高于对照组(3.76±0.97)×108.L-1、(1.27±0.60)%;罗红霉素组BALF细胞总数及嗜酸性粒细胞分类分别为(5.68±0.95)×108.L-1、(5.54±1.53)%,明显低于哮喘组,差异有统计学意义。哮喘组肺组织IL-4浓度、iNOS活性及NO含量高于对照组,罗红霉素组肺组织IL-4浓度、iNOS活性及NO含量低于哮喘组。哮喘组肺组织IFN-γ浓度低于对照组,罗红霉素组肺组织IFN-γ浓度高于哮喘组。哮喘大鼠支气管上皮细胞iNOS蛋白及肺组织iN-OSmRNA表达分布吸光度值分别为(0.25±0.06)、(0.52±0.14),较对照组[(0.14±0.05),(0.33±0.05)]明显增强;但罗红霉素组iNOS蛋白及mRNA表达为(0.15±0.03)、(0.35±0.07),均明显较哮喘组减弱。结论罗红霉素通过干预哮喘大鼠气道IL-4、IFN-γ以及iNOS/NO体系,抑制哮喘气道炎症反应。     

Distinct regulation of inner medullary collecting duct nitric oxide production from mice and rats

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高压氧对脑梗死后血清一氧化氮和一氧化氮合酶含量的影响

目的 研究高压氧对脑梗死后血清一氧化氮、一氧化氮合酶含量的影响。方法 将脑梗死患者分为高压氧治疗组和非高压氧治疗组,观察不同病期血清一氧化氮、一氧化氮合酶含量的变化,并与正常对照组进行比较。结果 高压氧治疗组一氧化氮含量较非高压氧治疗组上升快,在治疗后15天恢复正常,但在一疗程高压氧治疗结束后,却又有所下降;一氧化氮合酶含量在治疗后均有上升,未能恢复到正常水平,两组之间无差异。结论 高压氧通过提高NO的含量,减轻缺血区脑组织的损伤,改善脑血循环;高压氧对NOS有一定影响,但作用不大;应适当延长高压氧疗程,尽可能缓解因NOS含量下降所造成的NO释放量不足。     

一氧化氮在大鼠心肌缺血后处理中的作用

目的:探讨在体条件下,一氧化氮(NO)对缺血后处理心肌保护作用的影响及可能的途径。方法:建立大鼠在体缺血再灌注模型,将24只大鼠随机分为假手术组、缺血再灌注组、缺血后处理组及一氧化氮合酶(NO S)抑制剂NW-L硝-基精氨酸甲酯(L-NAM E)药物干预后处理组(药物干预组)。于再灌注末测定血浆肌钙蛋白I(cT n I),NO,超氧化物歧化酶(SOD)及丙二醛(M DA)的含量,测定心肌组织梗死面积,免疫组化方法观察心肌组织内皮型一氧化氮合酶(eNO S)的表达。结果:与缺血再灌注组及药物干预组相比,缺血后处理组心肌梗死面积明显减少,血浆cT n I,M DA含量降低,血浆NO,SOD含量升高,心肌细胞胞浆内eNO S表达增加。结论:缺血后处理通过eNO S/NO信号通路,抑制脂质过氧化反应,减轻心肌缺血/再灌注损伤。     

神经元型一氧化氮合酶在心脏功能调节中的作用

神经元型一氧化氮合酶(nNOS)不仅在神经细胞中表达,也存在于心肌细胞。生理状况下,nNOS源性的一氧化氮(NO)通过自分泌以负反馈的调节方式维持细胞内Ca2+浓度稳态,防止细胞内Ca2+浓度超载,对于维持正常的心功能具有重要意义。病理状况下,nNOS的活性发生明显变化,nNOS源性的NO可能参与了心脏疾病的发生和发展。     

一氧化氮在缺血性脑损伤中作用的实验研究进展

一氧化氮 (NO)在缺血性脑损伤中具有双重作用 ,既表现为神经保护作用 ,又有神经毒性作用。在脑缺血过程中 ,源于内皮型一氧化氮合酶 (eNOS)产生的NO有神经保护作用 ,源于神经元型一氧化氮合酶 (nNOS)和诱导型一氧化氮合酶 (iNOS)过度表达所形成的NO有神经毒性作用。利用NO的双重作用 ,找到防治脑缺血的药物及给药时间和剂量等一直是研究的热点。     

一氧化氮在阿霉素心脏毒性中的双重作用

蒽环类抗生素阿霉素（Doxombicin,DOX）是一种高效的抗肿瘤药物,主要用于治疗血液学疾病以及各种实体瘤。但因其引发多重生物化学通道的细胞损伤,进而导致严重的剂量依赖性心脏毒性作用,使其临床应用及治疗指数受到限制与影响。NO是与心脏病理生理学相关的重要生物信使分子,其在阿霉素心脏毒性中的重要作用受到了普遍的关注。本文通过查阅近年来的国内外有关文献,对于此焦点问题进行了分析总结。     

Role of nitric oxide produced by constitutive and inducible nitric oxide synthases in the mouse gastric fundus

In the present study, the role of nitric oxide (NO) produced by constitutive and inducible nitric oxide synthases (cNOS and iNOS, resepctively) on the contraction and relaxation of fundus in normal and lipopolysaccharide (LPS)-treated mice was examined. A whole fundic ring isolated from mice pretreated with reserpine was mounted in an organ bath containing Krebs' solution with 0.001 mmol/L atropine. Rings were contracted initially by 5-hydroxytryptamine (5-HT; 0.03 mmol/L) before relaxation was induced using ATP (0.03 mmol/L), ADP (0.03 mmol/L), pentoxifylline (0.002 mmol/L), electrical field stimulation (EFS; 50 V, 1 msec, 50 Hz, 3 min) and L-arginine (0.05 mmol/L). All drugs and EFS induced significant relaxation of isolated rings. The relaxations induced were significantly inhibited by N(G)-nitro-L-arginine methyl ester (L-NAME; 1.0 mmol/L). However, the iNOS inhibitors L-N(6)-(1-iminoethyl) lysine hydrochloride (L-NIL; 1.0 mmol/L) and amino guanidine (AMG; 1.0 mmol/L) had no significant effect on tissue relaxation. Then, the relaxant effects of 0.03 mmol/L ATP were tested on precontracted isolated fundic rings taken from 10 mg/kg LPS-treated animals. The non-selective NOS inhibitor L-NAME (10 mg/kg), the iNOS inhibitors L-NIL (3 mg/kg) and AMG (20 mg/kg) and betamethasone (0.1 mg/kg) were used to examine the role of NO produced by iNOS in the relaxation responses. It was found that the level of contraction induced by 0.03 mmol/L 5-HT in rings isolated from LPS-treated animals was significantly (P < 0.5) less than that in rings from untreated mice. However, precontracted tissues from LPS-treated mice were significantly relaxed by ATP and the relaxation response to ATP was significantly inhibited by L-NIL, ANG and betamethasone, but not by L-NAME. We suggest that, in LPS-treated mice, the production of NO from iNOS produces a reduction in the contractile response, as well as a decrease in NO formation by cNOS, resulting in changes to smooth muscle cell function.     

Dinoprostone potentiates cytokines and lipopolysaccharides inducing nitric oxide production in cultured rat hepatocytes 1

目的：探讨地诺前列酮（Ｄｉｎ）对细胞因子（ＩＬ１β,ＴＮＦα,ＩＦＮγ）及脂多糖（ＬＰＳ）诱导的原代培养大鼠肝细胞一氧化氮（ＮＯ）生成的影响,以及环腺苷一磷酸（ｃＡＭＰ）信号通路在诱导过程中的作用．方法：将吲哚美辛（Ｉｎｄ）,Ｄｉｎ,弗司扣林（Ｆｏｒ）及双丁酰环鸟苷一磷酸（ｄｂｃＧＭＰ）分别加入含细胞因子ＴＮＦα,ＩＬ１β,ＩＦＮγ及ＬＰＳ的培养液中,原代培养肝细胞２４ｈ后,采用Ｇｒｉｅｓ反应法测定细胞培养上清中ＮＯ含量,放射免疫法测定细胞内ｃＡＭＰ水平．结果：Ｉｎｄ明显抑制ＬＰＳ与细胞因子刺激所致ＮＯ生成,反之,Ｄｉｎ及Ｆｏｒ促进ＮＯ生成;在同样刺激条件下,Ｄｉｎ与Ｆｏｒ使细胞内ｃＡＭＰ水平增高,而在对照组细胞未观察到上述反应．ｄｂｃＧＭＰ则无论炎性刺激存在与否均无此作用．结论：Ｄｉｎ协同细胞因子及ＬＰＳ诱导肝细胞ＮＯ生成,细胞内第二信使ｃＡＭＰ通路参与此诱导过程．     

大鼠对氟西泮抗痫耐受和依赖时海马中一氧化氮合酶的变化

目的通过测定大鼠对氟西泮抗痫耐受性和依赖性时海马中一氧化氮合酶(NOS)蛋白表达及活性的变化,探讨一氧化氮(NO)在此过程中可能的作用。方法建立大鼠对氟西泮抗痫耐受性和依赖性的模型。运用免疫印迹及免疫组化法检测海马中NOS蛋白表达,以及比色法检测NOS活性的变化。结果大鼠对氟西泮抗痫耐受组的海马中NOS蛋白表达明显高于对照组;而对氟西泮抗痫依赖组则与对照组差别无统计学意义。两组NOS活性均显著高于各自的对照组。结论NO可能是介导氟西泮抗痫耐受性和依赖性的因素之一。