Evidence for enhanced vascular superoxide anion production in nitrate tolerance. A novel mechanism underlying tolerance and cross-tolerance

J Clin Invest. 1995 Jan;95(1):187-94. doi: 10.1172/JCI117637.

Abstract

We sought to examine mechanisms underlying nitroglycerin (NTG) tolerance and "cross-tolerance" to other nitrovasodilators. Rabbits were treated for 3 d with NTG patches (0.4 mg/h) and their aortic segments studied in organ chambers. Relaxations were examined after preconstriction with phenylephrine. In NTG tolerant rabbit aorta, relaxations to cGMP-dependent vasodilators such as NTG (45 +/- 6%), SIN-1 (69 +/- 7%), and acetylcholine (ACh, 64 +/- 5%) were attenuated vs. controls, (90 +/- 2, 94 +/- 3, and 89 +/- 2% respectively, P < 0.05 for all), while responses to the cAMP-dependent vasodilator forskolin remained unchanged. In tolerant aorta, endothelial removal markedly enhanced relaxations to NTG and SIN-1 (82 +/- 4 and 95 +/- 3%, respectively). Other studies were performed to determine how the endothelium enhances tolerance. Vascular steady state .-O2 levels (assessed by lucigenin chemiluminescence) was increased twofold in tolerant vs. control vessels with endothelium (0.31 +/- 0.01 vs. 0.61 +/- 0.01 nmol/mg per minute). This difference was less in vessels after denudation of the endothelium. Diphenylene iodonium, an inhibitor of flavoprotein containing oxidases, and Tiron a direct .-O2 scavenger normalized .-O2 levels. In contrast, oxypurinol (1 mM) an inhibitor of xanthine oxidase, rotenone (50 microM) an inhibitor of mitochondrial electron transport and NG-nitro-L-arginine (100 microM) an inhibitor of nitric oxide synthase did not affect the chemiluminescence signals from NTG-tolerant aortas. Pretreatment of tolerant aorta with liposome-entrapped, pH sensitive superoxide dismutase (600 U/ml) significantly enhanced maximal relaxation in response to NTG, SIN-1, and ACh, and effectively reduced chemiluminescence signals. These studies show that continuous NTG treatment is associated with increased vascular .-O2-production and consequent inhibition of NO. mediated vasorelaxation produced by both exogenous and endogenous nitrovasodilators.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acetylcholine / pharmacology
  • Animals
  • Aorta / metabolism*
  • Biphenyl Compounds / pharmacology
  • Colforsin / pharmacology
  • Dose-Response Relationship, Drug
  • Drug Tolerance
  • Endothelium, Vascular / metabolism
  • Female
  • In Vitro Techniques
  • Liposomes / pharmacology
  • Male
  • Molsidomine / analogs & derivatives
  • Molsidomine / pharmacology
  • Nitro Compounds / pharmacology*
  • Nitroglycerin / pharmacology*
  • Onium Compounds / pharmacology
  • Rabbits
  • Superoxide Dismutase
  • Superoxides / metabolism*
  • Vasodilation / drug effects
  • Vasodilator Agents / pharmacology*

Substances

  • Biphenyl Compounds
  • Liposomes
  • Nitro Compounds
  • Onium Compounds
  • Vasodilator Agents
  • diphenyliodonium
  • Superoxides
  • Colforsin
  • linsidomine
  • Molsidomine
  • Superoxide Dismutase
  • Nitroglycerin
  • Acetylcholine