(Circulation. 1997;96:1586-1592.)
© 1997 American Heart Association, Inc.
Articles |
From the First Department of Medicine, Osaka University School of Medicine, Osaka, Japan.
Correspondence to Masafumi Kitakaze, MD, The First Department of Medicine, Osaka University School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565, Japan. E-mail kitakaze{at}medone.med.osaka-u.ac.jp
| Abstract |
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Methods and Results The left anterior descending
coronary artery (LAD) was cannulated and perfused with blood
through a bypass tube from the left carotid artery in 65 open-chest
dogs. The intracoronary administration of
NG-nitro-L-arginine methyl ester
(L-NAME, 10 µg · kg-1 ·
min-1), an NO synthase inhibitor,
for 30 minutes increased (P<.05) adenosine levels
in coronary venous blood (123±10 versus 21±3 pmol/mL) and
ecto-5'-nucleotidase activity (64±6 versus 41±4 nmol ·
mg-1 · min-1)
in the LAD-perfused myocardium. The intracoronary
administration of
,ß-methyleneadenosine 5'-diphosphate, an
inhibitor of ecto-5'-nucleotidase, or GF109203X or
calphostin C, both of which are PKC inhibitors, attenuated
the L-NAMEinduced increases in adenosine levels and
ecto-5'-nucleotidase activity. Treatment of cultured human
coronary arterial endothelial cells
(HCAECs) with L-NAME for 30 minutes increased ecto-5'-nucleotidase
activity, which was inhibited by either GF109203X or calphostin C. NO
releasers decreased both ecto-5'-nucleotidase and PKC activities in
HCAECs. Treatment of HCAECs with zaprinast, a selective
inhibitor of cGMP-specific phosphodiesterase, with or
without atrial natriuretic peptide, increased intracellular
cGMP concentrations but did not change ecto-5'-nucleotidase
activity.
Conclusions These results indicate that the inhibition of NO synthesis increases both adenosine production and ecto-5'-nucleotidase activity through the activation of PKC and that NO modulates ecto-5'-nucleotidase via cGMP-independent mechanisms.
Key Words: adenosine nitric oxide proteins cells
| Introduction |
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We have previously reported that the activation of PKC activates ecto-5'-NT in myocardium11 12 and isolated coronary vessels.5 Because NO and NO-generating agents deactivate PKC,13 we hypothesized that the inhibition of NO synthesis increases ecto-5'-NT activity through the activation of PKC, resulting in increases in adenosine levels. To test this hypothesis, we examined the effects of the inhibition of NO synthesis on adenosine production and ecto-5'-NT activity and the role of PKC in this condition in the in vivo canine heart. We also examined the effects of NO and the increases in intracellular cGMP on ecto-5'-NT activity using cultured HCAECs.
| Methods |
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Instrumentation
We anesthetized 65 mongrel dogs of either sex (15 to 21
kg) with sodium pentobarbital (30 mg/kg IV). The
anesthetized dogs were prepared as described
previously11 12 ; the LAD was ligated, cannulated, and
perfused with blood from the left carotid artery through an
extracorporeal bypass tube. CBF in the perfused area was measured with
an electromagnetic flow probe attached to the bypass tube, and CPP was
monitored at the tip of the coronary artery cannula. A small
coronary vein near the center of the perfused area was
cannulated to sample coronary venous blood. A miniature
pressure transducer (P-5, Konigsberg Instruments, Inc) was inserted
into the LV cavity through the LV apex to determine LV dP/dt. A pair of
ultrasonic crystals (5 MHz, 2 mm in diameter; Schuessler) was
implanted in the endomyocardial segment of the LV
anterior wall in the center of the perfused area to measure segmental
length. The lengths of end-diastolic and
end-systolic segments were determined, and FS was calculated as
described previously.14 All hemodynamic
parameters were recorded on a multichannel recorder
(RM-6000, Nihon Kohden).
Human Coronary Arterial Endothelial
Cells
HCAECs (Cryo HCAEC; Clonetics Co Ltd, Sanko Jyunyaku Co Ltd)
were plated in dishes (10 cm in diameter) and grown at 37°C in a 5%
CO2 humidified incubator in modified MCDB131 medium
supplemented with 5% FBS, 10 ng/mL human epidermal growth
factor, 1 µg/mL hydrocortisone, 50 µg/mL gentamicin,
and 50 µg/mL amphotericin B. We preliminarily confirmed that
constitutive NOSs are expressed by immunoblotting
analysis and that NO2- and
NO3- measured with the Griess reaction can be
released in response to bradykinin (1x10-4
mol/L) in HCAECs (1.5±0.1 versus 2.1±0.2 µmol ·
mg protein-1 · 60
min-1, n=4). These cells were used at passages
5 through 10.
Experimental Protocols
Protocol 1. Effects of inhibitions of NO synthesis,
ecto-5'-NT, or PKC or antagonism of adenosine receptors on
coronary hemodynamic and metabolic
parameters in vivo. To examine the effects of the
inhibition of NO synthesis on coronary
hemodynamic and metabolic
parameters, we administered L-NAME (10 µg ·
kg-1 · min-1)
through the bypass tube for 30 minutes in 5 dogs. CBF, CPP, and the
lengths of end-diastolic and end-systolic segments
in the LAD-perfused myocardium were monitored throughout
the protocol. We measured the time course of changes in lactate
concentration, pH, and oxygen content in both coronary
arterial and venous blood. To examine the effects of
endogenous adenosine on coronary
hemodynamic and metabolic
parameters, we administered 8-SPT (25 µg ·
kg-1 · min-1),
an antagonist of adenosine receptors, into the LAD
for 30 minutes in the presence (n=5) and absence (n=5) of L-NAME (10
µg · kg-1 ·
min-1). This dose of 8-SPT completely
abolishes the coronary vasodilatory effect of an
intracoronary infusion of exogenous adenosine (1
µg · kg-1 ·
min-1). To examine the effects of inhibition
of ecto-5'-NT on coronary hemodynamic and
metabolic parameters, we administered AMP-CP
(40 µg · kg-1 ·
min-1), an inhibitor of
ecto-5'-NT, into the LAD for 30 minutes (n=5). The dose of AMP-CP used
in the present study inhibits adenosine production
via an extracellular pathway.15 To examine the effects of
the inhibition of PKC on coronary hemodynamic
and metabolic parameters, we administered
GF109203X (300 ng · kg-1 ·
min-1) or calphostin C (400 ng ·
kg-1 · min-1),
both of which are extensively used as a specific inhibitor
of PKC,16 17 through the bypass tube for 30 minutes (n=5,
respectively). We measured the time course of changes in
coronary hemodynamic and metabolic
parameters in all the groups in protocol 1 as in
L-NAME.
Protocol 2. Effects of the inhibition of NO synthesis on adenosine production in vivo. To examine whether the inhibition of NO synthesis increases adenosine production in the in vivo hearts, we measured the time course of changes in adenosine levels in both coronary arterial and venous blood with (n=5) and without (n=5) intracoronary administration of L-NAME (10 µg · kg-1 · min-1). To examine the mechanistic cellular pathway by which the inhibition of NO synthesis increases adenosine production in the myocardium, we measured the time course of changes in adenosine levels in both coronary arterial and venous blood after intracoronary administrations of AMP-CP (40 µg · kg-1 · min-1) and L-NAME (10 µg · kg-1 · min-1) in 5 dogs. Furthermore, because both NO and NO-generating agents induce an inactivation of PKC,13 we examined whether the inhibition of NO synthesis increased adenosine release through the activation of PKC. We measured the time course of changes in adenosine levels after intracoronary administration of GF109203X (300 ng · kg-1 · min-1) or calphostin C (400 ng · kg-1 · min-1) through the bypass tube during administration of L-NAME (10 µg · kg-1 · min-1) in 5 dogs each.
Protocol 3. Effects of the inhibition of NO synthesis on myocardial 5'-NT and PKC activities. To examine whether the inhibition of NO synthesis modulates ecto-5'-NT and PKC activities, we administered L-NAME (10 µg · kg-1 · min-1) through the bypass tube for 30 minutes in 5 dogs. To examine whether the inhibition of NO synthesis increases ecto-5'-NT activity through the activation of PKC, we administered GF109203X (300 ng · kg-1 · min-1) or calphostin C (400 ng · kg-1 · min-1) through the bypass tube during the administration of L-NAME (10 µg · kg-1 · min-1) in 5 dogs each. We sampled the LAD-perfused myocardium and the myocardium perfused through the LCx as a control. The samples were quickly stored in liquid nitrogen for measurement of ecto-5'-NT and PKC activities.
Protocol 4. Effects of NO on 5'-NT and PKC activities in HCAECs. To examine whether the inhibition of NO synthesis modulates ecto-5'-NT and PKC activities in HCAECs, we measured ecto-5'-NT and PKC activities in HCAECs 30 minutes after the addition of L-NAME (1x10-5 and 1x10-4 mol/L) or L-NMMA (1x10-4 mol/L). To examine whether NO itself modulated ecto-5'-NT and PKC activities, we measured ecto-5'-NT and PKC activities in HCAECs 30 minutes after the addition of Hb (1x10-5 mol/L), which deactivates NO by oxidizing it to NO2- and NO3-. Furthermore, to examine whether NO releasers decrease 5'-NT and PKC activities, we measured ecto-5'-NT and PKC activities in HCAECs 30 minutes after the addition of either SNP (1x10-4 mol/L) or SIN-1 (1x10-3 mol/L). To examine whether the inhibition of NO synthesis increased ecto-5'-NT through the activation of PKC, we measured ecto-5'-NT activity 30 minutes after the addition of GF109203X (1x10-7 mol/L) or calphostin C (5x10-7 mol/L) with L-NAME (1x10-5 mol/L) or L-NMMA (1x10-4 mol/L).
Protocol 5. Effects of increases in intracellular cGMP concentration on 5'-NT activity. To examine whether NO modulates 5'-NT activity via a cGMP-dependent mechanism, we measured intracellular cGMP concentration and ecto-5'-NT activity in HCAECs 30 minutes after the addition of zaprinast (1x10-4 mol/L), a selective inhibitor of cGMP-specific phosphodiesterase, with and without SNP (1x10-5 mol/L) or ANP (1x10-7 mol/L).
Chemical Analysis
The plasma concentration of lactate was determined
enzymatically.18 The blood oxygen differences of
coronary arterial and venous blood were assessed by
measurement of differences between coronary
arterial and venous oxygen contents. Blood gas
analysis was performed with an ABL300 blood gas
analyzer (Radiometer A/S). LER and
M
O2 (mL · 100
g-1 · min-1)
were calculated as previously described.18 The plasma
concentration of adenosine was measured as previously
described.14
Measurement of 5'-NT and PKC Activities in Myocardium
The myocardial segments obtained above were separated into
membrane and cytosolic fractions as described
previously.19 The activity of 5'-NT was assessed by an
enzymatic assay technique20 and is reported in units of
mol · mg protein-1 ·
min-1. We defined 5'-NT activity in membrane
fractions as ecto-5'-NT activity.
PKC activity was measured by enzyme assay with the RPN 77A kit (Amersham), which provides a simple and reliable method of estimating PKC without extensive purification of the samples.11 12 PKC activity in the presence of 12 mmol/L Ca2+ and 8 mol% phosphatidylserine was expressed as nmol · mg protein-1 · min-1. Protein concentration was measured by the method of Lowry et al21 with BSA as the standard.
Measurement of 5'-NT and PKC Activities in HCAECs
To prepare the total cell lysates, freshly isolated HCAECs
were suspended in cold lysis buffer (50 mmol/L Tris-HCl,
250 mmol/L sucrose, 5 mmol/L leupeptin, pH
7.4), vortexed, and kept at 4°C. Cell lysates were disrupted by three
cycles of rapid freezing and thawing. The methods to prepare membrane
and cytosolic fractions from HCAECs and the methods for measurements of
PKC and ecto-5'-NT have been described above.
Measurement of cGMP Concentration in HCAECs
After removal of culture medium, HCAECs were washed with
HBS supplemented with 15 mmol/L HEPES and 2
mmol/L L-glutamine (HBS-HEPES) and then preincubated
for 15 minutes at 37°C in HBS-HEPES. Zaprinast with and without ANP
or SNP was then added, and the cells were incubated at 37°C for 5
minutes. The reaction was terminated by aspiration and the addition of
0.1N HCl. The solubilized materials were centrifuged at
2000g for 10 minutes, and the supernatants were lyophilized.
The lyophilized materials were resuspended in 5 mmol/L
sodium acetate buffer, pH 4.75, and subjected to a radioimmunoassay for
cGMP. The radioimmunoassay was performed according to the method
described previously.22
Statistical Analysis
Data are expressed as mean±SEM. The time courses of changes in
coronary hemodynamic and metabolic
parameters were compared by one-way repeated-measures
ANOVA. The time courses of changes in adenosine
production were compared by two-way repeated-measures ANOVA.
5'-NT and PKC activities were compared by one-way factorial ANOVA.
Bonferroni's test was used to determine significance for group pairs
that exhibited statistical significance. A level of P<.05
was accepted as statistically significant.
| Results |
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O2, LER, and pH of
coronary venous blood were similarly unaffected by L-NAME,
AMP-CP, GF109203X, calphostin C, 8-SPT, or L-NAME+8-SPT (Table 1
|
Adenosine Levels
L-NAME increased (P<.05) adenosine levels in
coronary venous blood and the difference of adenosine
levels between coronary venous and arterial blood.
Either AMP-CP, GF109203X, or calphostin C blunted the increases in
adenosine levels in coronary venous blood and the
difference of adenosine levels between coronary venous
and arterial blood induced by L-NAME (Table 2
).
|
Ecto-5'-NT and PKC Activities in Myocardium
L-NAME increased ecto-5'-NT activity in the LAD-perfused
myocardium compared with the LCx-perfused
myocardium, which was blunted by the concomitant
administration of GF109203X or calphostin C (Fig 1
). L-NAME increased PKC activity in the
membrane but not the cytosolic fraction in the LAD-perfused
myocardium compared with the LCx-perfused
myocardium (Fig 2
).
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Ecto-5'-NT and PKC Activities in HCAECs
Ecto-5'-NT activity was increased (P<.05) by
10-5 mol/L L-NAME (2.8±0.2
µmol · mg protein-1 ·
min-1, n=6), 10-4
mol/L L-NAME (2.7±0.2 µmol · mg
protein-1 ·
min-1, n=5), L-NMMA (2.6±0.2 µmol
· mg protein-1 ·
min-1, n=5), or Hb (2.5±0.3 µmol
· mg protein-1 ·
min-1, n=5) compared with control
(1.9±0.2 µmol · mg
protein-1 ·
min-1, n=6). PKC activity in the membrane
fraction in HCAECs was increased (P<.05) by
10-5 mol/L L-NAME (3.4±0.4 nmol
· mg protein-1 ·
min-1, n=6), 10-4
mol/L L-NAME (3.2±0.4 nmol · mg
protein-1 ·
min-1, n=5), L-NMMA (3.0±0.4 nmol · mg
protein-1 ·
min-1, n=5), or Hb (2.9±0.4 nmol · mg
protein-1 ·
min-1, n=5) compared with control (2.2±0.3
nmol · mg protein-1 ·
min-1, n=5). However, ecto-5'-N activity was
decreased (P<.05) by SNP (1.7±0.1 µmol · mg
protein-1 ·
min-1, n=5) or SIN-1 (1.5±0.1
µmol · mg protein-1 ·
min-1, n=5). PKC activity in the membrane
fraction in HCAECs was decreased (P<.05) by SNP (1.3±0.3
nmol · mg protein-1 ·
min-1, n=5) or SIN-1 (1.2±0.2 nmol ·
mg protein-1 ·
min-1, n=5). Neither L-NAME (37±4 nmol
· mg protein-1 ·
min-1), L-NMMA (34±6 nmol · mg
protein-1 ·
min-1), Hb (35±5 nmol · mg
protein-1 ·
min-1), SNP (39±4 nmol · mg
protein-1 ·
min-1), nor SIN-1 (36±5 nmol · mg
protein-1 ·
min-1) affected PKC activity in the cytosolic
fraction. GF109203X blunted the increases in ecto-5'-NT activity
induced by L-NAME (1.8±0.3 µmol · mg
protein-1 ·
min-1, n=5) or L-NMMA (2.1±0.4
µmol · mg protein-1 ·
min-1, n=4). Calphostin C blunted the
increases in ecto-5'-NT activity induced by L-NAME (1.9±0.4
µmol · mg protein-1 ·
min-1, n=5) or L-NMMA (2.0±0.3
µmol · mg protein-1 ·
min-1, n=5).
cGMP Concentrations on Ecto-5'-NT
Zaprinast with and without ANP or SNP increased the cGMP
concentration in HCAECs (Fig 3A
).
However, zaprinast alone or zaprinast with ANP did not change
ecto-5'-NT activity in HCAECs (Fig 3B
).
|
| Discussion |
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Role of NO and Adenosine in Coronary Circulation in
the In Vivo Hearts
Although NO is known as a potent vasodilator,1 its
role in the coronary circulation is controversial. The
intracoronary administration of NO synthesis
inhibitors does not change either baseline CBF or CPP in
conscious and anesthetized dogs.23 24 25 However,
Woolfson et al7 reported that L-NAME increases CPP in
isolated rabbit hearts perfused at a constant flow rate, in which the
level of shear stress is greater than that in the in vivo heart.
Species difference (dogs versus rabbits) and varied experimental models
(in vivo hearts versus isolated perfused hearts) are possible
explanations for the differences in the role of NO in the
coronary circulation. In the present study, the
intracoronary administration of L-NAME did not change either
CBF or CPP, which was compatible with the previous studies using in
vivo hearts.23 24 25 This finding suggests two possible
explanations for the role of NO in coronary circulation.
One is that NO is not a major regulator of coronary
circulation under baseline conditions. However, Jones et
al23 demonstrated that the inhibition of NO synthesis
by L-NAME leads to the constriction of small coronary
arteries (diameters >100 µm), indicating that the basal
flow-dependent activity of NO synthesis reduces the tone of these
vessels. This finding suggests the important role of NO in
coronary circulation in the in vivo model. Another possible
explanation is that the increased adenosine levels compensate
for the reduced CBF caused by the inhibition of NO synthesis. However,
8-SPT did not decrease baseline CBF in the presence and absence of
L-NAME, suggesting that increased adenosine levels during the
inhibition of NO synthesis may not contribute to coronary
regulation or that some vasoactive substance(s) other than NO and
adenosine may play a compensatory role when both of them are
inhibited. Puybasset et al24 recently reported that the
cyclooxygenase pathway is also activated
when NO synthesis is inhibited, suggesting that eicosanoids, which are
also involved in coronary circulation, could play a
compensatory role when both NO and adenosine are inhibited.
Recently, Matsunaga et al9 reported that increases in CBF
in response to increased myocardial oxygen consumption during cardiac
pacing are decreased by concomitant administration of an NOS
inhibitor and an antagonist of
adenosine receptors but not by an NOS inhibitor
alone in the open-chest dog model. This finding implies that increased
adenosine production caused by the inhibition of NO
synthesis may compensate for the reduced increases in CBF in response
to myocardial oxygen requirement when NO synthesis is diminished. These
findings suggest that some vasoactive substance(s) other than NO and
adenosine could play a compensatory role only under normal
conditions and that the role of increased adenosine during the
inhibition of NO synthesis may be augmented under
pathophysiological conditions. Further
investigations are needed to clarify the interaction of vasoactive
substances in the coronary circulation.
Mechanism by Which Adenosine Production Is
Increased During the Inhibition of NO Synthesis
Endothelium-derived vasoactive factors may
interact with each other and synergistically regulate vascular
tone.26 27 However, little is known about the potential
interactions between NO and adenosine. Importantly, we
demonstrated that the inhibition of NO synthesis increases
adenosine levels in the in vivo model, which is
consistent with previous studies using isolated
hearts.7 8 25 Adenosine levels are markedly
increased in ischemic hearts,4 14 suggesting that
L-NAME may cause myocardial ischemia. However, we demonstrated
that L-NAME did not change hemodynamic and
metabolic parameters, including LER,
M
O2, and FS, indicating that the
inhibition of NO synthesis did not induce myocardial ischemia.
Adenosine can be produced intracellularly by cytosolic 5'-NT
and S-adenosyl-L-homocysteine hydrolase and
extracellularly by ecto-5'-NT.3 4 We demonstrated that an
inhibitor of ecto-5'-NT, AMP-CP, attenuates the increases
in adenosine levels caused by L-NAME. These findings suggest
that the inhibition of NO synthesis increases adenosine
production via an extracellular pathway without myocardial
ischemia. The possible mechanisms by which L-NAME increased
adenosine production via an extracellular pathway are
by (1) increasing the concentration of adenine nucleotides,
the substrates for ecto-5'-NT, and/or (2) by increasing the activity of
extracellular ectophosphatases. Bodin et al28 reported
that increased blood flow augments ATP release from
endothelial cells. In the present study, we have
demonstrated that the inhibition of NO synthesis increased ecto-5'-NT
activity both in the in vivo heart model and in cultured
endothelial cells without changing blood flow. Thus,
increased concentrations of adenosine via an extracellular
pathway caused by L-NAME may be attributable, at least in part, to the
activation of ecto-5'-NT. However, we cannot completely deny the former
mechanism.
Activation of Ecto-5'-NT During the Inhibition of NO
Synthesis
Ecto-5'-NT is a plasma membrane enzyme attached by a glycosyl
phosphatidylinositol anchor.29 We demonstrated that the
treatment of L-NAME for 30 minutes increases ecto-5'-NT activity in
both the in vivo hearts and in vitro HCAECs. Although the mechanism by
which the inhibition of NO synthesis increases ecto-5'-NT activity is
not identified at this time, the time course of the activation of
ecto-5'-NT suggests that it is not due to the synthesis of new enzyme
protein. Because we have shown that okadaic acid inhibits deactivation
of ecto-5'-NT caused by ischemia,
phosphorylation of ecto-5'-NT itself or
phosphorylation of proteins that interact with this
enzyme may activate ecto-5'-NT.30 We have also
demonstrated in the present study that the inhibition of PKC blunts
the L-NAMEinduced activation of ecto-5'-NT. We have previously
reported that the deactivation of PKC blunts the activation of
ecto-5'-NT induced by ischemia or hypoxia in the
myocardium11 12 and isolated coronary
vessels.5 These findings suggest that
phosphorylation processes mediated by PKC are involved
in the activation of ecto-5'-NT.
NO exerts many cardiovascular effects via several signaling pathways: stimulation of guanylate cyclase resulting in an increase of intracellular cGMP concentrations, ADP-ribosylation-like reaction with proteins, and S-nitrosylation of proteins.31 Recently, Siegfried et al10 reported that ecto-5'-NT is inhibited by NO donors via a cGMP-independent mechanism, possibly via S-nitrosylation, in cultured renal epithelial cells. In the present study, we demonstrate that the inhibition of NO synthesis by two different inhibitors or deactivation of NO by Hb increases ecto-5'-NT activity and that two different NO donors decrease the activity of this enzyme, indicating that the inhibition of NO synthesis increases ecto-5'-NT activity and that increases in NO synthesis decrease its activity in HCAECs. It is reported that both NO and NO-generating agents induce an inactivation of PKC, suggesting that PKC is a susceptible target of NO.13 32 We demonstrated that the activation of ecto-5'-NT during the inhibition of NO synthesis is blunted by two different PKC inhibitors in both the in vivo hearts and in vitro HCAECs, suggesting that the inhibition of NO synthesis increases ecto-5'-NT activity through the activation of PKC. Furthermore, we demonstrated that increases in intracellular cGMP concentration by zaprinast with and without ANP did not alter ecto-5'-NT activity. These findings suggest that the inhibition of NO synthesis increases ecto-5'-NT activity through the activation of PKC via cGMP-independent mechanisms.
Clinical Implications
Recently, Quyyumi et al33 demonstrated that increases
in CBF during cardiac pacing are not regulated by NO in patients with
angiographically normal coronary arteries who have risk factors
for coronary artery disease, in whom the release of
endothelium-dependent factor/NO is known to be
impaired.34 Because adenosine is also a potent
vasodilator, increased adenosine levels caused by decreased NO
release might compensate for the impairment of NO-mediated function in
patients with risk factors for coronary artery disease.
In conclusion, when NO synthesis is suppressed, adenosine production is increased via extracellular pathways through the activation of PKC via cGMP-independent mechanisms. This increased concentration of adenosine may be an important compensatory mechanism under pathophysiological conditions in which NO release and/or NO-mediated cardiovascular functions are diminished.
| Selected Abbreviations and Acronyms |
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| Acknowledgments |
|---|
Received January 8, 1997; revision received February 28, 1997; accepted March 14, 1997.
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