Role of bradykinin in preconditioning and protection of the ischaemic myocardium.

Abstract

Since the first description of bradykinin more than 50 years ago (Rocha e Silva et al., 1949), actions of the peptide in a variety of physiological and pathological responses have been extensively researched (reviewed in Bhoola et al., 1992; Wirth et al., 1997; Calixto et al., 2000). In the cardiovascular system, the classical action of bradykinin is vasodilatation, mediated in several vascular beds by the release of nitric oxide (NO) and prostacyclin (Hatta et al., 1997; Wirth et al., 1997). In the heart, exogenously-administered bradykinin is a potent coronary artery vasodilator substance, although the contribution of endogenous bradykinin to the regulation of coronary vascular tone is unclear. Several actions of bradykinin in the heart are of particular interest as they are independent of the vasodilator actions of the peptide. Such actions include the modulation of cell growth and division in the heart and the modulation of myocardial responses to ischaemia-reperfusion. The ability of bradykinin to act as an endogenous cytoprotective mediator in the ischaemic myocardium has received a great deal of attention in recent years. Much of this research on bradykinin has been fuelled by a growing appreciation of ischaemic preconditioning, an adaptive mechanism in which bradykinin plays an important role. This review focuses on the cytoprotective actions of bradykinin in the ischaemic and reperfused myocardium, discusses its role in the ischaemic preconditioning response, and examines the potential for manipulating endogenous bradykinin for therapeutic benefit in myocardial ischaemia.