Inhibition Of cGMP Degradation Research Articles

Established and emerging therapeutic uses of PDE type 5 inhibitors in cardiovascular disease.

PDE type 5 inhibitors (PDE5Is), such as sildenafil, tadalafil and vardenafil, are a class of drugs used to prolong the physiological effects of NO/cGMP signalling in tissues through the inhibition of cGMP degradation. Although these agents were originally developed for the treatment of hypertension and angina, unanticipated side effects led to advances in the treatment of erectile dysfunction and, later, pulmonary arterial hypertension. In the last decade, accumulating evidence suggests that PDE5Is may confer a wider range of clinical benefits than was previously recognised. This has led to a broader interest in the cardiovascular therapeutic potential of PDE5Is, in conditions such as hypertension, myocardial infarction, stroke, peripheral arterial disease, chronic kidney disease and diabetes mellitus. Here, we review the pharmacological properties and established licensed uses of this class of drug, along with emerging therapeutic developments and possible future indications.

Activators and stimulators of soluble guanylate cyclase counteract myofibroblast differentiation of prostatic and dermal stromal cells

BackgroundFibrotic diseases encompass numerous systemic and organ-specific disorders characterized by the development and persistence of myofibroblasts. TGFβ1 is considered the key inducer of fibrosis and drives myofibroblast differentiation in cells of diverse histological origin by a pro-oxidant shift in redox homeostasis associated with decreased nitric oxide (NO)/cGMP signaling. Thus, enhancement of NO/cGMP represents a potential therapeutic strategy to target myofibroblast activation and therefore fibrosis. MethodsMyofibroblast differentiation was induced by TGFβ1 in human primary prostatic (PrSCs) and normal dermal stromal cells (NDSCs) and monitored by α smooth muscle cell actin (SMA) and IGF binding protein 3 (IGFBP3) mRNA and protein levels. The potential of enhanced cGMP production by the sGC stimulator BAY 41-2272 or the sGC activator BAY 60-2770 to inhibit and revert myofibroblast differentiation in vitro was analyzed. Moreover, potential synergisms of BAY 41-2272 or BAY 60-2770 and inhibition of cGMP degradation by the PDE5 inhibitor vardenafil were investigated. ResultsBAY 41-2272 and BAY 60-2770 at doses of 30µM significantly inhibited induction of SMA and IGFBP3 levels in PrSCs and reduced myofibroblast marker levels in TGFβ1-predifferentiated cells. At lower concentrations (3 and 10µM) only BAY 41-2272 but not BAY 60-2770 significantly inhibited and reverted myofibroblast differentiation. In NDSCs both substances significantly inhibited differentiation at all concentrations tested. Attenuation of SMA expression was more pronounced in NDSCs whereas reduction of IGFBP3 levels by BAY 41-2272 appeared more efficient in PrSCs. Moreover, administration of BAY 41-2272 or BAY 60-2770 enhanced the efficiency of the PDE5 inhibitor vardenafil to inhibit and revert myofibroblast differentiation in vitro. ConclusionsIncrease of cGMP by sGC stimulation/activation significantly inhibited and reverted myofibroblast differentiation. This effect was even more pronounced when a combination treatment with a PDE5 inhibitor was applied. Thus, enhancement of NO/cGMP-signaling by sGC stimulation/activation is a promising strategy for the treatment of fibrotic diseases. Whereas, in NDSCs BAY 60-2770 and BAY 41-2272 exerted similar effects on myofibroblast differentiation, higher potency of BAY 41-2272 was observed in PrSCs, indicating phenotypical differences between fibroblasts form different organs that should be taken into account in the search for antifibrotic therapies.

Atrial Natriuretic Peptide–Mediated Inhibition of Microcirculatory Endothelial Ca 2+ and Permeability Response to Histamine Involves cGMP-Dependent Protein Kinase I and TRPC6 Channels

Histamine increases microvascular endothelial leakage by activation of complex calcium-dependent and -independent signaling pathways. Atrial natriuretic peptide (ANP) via its cGMP-forming guanylyl cyclase-A (GC-A) receptor counteracts this response. Here, we characterized the molecular mechanisms underlying this interaction, especially the role of cGMP-dependent protein kinase I (cGKI). We combined intravital microscopy studies of the mouse cremaster microcirculation with experiments in cultured microvascular human dermal endothelial cells. In wild-type mice, ANP had no direct effect on the extravasation of fluorescent dextran from postcapillary venules, but strongly reduced the histamine-provoked vascular leakage. This anti-inflammatory effect of ANP was abolished in mice with endothelial-restricted inactivation of GC-A or cGKI. Histamine-induced increases in endothelial [Ca(2+)]i in vitro and of vascular leakage in vivo were markedly attenuated by the Ca(2+)-entry inhibitor SKF96365 and in mice with ablated transient receptor potential canonical (TRPC) 6 channels. Conversely, direct activation of TRPC6 with hyperforin replicated the hyperpermeability responses to histamine. ANP, via cGKI, stimulated the inhibitory phosphorylation of TRPC6 at position Thr69 and prevented the hyperpermeability responses to hyperforin. Moreover, inhibition of cGMP degradation by the phosphodiesterase 5 inhibitor sildenafil prevented the edematic actions of histamine in wild types but not in mice with endothelial GC-A or cGKI deletion. ANP attenuates the inflammatory actions of histamine via endothelial GC-A/cGMP/cGKI signaling and inhibitory phosphorylation of TRPC6 channels. The therapeutic potential of this novel regulatory pathway is indicated by the observation that sildenafil improves systemic endothelial barrier functions by enhancing the endothelial effects of endogenous ANP.

Extracellular cyclic GMP and its derivatives GMP and guanosine protect from oxidative glutamate toxicity

Cell death in response to oxidative stress plays a role in a variety of neurodegenerative diseases and can be studied in detail in the neuronal cell line HT22, where extracellular glutamate causes glutathione depletion by inhibition of the glutamate/cystine antiporter system xc−, elevation of reactive oxygen species and eventually programmed cell death caused by cytotoxic calcium influx. Using this paradigm, we screened 54 putative extracellular peptide or small molecule ligands for effects on cell death and identified extracellular cyclic guanosine monophosphate (cGMP) as a protective substance. Extracellular cGMP was protective, whereas the cell-permeable cGMP analog 8-pCPT-cGMP or the inhibition of cGMP degradation by phosphodiesterases was toxic. Interestingly, metabolites GMP and guanosine were even more protective than cGMP and the inhibition of the conversion of GMP to guanosine attenuated its effect, suggesting that GMP offers protection through its conversion to guanosine. Guanosine increased system xc− activity and cellular glutathione levels in the presence of glutamate, which can be explained by transcriptional upregulation of xCT, the functional subunit of system xc−. However, guanosine also provided protection when added late in the cell death cascade and significantly reduced the number of calcium peaking cells, which was most likely not mediated by transcriptional mechanisms. We observed no changes in the classical protective pathways such as phosphorylation of Akt, ERK1/2 or induction of Nrf2 or ATF4. We conclude that extracellular guanosine protects against endogenous oxidative stress by two probably independent mechanisms involving system xc− induction and inhibition of cytotoxic calcium influx.

Differential effects of nitric oxide on blood-brain barrier integrity and cerebral blood flow in intracerebral C6 gliomas

Nitric oxide (NO) signaling in tumors and endothelial cells regulates vascular permeability and blood flow and therefore influences tumor uptake and response to therapeutic compounds. As delivery and efficacy of chemotherapy is impaired in CNS neoplasms due to a partially intact blood-brain barrier (BBB), we studied the effects of NO released by the short-acting NO donor disodium 1-[2-(carboxylato)pyrrolidin-1-yl]diazen-1-ium-1,2-diolate methanolate (PROLI/NO) on BBB integrity and blood flow in C6 gliomas using [¹⁴C]-aminoisobutyric acid (AIB) and [¹⁴C]-iodoantipyrine quantitative autoradiography. PROLI/NO selectively increased intratumoral uptake of [¹⁴C]AIB and [¹⁴C]sucrose when given as a 3-minute intracarotid infusion or a 15-minute i.v. infusion (AIB: tumor, K₁ = 68.7 ± 3.2 vs 24.9 ± 0.9 µL g⁻¹ min⁻¹, P < .0001; sucrose, K₁ = 16.9 ± 0.9 vs 11.5 ± 0.9 µL g⁻¹ min⁻¹, P = .0007). This effect was achieved without significant changes in cerebral and tumor blood flow or arterial blood pressure, which indicates that the effect on vascular permeability is independent of changes in vascular tone induced by NO. This effect was mediated by activation of the NO/3',5'-cyclic guanosine monophosphate (cGMP) pathway, as it was blocked by guanylate cyclase inhibition by LY83583 and reproduced by the delivery of 8-bromoguanosine 5'-monophosphate or inhibition of cGMP degradation by the phosphodiesterase inhibitor zaprinast. Inhibition of inducible NO synthase by aminoguanidine or cyclooxygenase inhibition by indometacin or dexamethasone did not reduce the blood-tumor barrier (BTB) response to PROLI/NO. PROLI/NO, and perhaps other NO-donating compounds, can be used to selectively increase BTB permeability in gliomas through the NO/cGMP pathway at doses that do not cause unwanted vasodilatory changes in blood flow and that do not affect the systemic circulation.

Negative-Feedback Loop Attenuates Hydrostatic Lung Edema via a cGMP-Dependent Regulation of Transient Receptor Potential Vanilloid 4

Although the formation of hydrostatic lung edema is generally attributed to imbalanced Starling forces, recent data show that lung endothelial cells respond to increased vascular pressure and may thus regulate vascular permeability and edema formation. In combining real-time optical imaging of the endothelial Ca(2+) concentration ([Ca(2+)](i)) and NO production with filtration coefficient (K(f)) measurements in the isolated perfused lung, we identified a series of endothelial responses that constitute a negative-feedback loop to protect the microvascular barrier. Elevation of lung microvascular pressure was shown to increase endothelial [Ca(2+)](i) via activation of transient receptor potential vanilloid 4 (TRPV4) channels. The endothelial [Ca(2+)](i) transient increased K(f) via activation of myosin light-chain kinase and simultaneously stimulated NO synthesis. In TRPV4 deficient mice, pressure-induced increases in endothelial [Ca(2+)](i), NO synthesis, and lung wet/dry weight ratio were largely blocked. Endothelial NO formation limited the permeability increase by a cGMP-dependent attenuation of the pressure-induced [Ca(2+)](i) response. Inactivation of TRPV4 channels by cGMP was confirmed by whole-cell patch-clamp of pulmonary microvascular endothelial cells and intravital imaging of endothelial [Ca(2+)](i). Hence, pressure-induced endothelial Ca(2+) influx via TRPV4 channels increases lung vascular permeability yet concomitantly activates an NO-mediated negative-feedback loop that protects the vascular barrier by a cGMP-dependent attenuation of the endothelial [Ca(2+)](i) response. The identification of this novel regulatory pathway gives rise to new treatment strategies, as demonstrated in vivo in rats with acute myocardial infarction in which inhibition of cGMP degradation by the phosphodiesterase 5 inhibitor sildenafil reduced hydrostatic lung edema.

Endothelin-1 reduces mesenteric microvascular hydraulic permeability via cyclic AMP and protein kinase A signal transduction

We have previously shown that endothelin-1 (ET-1) decreases microvascular hydraulic permeability. In this study, we tested the hypothesis that ET-1 exerts its permeability-decreasing effect through cAMP, cGMP, and protein kinase A (PKA) by determining the effect of ET-1 on venular fluid leak during inhibition of cAMP synthesis, inhibition of cGMP degredation, and inhibition of PKA. Rat mesenteric venules were cannulated to measure hydraulic permeability, L p (units × 10 −7 cm/(s cmH 2O)). L p was measured during continuous perfusion of 80 pM ET-1 and either (1) an inhibitor of cAMP synthesis (10 μM 2′,5′ddA), (2) an inhibitor of cGMP degradation (100 μM Zaprinast), or (3) an inhibitor of PKA (10 μM H-89). Inhibition of cAMP synthesis blocked the permeability decreasing effects of ET-1. The peak L p of the cAMP inhibitor alone and with ET-1 was 4.11 ± 0.53 and 3.86 ± 0.19, respectively ( p = 0.36, n = 6). Inhibition of cGMP degradation did not block the permeability decreasing effects of ET-1. The peak L p during inhibition of cGMP degradation alone and with ET-1 was 2.26 ± 0.15 and 1.44 ± 0.09, respectively ( p < 0.001, n = 6). Inhibition of PKA activation blocked the permeability decreasing effects of ET-1. The peak L p of the PKA inhibitor alone and with ET-1 was 2.70 ± 0.15 and 2.59 ± 0.15, respectively ( p = 0.38, n = 6). The data support the notion that the signal transduction mechanism of ET-1 with regard to decreasing microvascular fluid leak involves cAMP production and PKA activation, but not cGMP degradation. Further understanding of intracellular mechanisms that control microvascular fluid leak could lead to the development of a pharmacologic therapy to control third space fluid loss in severely injured or septic patients.

Angiotensin II Subtype AT1 and AT2 Receptors Regulate Microvascular Hydraulic Permeability via cAMP and cGMP

Angiotensin II receptor subtypes (AT1 and AT2) have been shown to modulate microvascular fluid leak. However, their intracellular signal transduction pathways have not been elucidated. We hypothesized that AT1 activation exerts its permeability-increasing effect by provoking cGMP synthesis and inducing cAMP degradation and that AT2 activation decreases fluid leak by stimulating cAMP synthesis and enhancing cGMP degradation. Using a microcannulation technique, hydraulic permeability (Lp) was measured in rat mesenteric venules. The messenger signal transduction of ATI was studied during continuous perfusion with the AT1 agonist, Sar1 plus either 1) a cGMP synthesis inhibitor, LY83583, or 2) an inhibitor of cAMP degradation, Rolipram. Likewise, AT2 signal transduction was studied with the AT2 agonist, CGP42112A, plus either 1) a cAMP synthesis inhibitor, dideoxyadenosine, or 2) an inhibitor of cGMP degradation, Zaprinast. Lp values are represented as mean +/- SEM x 10(-7) cm/s/cm H2O. For each group n = 6. Inhibition of cGMP synthesis blunted the permeability-increasing effect of AT1 agonism and decreased the peak Lp from 4.91 +/- 0.25 to 2.30 +/- 0.10 (P < 0.001). Inhibition of cAMP degradation also reduced the effect of AT1 agonism on peak L(p) from 2.25 +/- 0.22 to 1.30 +/- 0.13 (P < 0.001). Meanwhile, cAMP synthesis inhibition completely blocked the permeability-decreasing effect of AT2 agonism during which Lp increased from a baseline of 0.92 +/- 0.08 to a peak of 4.38 +/- 0.20 (P < 0.001). During inhibition of cGMP degradation, AT2 activation was able to decrease peak Lp from 2.26 +/- 0.15 to 1.46 +/- 0.05 (P < 0.001). When cGMP synthesis and cAMP degradation were inhibited, the effect on fluid leak by AT1 activation was blunted. Inhibition of cAMP synthesis completely blocked the effect of AT2 activation on fluid leak, while AT2 activation continued to decrease fluid leak despite inhibition of cGMP degradation. The AT1 receptor appears to increase fluid leak by stimulating both cGMP synthesis and cAMP degradation, while the AT2 receptor decreases fluid leak by stimulating cAMP synthesis, but not cGMP degradation.

Cyclic Nucleotide Second Messengers (cAMP and cGMP) Play a Central Role in Signal Transduction and Regulation of Mesenteric Postcapillary Fluid Leak

Endothelial cell receptors involved in post-injury/sepsis fluid extravasation are coupled to G-proteins that stimulate production of cGMP and cAMP. We hypothesize that cGMP and cAMP are endothelial second messengers that control microvascular permeability. The purposes of this series of experiments are to determine microvascular permeability under the following conditions: 1) reduced cGMP levels, 2) elevated cGMP levels, 3) reduced cAMP levels, and 4) elevated cAMP levels. Rat mesenteric venules were cannulated and hydraulic permeability (Lp) was measured at 3 to 5 minute intervals during 1) cGMP synthesis inhibition, 2) inhibition of cGMP degradation, 3) cAMP synthesis inhibition, and 4) inhibition of cAMP degradation (n = 6 in each study group). Lp units are x10 cm(-7)/sec/cmH2O and represented as mean +/- SEM. Compared with baseline Lp (1.10 +/- 0.06), reduced cGMP levels by inhibiting its synthesis decreased Lp by over 50% (0.50 +/- 0.02, p < 0.001), while elevated cGMP levels by preventing its degradation increased Lp by more than 2-fold (0.91 +/- 0.10 to 2.26 +/- 0.15, p < 0.001). The reduction of cAMP levels by synthesis inhibition elevated Lp over 400% from 0.92 +/- 0.04 to 4.11 +/- 0.54 (p < 0.001), and elevation of cAMP level by blocking its degradation reduced Lp almost 50% from 1.11 +/- 0.04 to 0.59 +/- 0.06 (p < 0.001). The second messengers, cGMP and cAMP, contribute to the control mechanisms that govern fluid leak across the endothelial barrier: cGMP increases microvascular permeability, while cAMP decreases microvascular permeability. Endothelial cell cyclic nucleotide second messengers are pharmacologically accessible and may be targeted during post-injury/sepsis-associated microvascular fluid leak.

Enhancing cGMP in experimental progressive renal fibrosis: soluble guanylate cyclase stimulation vs. phosphodiesterase inhibition

cGMP serves as the main second messenger of nitric oxide (NO). Antifibrotic effects of enhancing renal cGMP levels have recently been documented in experimental acute anti-Thy-1 glomerulonephritis. The present study compares the effects of the cGMP production-increasing soluble guanylate cyclase (sGC) stimulator BAY 41-2272 with those of the cGMP degradation-limiting phosphodiesterase inhibitor pentoxifylline (PTX) in a progressive model of renal fibrosis. At 1 wk after induction of anti-Thy-1-induced chronic glomerulosclerosis (cGS), rats were randomly assigned to groups as follows: cGS, cGS + BAY 41-2272 (10 mg x kg body wt(-1) x day(-1)), or cGS + PTX (50 mg x kg body wt(-1) x day(-1)). BAY 41-2272 and PTX reduced systolic blood pressure significantly. At 16 wk, tubulointerstitial expressions of sGC mRNA and NO-induced cGMP synthesis were increased in untreated cGS animals, whereas their glomerular activity was depressed compared with normal controls. Tubulointerstitial and glomerular cGMP production in response to NO were significantly enhanced in animals treated with BAY 41-2272, but not in those treated with PTX. BAY 41-2272 administration resulted in marked reductions of glomerular and tubulointerstitial histological matrix accumulation, expression of TGF-beta1 and fibronectin, macrophage infiltration, and cell proliferation as well as improved renal function. In contrast, only moderate and nonsignificant renoprotective changes were observed in the cGS + PTX group. In conclusion, increasing renal cGMP production through BAY 41-2272 significantly improved renal NO-cGMP signaling and limited progression in anti-Thy-1-induced chronic renal fibrosis, whereas inhibition of cGMP degradation by PTX was only moderately effective. The findings indicate that pharmacological enhancement of renal cGMP levels by sGC stimulation represents a novel and effective antifibrotic approach in progressive kidney disorders.

Endothelin-1 decreases microvascular fluid leak via second messenger cyclic nucleotides and protein kinase a signal transduction

Introduction. Endothelin-1 (ET-1) decreases microvascular fluid leak by an unknown mechanism. Elevated cAMP levels, depressed cGMP levels, and protein kinase A (PKA) activation are all known to decrease fluid leak. We hypothesized that ET-1 decreases permeability by increased cAMP levels, decreased cGMP levels, and PKA activation. The purpose of this series of experiments was to determine ET-1’s effect on venular fluid leak during (1) cAMP synthesis inhibition, (2) increased cGMP levels, and (3) PKA activation inhibition. Methods. Using the modified-Landis technique, rat mesenteric venules were cannulated to measure hydraulic permeability, L p (units × 10 −7 cm/s/cmH 2O). L p was measured during continuous perfusion of ET-1 and a test solution. The test solutions consisted of (1) a cAMP synthesis inhibitor (2′,5′ddA), (2) an inhibitor of cGMP degradation (zaprinast), or (3) an inhibitor of PKA (H-89). These results were compared to L p measurements from the different test solutions alone. Data were statistically analyzed using unpaired t-tests. L p values are represented as mean ± standard error. Results. ET-1 did not change L p during (1) cAMP synthesis inhibition and (2) PKA inhibition: cAMP inhibitor with and without ET-1 (L p = 3.6 ± 0.1 versus 3.6 ± 0.2, P = 0.4, n = 4) and PKA inhibitor with and without ET-1 (L p = 2.3 ± 0.2 versus 2.6 ± 0.2, P = 0.3, n = 5). Increased cGMP levels (inhibition of cGMP degradation) failed to block the permeability-decreasing effect of ET-1. Compared to increased levels of cGMP alone, ET-1 in the presence of increased cGMP levels decreased L p from 2.3 ± 0.2 to 1.5 ± 0.1 ( P < 0.008, n = 6). Conclusion. The permeability-decreasing effect of ET-1 was blocked by cAMP and PKA inhibition. In contrast, ET-1 was able to decrease fluid leak while cGMP degradation was inhibited. The intracellular mechanism of ET-1 may involve increased cAMP production and PKA activation, but not cGMP degradation. Further understanding of intracellular mechanisms that control microvascular fluid leak may lead to the development of a pharmacologic therapy to control third space fluid loss in severely injured or septic patients.

Intermittent nitric oxide combined with intravenous dipyridamole in a piglet model of acute pulmonary hypertension.

Continuous administration of inhaled nitric oxide is now widely used as a potent and selective pulmonary vasodilator. We have evaluated the effects of IV dipyridamole, a cyclic guanosine monophosphate (cGMP) phosphodiesterase inhibitor, on the magnitude and duration of action of inhaled nitric oxide (NO)-mediated pulmonary vasodilation. We hypothesized that inhibition of cGMP degradation could augment and prolong the pulmonary vasodilating effects of NO and allow for intermittent NO inhalation. In eight anesthetized and mechanically ventilated piglets, IV U-46619, a thromboxane A(2) analog, was used to induce pulmonary hypertension. The effects of 2, 5, and 10 ppm of NO, delivered during 4 min for each concentration and followed by a 10-min NO-free interval after each NO concentration, were evaluated without and with dipyridamole. Pulmonary vascular resistance decreased from 825 +/- 49 dynes. s. cm(-5) (U-46619) to 533 +/- 48 dynes. s. cm(-5) (10 ppm NO) (P < 0.05 versus U-46619) and 396 +/- 42 dynes. s. cm(-5) (dipyridamole 10 microg kg-1x min-1 and 10 ppm NO) (P <0.05 versus NO), and cardiac output increased from 1.93 +/- 0.09 L/min to 2.03 +/- 0.13 L/min and 2.60 +/- 0.30 L/min (P < 0.05 versus NO). Mean arterial blood pressure decreased from 90 +/- 5 mm Hg (10 ppm NO) to 75 +/- 3 mm Hg (dipyridamole plus 10 ppm NO) (P < 0.01). The pulmonary vasodilation obtained with NO alone could be prolonged from 12 to 42 min when inhaled NO was combined with IV dipyridamole, accounting for a time-weighted reduction in NO exposure by 72%. We conclude that dipyridamole augments the effects of NO on right ventricular afterload, allows for intermittent NO inhalation, and can significantly reduce exposure to NO. IV dipyridamole prolongs the action of inhaled nitric oxide (NO) in a piglet model of acute pulmonary hypertension. Intermittent NO inhalation combined with IV dipyridamole decreases pulmonary artery pressure for a prolonged period of time and reduces exposure to NO.

Sildenafil, a Phosphodiesterase-5 Inhibitor, Enhances the Antinociceptive Effect of Morphine

Various evidence has demonstrated a role of the nitric oxide (NO)/cGMP signaling pathway in the processing of nociception. The exact role of phosphodiesterase-5 (PDE-5) via the NO/cGMP pathway is not fully understood in pain response. The aim of the present study was to investigate the possible peripheral interaction between a PDE-5 inhibitor (sildenafil) and morphine. Carrageenan-induced hyperalgesia in rats and the acetic-acid-induced writhing test in mice were used as animal models. Local administration of sildenafil (50–200 µg/paw, i.pl.) exhibited a dose-dependent antinociceptive effect against the paw pressure test. Sildenafil also demonstrated an antinociceptive effect (1–10 mg/kg, i.p.) against in the writhing test. Co-administration of sildenafil (100 µg/paw, i.pl. and 2 mg/kg, i.p.) significantly enhanced the antinociceptive effect of morphine (2 µg/ paw, i.pl. and 2 mg/kg, i.p respectively). The antinociception produced by the drugs alone or combined was due to a local action, as its administration in the contralateral paws was ineffective. Pretreatment with N^G-nitro-L-arginine methyl ester (an NO synthesis inhibitor), methylene blue (gunalyl cyclase inhibitor) or naloxone (opioid receptor antagonist) blocked the effect of a sildenafil-morphine combination in both tests. The results suggest that opioid receptor (NO and cGMP) mechanisms are involved in the combined antinociceptive effect. Further, sildenafil produced antinociception per se and increased the response of morphine, probably through the inhibition of cGMP degradation.

Immunolocalization of Multidrug Resistance Protein 5 in the Human Genitourinary System

The intracellular messenger cyclic guanosine monophosphate (cGMP) has an important role in regulating smooth muscle tone. An increase in intracellular cGMP levels is a prerequisite for penile erection. Inhibition of cGMP degradation by cGMP specific phosphodiesterase 5 has been used for treating erectile dysfunction. In addition to degradation by phosphodiesterase, cGMP is exported from cells by multidrug resistance protein 5 (MRP5), also called ABCC5, which we recently identified as an adenosine triphosphate dependent export pump for cGMP. MRP5 is potently inhibited by substances known as phosphodiesterase inhibitors, including sildenafil and trequinsin. Therefore, we analyzed whether MRP5 is expressed in tissues of the human genitourinary system and whether MRP5 and phosphodiesterase 5 proteins are localized in the same cell types. Localization of MRP5 and phosphodiesterase 5 was analyzed by immunofluorescence microscopy in cryosections of various tissues of the human genitourinary system. MRP5 and phosphodiesterase 5 were co-expressed in smooth muscle cells of the corpus cavernosum, ureter, urethra and bladder. In addition, MRP5 and phosphodiesterase 5 were localized in epithelial cells of the mucosa in the ureter and urethra, and in blood vessels of the lamina propria. The co-expression of MRP5 and phosphodiesterase 5 in smooth muscle cells of the genitourinary system indicates 2 distinct pathways for cGMP removal. Thus, MRP5 inhibition represents a new approach for enhancing cGMP levels in smooth muscle cells and developing drugs for erectile dysfunction.

CGMP-Mediated Inhibition of cAMP Degradation Stimulates Renin Secretion Without Affecting Renal Hemodynamics.

P100 The stimulatory second messenger for renin is cAMP, which is degraded by phosphodiesterase (PDE)-3. PDE-3 is inhibited by cGMP, while PDE-5 degrades cGMP. We hypothesized that if endogenous cGMP was increased, it could inhibit PDE-3, increasing cAMP, and stimulating renin. We used the selective PDE-5 inhibitor Zaprinast at a dose we determined would not change either blood pressure or renal blood flow (RBF). In inactin-anesthetized rats, renin secretion rate (RSR) was determined by collecting arterial and renal venous blood while measuring RBF before and 75 min after administering 20 mg/kg bw Zaprinast (n=9) ip, or vehicle (n=7). Blood pressure before and after Zaprinast was unchanged at 102 ±2 and 98 ±2 mmHg, respectively, similar to vehicle controls (107 ±3 to 105 ±4 mmHg). RBF was unchanged by either Zaprinast (5.57 ±0.38 to 5.77 ±0.41 ml/min/gkw) or vehicle (6.21 ±0.47 to 6.25 ±0.42 ml/min/gkw). Zaprinast increased RSR 6-fold (from 2.95 ±1.74 to 17.62 ±5.46 ng Ang1/hr/min, p p mol/min (p p mol/min). Thus, inhibition of cGMP degradation by the PDE-5 inhibitor Zaprinast increased endogenous cGMP (as reflected in excretion) and also stimulated renin secretion, despite not significantly changing renal hemodynamics. These data suggest that endogenous cGMP may indirectly regulate renin through its direct effect on cAMP degradation.

CGMP-Mediated Inhibition of cAMP Degradation Stimulates Renin Secretion Without Affecting Renal Hemodynamics.

P100 The stimulatory second messenger for renin is cAMP, which is degraded by phosphodiesterase (PDE)-3. PDE-3 is inhibited by cGMP, while PDE-5 degrades cGMP. We hypothesized that if endogenous cGMP was increased, it could inhibit PDE-3, increasing cAMP, and stimulating renin. We used the selective PDE-5 inhibitor Zaprinast at a dose we determined would not change either blood pressure or renal blood flow (RBF). In inactin-anesthetized rats, renin secretion rate (RSR) was determined by collecting arterial and renal venous blood while measuring RBF before and 75 min after administering 20 mg/kg bw Zaprinast (n=9) ip, or vehicle (n=7). Blood pressure before and after Zaprinast was unchanged at 102 ±2 and 98 ±2 mmHg, respectively, similar to vehicle controls (107 ±3 to 105 ±4 mmHg). RBF was unchanged by either Zaprinast (5.57 ±0.38 to 5.77 ±0.41 ml/min/gkw) or vehicle (6.21 ±0.47 to 6.25 ±0.42 ml/min/gkw). Zaprinast increased RSR 6-fold (from 2.95 ±1.74 to 17.62 ±5.46 ng Ang1/hr/min, p &lt;0.024), while vehicle had no effect (4.08 ±2.02 to 3.87 ±1.53 ng Ang1/hr/min). Zaprinast also increased renal cGMP excretion from 12.75 ±1.57 to 18.67 ±1.87 p mol/min (p&lt;0.003), while cGMP excretion was unchanged by vehicle (13.07 ±1.76 to 12.42 ±2.16 p mol/min). Thus, inhibition of cGMP degradation by the PDE-5 inhibitor Zaprinast increased endogenous cGMP (as reflected in excretion) and also stimulated renin secretion, despite not significantly changing renal hemodynamics. These data suggest that endogenous cGMP may indirectly regulate renin through its direct effect on cAMP degradation.