Organic nitrates act as vasodilators and have long been used for treatment of cardiovascular diseases. However, the therapeutic effect of nitrates is limited by induction of nitrate tolerance which is associated with endothelial dysfunction and enhanced vasoconstriction. Multiple mechanisms cause nitrate tolerance including alterations in gene expression. To identify genes whose expression is altered due to chronic treatment with nitroglycerin (NTG), nitrate-tolerant rats were made by infusion of NTG for 3 days (10 µg/kg/min) using an osmotic minipump. We constructed a PCR-selected cDNA subtracted library from NTG-treated and vehicle-treated rat aortas. Screening of ∼500 clones in the subtracted library showed that four genes were regulated by NTG treatment. Specifically, mRNA levels of β-globin, tropoelastin, gelsolin and a small G protein were confirmed to be upregulated consistently by NTG treatment. These identified genes may play important roles in the development of nitrate tolerance and represent promising candidates to understand the mechanisms of nitrate tolerance and endothelial dysfunction in the vasculature.

1.
Corwin S, Reiffel JA: Nitrate therapy for angina pectoris. Current concepts about mechanism of action and evaluation of currently available preparations. Arch Intern Med 1985;145:538–543.
2.
Ignarro LJ, Gruetter CA: Requirement of thiols for activation of coronary arterial guanylate cyclase by glyceryl trinitrate and sodium nitrite: Possible involvement of S-nitrosothiols. Biochim Biophys Acta 1980;631:221–231.
3.
Ignarro LJ, Lippton H, Edwards JC, Baricos WH, Hyman AL, Kadowitz PJ, Gruetter CA: Mechanism of vascular smooth muscle relaxation by organic nitrates, nitrites, nitroprusside and nitric oxide: Evidence for the involvement of S-nitrosothiols as active intermediates. J Pharmacol Exp Ther 1981;218:739–749.
4.
Elkayam U: Tolerance to organic nitrates: Evidence, mechanisms, clinical relevance, and strategies for prevention. Ann Intern Med 1991;114:667–677.
5.
Brien JF, McLaughlin BE, Breedon TH, Bennett BM, Nakatsu K, Marks GS: Biotransformation of glyceryl trinitrate occurs concurrently with relaxation of rabbit aorta. J Pharmacol Exp Ther 1986;237:608–614.
6.
Needleman P, Johnson EM Jr: Mechanism of tolerance development to organic nitrates. J Pharmacol Exp Ther 1973;184:709–715.
7.
Elkayam U, Roth A, Henriquez B, Weber L, Tonnemacher D, Rahimtoola SH: Hemodynamic and hormonal effects of high-dose transdermal nitroglycerin in patients with chronic congestive heart failure. Am J Cardiol 1985;56:555–559.
8.
Munzel T, Sayegh H, Freeman BA, Tarpey MM, Harrison DG: Evidence for enhanced vascular superoxide anion production in nitrate tolerance. A novel mechanism underlying tolerance and cross-tolerance. J Clin Invest 1995;95:187–194.
9.
Axelsson KL, Andersson RG: Tolerance towards nitroglycerin, induced in vivo, is correlated to a reduced cGMP response and an alteration in cGMP turnover. Eur J Pharmacol 1983;88:71–79.
10.
Soff GA, Cornwell TL, Cundiff DL, Gately S, Lincoln TM: Smooth muscle cell expression of type I cyclic GMP-dependent protein kinase is suppressed by continuous exposure to nitrovasodilators, theophylline, cyclic GMP, and cyclic AMP. J Clin Invest 1997;100:2580–2587.
11.
Munzel T, Li H, Mollnau H, Hink U, Matheis E, Hartmann M, Oelze M, Skatchkov M, Warnholtz A, Duncker L, Meinertz T, Forstermann U: Effects of long-term nitroglycerin treatment on endothelial nitric oxide synthase (NOS III) gene expression, NOS III-mediated superoxide production, and vascular NO bioavailability. Circ Res 2000;86:E7–E12.
12.
Parker JD, Farrell B, Fenton T, Cohanim M, Parker JO: Counter-regulatory responses to continuous and intermittent therapy with nitroglycerin. Circulation 1991;84:2336–2345.
13.
Kurz S, Hink U, Nickenig G, Borthayre AB, Harrison DG, Munzel T: Evidence for a causal role of the renin-angiotensin system in nitrate tolerance. Circulation 1999;99:3181–3187.
14.
Munzel T, Giaid A, Kurz S, Stewart DJ, Harrison DG: Evidence for a role of endothelin 1 and protein kinase C in nitroglycerin tolerance. Proc Natl Acad Sci USA 1995;92:5244–5248.
15.
Rajagopalan S, Kurz S, Munzel T, Tarpey M, Freeman BA, Griendling KK, Harrison DG: Angiotensin II-mediated hypertension in the rat increases vascular superoxide production via membrane NADH/NADPH oxidase activation. Contribution to alterations of vasomotor tone. J Clin Invest 1996;97:1916–1923.
16.
Kim D, Rybalkin SD, Pi X, Wang Y, Zhang C, Munzel T, Beavo JA, Berk BC, Yan C: Upregulation of phosphodiesterase 1A1 expression is associated with the development of nitrate tolerance. Circulation 2001;104:2338–2343.
17.
Belknap JK, Weiser-Evans MC, Grieshaber SS, Majack RA, Stenmark KR: Relationship between perlecan and tropoelastin gene expression and cell replication in the developing rat pulmonary vasculature. Am J Respir Cell Mol Biol 1999;20:24–34.
18.
Poole RK, Hughes MN: New functions for the ancient globin family: Bacterial responses to nitric oxide and nitrosative stress. Mol Microbiol 2000;36:775–783.
19.
Nath KA, Shah V, Haggard JJ, Croatt AJ, Smith LA, Hebbel RP, Katusic ZS: Mechanisms of vascular instability in a transgenic mouse model of sickle cell disease. Am J Physiol 2000;279:R1949–R1955.
20.
Aoyagi M, Yamamoto M, Azuma H, Niimi Y, Tajima S, Hirakawa K, Yamamoto K: Smooth muscle cell proliferation, elastin formation, and tropoelastin transcripts during the development of intimal thickening in rabbit carotid arteries after endothelial denudation. Histochem Cell Biol 1997;107:11–17.
21.
Groult V, Hornebeck W, Ferrari P, Tixier JM, Robert L, Jacob MP: Mechanisms of interaction between human skin fibroblasts and elastin: Differences between elastin fibres and derived peptides. Cell Biochem Funct 1991;9:171–182.
22.
Ghuysen-Itard AF, Robert L, Jacob MP: Effect of elastin peptides on cell proliferation (in French). CR Acad Sci III 1992;315:473–478.
23.
Senior RM, Griffin GL, Mecham RP: Chemotactic activity of elastin-derived peptides. J Clin Invest 1980;66:859–862.
24.
Bank AJ, Wang H, Holte JE, Mullen K, Shammas R, Kubo SH: Contribution of collagen, elastin, and smooth muscle to in vivo human brachial artery wall stress and elastic modulus. Circulation 1996;94:3263–3270.
25.
Cipolla MJ, Osol G: Vascular smooth muscle actin cytoskeleton in cerebral artery forced dilatation. Stroke 1998;29:1223–1228.
26.
Lu M, Witke W, Kwiatkowski DJ, Kosik KS: Delayed retraction of filopodia in gelsolin null mice. J Cell Biol 1997;138:1279–1287.
27.
Furukawa K, Fu W, Li Y, Witke W, Kwiatkowski DJ, Mattson MP: The actin-severing protein gelsolin modulates calcium channel and NMDA receptor activities and vulnerability to excitotoxicity in hippocampal neurons. J Neurosci 1997;17:8178–8186.
28.
Ohtsu M, Sakai N, Fujita H, Kashiwagi M, Gasa S, Shimizu S, Eguchi Y, Tsujimoto Y, Sakiyama Y, Kobayashi K, Kuzumaki N: Inhibition of apoptosis by the actin-regulatory protein gelsolin. Embo J 1997;16:4650–4656.
29.
Yamashita T, Kawashima S, Ohashi Y, Ozaki M, Rikitake Y, Inoue N, Hirata K, Akita H, Yokoyama M: Mechanisms of reduced nitric oxide/cGMP-mediated vasorelaxation in transgenic mice overexpressing endothelial nitric oxide synthase. Hypertension 2000;36:97–102.
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