Release of nitric oxide from glyceryl trinitrate by captopril but not enalaprilat: in vitro and in vivo studies
Authors: Salvemini Daniela , Pistelli Alessandra , Mollace Vincenzo 
Published: July 2012

The hypotensive effects of glyceryl trinitrate (GTN, 0.5 mg kg−1) but not of 3‐morpholinosydnonimine (SIN‐1, 0.125 mg kg−1) in anaesthetized rats were attenuated following a seven day (using a q.i.d. dosing schedule) oral treatment with isosorbide‐5‐mononitrate (IS‐5‐MN; 5 mg kg−1) indicative of the induction of tolerance to GTN but not to SIN‐1. The hypotensive effects of GTN did not decline when the sulphydryl (SH) containing angiotensin converting enzyme inhibitor (ACE‐I), captopril (CPT, 5 mg kg−1) or the structurally unrelated SH‐containing, N‐acetylcysteine (NAC, 10 mg kg−1) but not the non‐SH‐containing ACE‐I, enalaprilat (ENA, 5 mg kg−1) were given together with IS‐5‐MN for the seven days treatment.

The attenuated hypotensive effects of GTN (0.5 mg kg−1) in rats treated with IS‐5‐MN were also restored when CPT (1 mg kg−1) or NAC (2.5 mg kg−1) but not ENA (1 mg kg−1) was administered intraperitoneally (i.p.) 30 min before GTN. Furthermore, in control rats, CPT or NAC but not ENA given i.p. 30 min before GTN, potentiated its haemodynamic effects. These effects were blocked by methylene blue (10 mg kg−1). At the same doses, CPT or NAC did not affect the hypotensive effects of SIN‐1.

The reduced ability of cultured tolerant smooth muscle cells (SMC, 24 × 103 cells) or endothelial cells (EC, 40 × 103 cells) to potentiate the anti‐platelet effects of GTN (44 μm) was restored by CPT or NAC but not by ENA or glutathione (all at 0.5 mm). Potentiation of the anti‐platelet effects of tolerant SMC or EC by CPT or NAC was abolished by co‐incubation with oxyhaemoglobin (Oxy‐Hb, 10 μm) indicative of nitric oxide (NO) formation.

When GTN (150–2400 μm) was incubated with CPT, NAC or glutathione but not ENA (all at 0.1 mm) for 30 min in Krebs buffer at 37°C a concentration‐dependent increase in nitrite (NO2−) formation was observed.

The antiplatelet effects of GTN (5.5–352 μm) were potentiated by co‐incubation with CPT or NAC but not with ENA or glutathione (all at 0.5 mm). The concentration of GTN required to inhibit platelet aggregation by 50% (IC50) was 110 ± 2 μm for GTN alone, 14 ± 2 μm for GTN in the presence of NAC and 30 ± 2 μm for GTN in the presence of CPT. The potentiation of the effects of GTN by CPT or NAC was inhibited by co‐incubation with Oxy‐Hb (10 μm). By themselves, CPT or NAC did not inhibit platelet aggregation.

The ability of CPT to restore (a) the haemodynamic effects of GTN in tolerant rats and (b) the reduced capacity of tolerant SMC or EC to potentiate the anti‐platelet effects of GTN is not related to its ACE inhibitory activity.

CPT also potentiated the hypotensive effects of GTN in non‐tolerant rats, and in vitro CPT released NO from GTN in the absence of a GTN to NO converting cell, so that it is unlikely that reversal of tolerance by CPT is due to the replenishment of intracellular thiols. Rather it can be explained by the ability of CPT to release NO from GTN in the extracellular space. This extracellular formation of NO from GTN by CPT would then compensate for the impaired enzymic biotransformation of GTN to NO that develops during tolerance as was originally proposed for NAC.