This Article Full Text Full Text (PDF) Data Supplement All Versions of this Article: 27/8/1729    most recent ATVBAHA.107.143909v1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wenzel, P. Articles by Daiber, A. Search for Related Content PubMed PubMed Citation Articles by Wenzel, P. Articles by Daiber, A. Related Collections Related Article

(Arteriosclerosis, Thrombosis, and Vascular Biology. 2007;27:1729.)
© 2007 American Heart Association, Inc.

Vascular Biology

Heme Oxygenase-1

A Novel Key Player in the Development of Tolerance in Response to Organic Nitrates

Philip Wenzel; Matthias Oelze; Meike Coldewey; Marcus Hortmann; Andreas Seeling; Ulrich Hink; Hanke Mollnau; Dirk Stalleicken; Henry Weiner; Jochen Lehmann; Huige Li; Ulrich Förstermann; Thomas Münzel; Andreas Daiber

From the II. Medizinische Klinik (P.W., M.O., M.C., U.H., H.M., T.M., A.D.), Johannes-Gutenberg-Universität Mainz, Germany; Institut für Pharmakologie (M.H., H.L., U.F.), Johannes-Gutenberg-Universität Mainz, Germany; Institut für Pharmazie (A.S., J.L.), Friedrich-Schiller-Universität Jena, Germany; Actavis Deutschland GmbH (D.S.), Langenfeld, Germany; and the Department of Biochemistry (H.W.), Purdue University, West Lafayette, Ind.

Correspondence Prof Dr Thomas Münzel, II. Medizinische Klinik, Johannes-Gutenberg-Universität Mainz, Langenbeckstr. 1, 55131 Mainz, Germany. E-mail tmuenzel{at}uni-mainz.de

Objective— Nitrate tolerance is likely attributable to an increased production of reactive oxygen species (ROS) leading to an inhibition of the mitochondrial aldehyde dehydrogenase (ALDH-2), representing the nitroglycerin (GTN) and pentaerythrityl tetranitrate (PETN) bioactivating enzyme, and to impaired nitric oxide bioactivity and signaling. We tested whether differences in their capacity to induce heme oxygenase-1 (HO-1) might explain why PETN and not GTN therapy is devoid of nitrate and cross-tolerance.

Methods and Results— Wistar rats were treated with PETN or GTN (10.5 or 6.6 µg/kg/min for 4 days). In contrast to GTN, PETN did not induce nitrate tolerance or cross-tolerance as assessed by isometric tension recordings in isolated aortic rings. Vascular protein and mRNA expression of HO-1 and ferritin were increased in response to PETN but not GTN. In contrast to GTN therapy, NO signaling, ROS formation, and the activity of ALDH-2 (as assessed by an high-performance liquid chromatography–based method) were not significantly influenced by PETN. Inhibition of HO-1 expression by apigenin induced "tolerance" to PETN whereas HO-1 gene induction by hemin prevented tolerance in GTN treated rats.

Conclusions— HO-1 expression and activity appear to play a key role in the development of nitrate tolerance and might represent an intrinsic antioxidative mechanism of therapeutic interest.

Tolerance to nitroglycerin is likely attributable to an increased production of reactive oxygen species and an inhibition of its bioactivating enzyme. Pentaerythrityl tetranitrate (PETN) therapy is devoid of tolerance, potentially because of HO-1 induction. Inhibition of HO-1 expression induced "tolerance" to PETN, whereas HO-1 induction prevented tolerance in nitroglycerin-treated rats.

Key Words: organic nitrates • nitrate tolerance • heme oxygenase-1 • reactive oxygen species

Related Article:

Combating Nitrate Tolerance: A Novel Endogenous Mechanism

David D. Gutterman
Arterioscler Thromb Vasc Biol 2007 27: 1673-1676. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				A. Pautz, P. Rauschkolb, N. Schmidt, J. Art, M. Oelze, P. Wenzel, U. Forstermann, A. Daiber, and H. Kleinert Effects of nitroglycerin or pentaerithrityl tetranitrate treatment on the gene expression in rat hearts: evidence for cardiotoxic and cardioprotective effects Physiol Genomics, July 9, 2009; 38(2): 176 - 185. [Abstract] [Full Text] [PDF]

				P. Wenzel, E. Schulz, T. Gori, M. A. Ostad, F. Mathner, S. Schildknecht, S. Gobel, M. Oelze, D. Stalleicken, A. Warnholtz, et al. Monitoring White Blood Cell Mitochondrial Aldehyde Dehydrogenase Activity: Implications for Nitrate Therapy in Humans J. Pharmacol. Exp. Ther., July 1, 2009; 330(1): 63 - 71. [Abstract] [Full Text] [PDF]

				U. Hink, A. Daiber, N. Kayhan, J. Trischler, C. Kraatz, M. Oelze, H. Mollnau, P. Wenzel, C. F. Vahl, K. K. Ho, et al. Oxidative Inhibition of the Mitochondrial Aldehyde Dehydrogenase Promotes Nitroglycerin Tolerance in Human Blood Vessels J. Am. Coll. Cardiol., December 4, 2007; 50(23): 2226 - 2232. [Abstract] [Full Text] [PDF]

				D. D. Gutterman Combating Nitrate Tolerance: A Novel Endogenous Mechanism Arterioscler Thromb Vasc Biol, August 1, 2007; 27(8): 1673 - 1676. [Full Text] [PDF]