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Circulation. 2000;102:2190-2196

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(Circulation. 2000;102:2190.)
© 2000 American Heart Association, Inc.


Clinical Investigation and Reports

Bradykinin Stimulates Tissue Plasminogen Activator Release From Human Forearm Vasculature Through B2 Receptor–Dependent, NO Synthase–Independent, and Cyclooxygenase-Independent Pathway

Nancy J. Brown, MD; James V. Gainer, MD; Laine J. Murphey, MD, PhD; Douglas E. Vaughan, MD

From the Departments of Medicine and Pharmacology (N.J.B., J.V.G., L.J.M., D.E.V.), Vanderbilt University Medical Center, and the Nashville Veteran’s Administration Medical Center (D.E.V.), Nashville, Tenn.

Background—Bradykinin stimulates dose-dependent tissue plasminogen activator (tPA) release from human endothelium. Although bradykinin is known to cause vasodilation through B2 receptor–dependent effects on NO, prostacyclin, and endothelium-derived hyperpolarizing factor production, the mechanism(s) underlying tPA release is unknown.

Methods and Results—We measured the effects of intra-arterial bradykinin (100, 200, and 400 ng/min), acetylcholine (15, 30, and 60 µg/min), and nitroprusside (0.8, 1.6, and 3.2 µg/min) on forearm vasodilation and tPA release in healthy volunteers in the presence and absence of (1) the B2 receptor antagonist HOE 140 (100 µg/kg IV), (2) the NO synthase inhibitor L-NG-monomethyl-L-arginine (L-NMMA, 4 µmol/min intra-arterially), and (3) the cyclooxygenase inhibitor indomethacin (50 mg PO TID). B2 receptor antagonism attenuated vasodilator (P=0.004) and tPA (P=0.043) responses to bradykinin, without attenuating the vasodilator response to nitroprusside (P=0.36). L-NMMA decreased basal forearm blood flow (from 2.35±0.31 to 1.73±0.22 mL/min per 100 mL, P=0.01) and blunted the vasodilator response to acetylcholine (P=0.013) and bradykinin (P=0.07, P=0.038 for forearm vascular resistance) but not that to nitroprusside (P=0.47). However, there was no effect of L-NMMA on basal (P=0.7) or bradykinin-stimulated tPA release (P=0.45). Indomethacin decreased urinary excretion of the prostacyclin metabolite 2,3-dinor-6-keto-prostaglandin F1{alpha} (P=0.04). The vasodilator response to endothelium-dependent (P=0.019 for bradykinin) and endothelium-independent (P=0.019) vasodilators was enhanced during indomethacin administration. In contrast, there was no effect of indomethacin alone (P=0.99) or indomethacin plus L-NMMA (P=0.36) on bradykinin-stimulated tPA release.

Conclusions—These data indicate that bradykinin stimulates tPA release from human endothelium through a B2 receptor–dependent, NO synthase–independent, and cyclooxygenase-independent pathway. Bradykinin-stimulated tPA release may represent a marker for the endothelial effects of endothelium-derived hyperpolarizing factor.


Key Words: bradykinin • endothelium • endothelium-derived factors • nitric oxide synthase • plasminogen activators




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