Mechanisms of cardioprotection by peroxynitrite in myocardial ischemia and reperfusion injury.

Peroxynitrite (ONOO-), an intermediate formed from the equimolar interaction of nitric oxide (NO) and superoxide, is thought to be an important mediator of tissue injury in myocardial ischemia-reperfusion. However, physiologically relevant (i.e., maximally achievable) concentrations of ONOO- significantly decreased neutrophil-endothelium interactions in the rat mesentery. We therefore examined the dose-response relationship of infusion of different concentrations of ONOO- in a feline model of myocardial ischemia-reperfusion and provide data on the cellular mechanisms responsible for these observed effects. Cats subjected to 90 min of ischemia followed by 270 min of reperfusion were infused with different concentrations of ONOO- 10 min before reperfusion and continuing throughout reperfusion. We observed that infusion of 2 microM ONOO- provided significant cardioprotection, whereas either 0.2 or 20 microM ONOO- did not protect. ONOO- at 2 microM also preserved coronary endothelial function, decreased P-selectin expression, and attenuated polymorphonuclear leukocyte (PMN) adherence to the vascular endothelium. ONOO- did not exert its cardioprotective effects by acting as a direct NO donor in solution. However, in vitro, ONOO- can react with glutathione to form S-nitrosoglutathione, which can act as an NO carrier and exert beneficial effects. Thus only maximally achievable concentrations of ONOO- exert significant cardioprotective effects, in part by decreasing surface expression of P-selectin and decreasing PMN-endothelium interactions.