Tian Y, Zhang C, Fang Z, Betts W H
Department of Clinical Biochemistry, Chinese PLA General Hospital, 100853, Beijing, PR China.
Clin Chim Acta. 2001 Nov;313(1-2):51-7. doi: 10.1016/s0009-8981(01)00649-0.
Extensive research has been conducted regarding the mechanism of action of glyceryl trinitrate (GTN). It is currently believed that GTN undergoes a thiol-dependent metabolic pathway and releases its active metabolite, nitric oxide (NO) and/or S-nitrosothiols (R-SNO). This activates guanylyl cyclase (GC) leading to the formation of cGMP, which is responsible for the relaxation of vascular smooth muscles and the inhibition of platelet aggregation. The lack of knowledge as to the precise mechanism of GTN action and the modulation of its formation has limited the prevention of tolerance to GTN.
With cultured human vascular endothelial cells (EC), we showed that nitrite was first formed in endothelial cells whose concentration was dependent on reduced thiols. Cells preexposed to GTN significantly decreased the production of nitrite compared with cells that were not preexposed. Furthermore, we showed that thiols in cultured cells were oxidized during interaction with GTN, which correlated with the time of exposure to GTN.
Nitrite is the first active intermediate of GTN metabolism in endothelial cells. The analysis of the changes of the blood nitrite and reduced thiols concentration is helpful for evaluating the vasodilatation activity of GTN during therapeutic treatments.
关于硝酸甘油(GTN)的作用机制已开展了广泛研究。目前认为,GTN经历一条依赖硫醇的代谢途径并释放其活性代谢物一氧化氮(NO)和/或S-亚硝基硫醇(R-SNO)。这会激活鸟苷酸环化酶(GC),导致环磷酸鸟苷(cGMP)的形成,而cGMP负责血管平滑肌的舒张和血小板聚集的抑制。对GTN作用的精确机制及其形成调节的认识不足限制了对GTN耐受性的预防。
利用培养的人血管内皮细胞(EC),我们发现亚硝酸盐首先在内皮细胞中形成,其浓度取决于还原型硫醇。与未预先暴露于GTN的细胞相比,预先暴露于GTN的细胞显著降低了亚硝酸盐的产生。此外,我们表明培养细胞中的硫醇在与GTN相互作用期间被氧化,这与暴露于GTN的时间相关。
亚硝酸盐是内皮细胞中GTN代谢的首个活性中间体。分析血液中亚硝酸盐和还原型硫醇浓度的变化有助于评估治疗期间GTN的血管舒张活性。