Methylene blue inhibits vasodilation of skeletal muscle arterioles to acetylcholine and nitric oxide via the extracellular generation of superoxide anion.

The mechanism of modulation of cyclic GMP-associated vascular responses by methylene blue, an agent employed to inhibit the activation of soluble guanylate cyclase in tissues, was investigated in the cremaster muscle microcirculation of pentobarbital-anesthetized rats. The effect of topically applied agents on the diameter of third-order arterioles (15-20 microns diameter) was determined by in vivo television microscopy. Topical application (100 microliters) of acetylcholine (0.01 microgram) or nitric oxide (0.06-6 micrograms) caused vasodilator responses that were inhibited (P less than .05, n = 6-8) 64% and 30 to 100%, respectively, by suffusion of the preparation with 5 microM methylene blue. Agents that are thought to produce activation of guanylate cyclase via cellular metabolism to nitric oxide, nitroglycerin (0.5 ng-0.5 microgram) or nitroprusside (0.5 ng-0.5 microgram), also produced vasodilation. However, methylene blue suffusion did not inhibit these responses (n = 6-9). The inhibition of vasodilation to acetylcholine or nitric oxide by methylene blue was completely prevented by suffusion of superoxide dismutase, but not affected by suffusion of catalase. Based on the current conceptualization of the mechanism of action of these vasodilator agents in isolated larger blood vessels, methylene blue appears to inhibit responses in this skeletal muscle microcirculatory preparation through the extracellular generation of superoxide anion and not via a direct interaction with guanylate cyclase.