Role of endothelial nitric oxide synthase and vagal activity in the endothelial protection of atorvastatin in ischemia/reperfusion injury.

Vascular endothelial dysfunction plays a pivotal role in the development and maintenance of ischemia/reperfusion (I/R) injury. Statins, developed as lipid-lowering drugs, partially restore vagal activity and exhibit pleiotropic effects. This study was aimed at determining the effect of atorvastatin (ATV) on endothelial dysfunction in peripheral resistance arteries after I/R injury. After pretreatment with ATV (10 mg·kg·d) or its vehicle for 3 days, the superior mesenteric artery was occluded for 60 minutes and reperfusion for 90 minutes or the rats were anesthetized without being subjected to ischemia. In the ATV-treated I/R group, the increased contractions to KCl and 5-hydroxytryptamine induced by I/R were ameliorated, and attenuated endothelium-dependent relaxations to acetylcholine (ACh) were normalized. The restored relaxation to ACh was abolished by N-nitro-L-arginine methyl ester. ATV prevented the structural damage of vascular endothelial cells. Furthermore, the activities of phosphatidylinositol-3-kinase, Akt, and endothelial nitric oxide synthase were elevated in mesenteric arteries after ATV treatment. In addition, I/R-induced increment of endothelial cells apoptosis was also attenuated by ATV. Intriguingly, ATV also increased baroreflex sensitivity and serum ACh content after I/R. In conclusion, the endothelial protective effect of ATV in peripheral arteries is associated with the activated phosphatidylinositol-3-kinase/Akt/endothelial nitric oxide synthase pathway and restored vagal activity.