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Cytoprotective effects of nitrite during in vivo ischemia-reperfusion of the heart and liver
Mark R. Duranski, James J.M. Greer, Andre Dejam, Sathya Jaganmohan, Neil Hogg, William Langston, Rakesh P. Patel, Shaw-Fang Yet, Xunde Wang, Christopher G. Kevil, Mark T. Gladwin, David J. Lefer
Mark R. Duranski, James J.M. Greer, Andre Dejam, Sathya Jaganmohan, Neil Hogg, William Langston, Rakesh P. Patel, Shaw-Fang Yet, Xunde Wang, Christopher G. Kevil, Mark T. Gladwin, David J. Lefer
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Article Cardiology

Cytoprotective effects of nitrite during in vivo ischemia-reperfusion of the heart and liver

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Abstract

Nitrite represents a circulating and tissue storage form of NO whose bioactivation is mediated by the enzymatic action of xanthine oxidoreductase, nonenzymatic disproportionation, and reduction by deoxyhemoglobin, myoglobin, and tissue heme proteins. Because the rate of NO generation from nitrite is linearly dependent on reductions in oxygen and pH levels, we hypothesized that nitrite would be reduced to NO in ischemic tissue and exert NO-dependent protective effects. Solutions of sodium nitrite were administered in the setting of hepatic and cardiac ischemia-reperfusion (I/R) injury in mice. In hepatic I/R, nitrite exerted profound dose-dependent protective effects on cellular necrosis and apoptosis, with highly significant protective effects observed at near-physiological nitrite concentrations. In myocardial I/R injury, nitrite reduced cardiac infarct size by 67%. Consistent with hypoxia-dependent nitrite bioactivation, nitrite was reduced to NO, S-nitrosothiols, N-nitros-amines, and iron-nitrosylated heme proteins within 1–30 minutes of reperfusion. Nitrite-mediated protection of both the liver and the heart was dependent on NO generation and independent of eNOS and heme oxygenase-1 enzyme activities. These results suggest that nitrite is a biological storage reserve of NO subserving a critical function in tissue protection from ischemic injury. These studies reveal an unexpected and novel therapy for diseases such as myocardial infarction, organ preservation and transplantation, and shock states.

Authors

Mark R. Duranski, James J.M. Greer, Andre Dejam, Sathya Jaganmohan, Neil Hogg, William Langston, Rakesh P. Patel, Shaw-Fang Yet, Xunde Wang, Christopher G. Kevil, Mark T. Gladwin, David J. Lefer

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Figure 3

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Blood and liver tissue levels of nitrite, RSNO, and RxNO. (A) Liver nitr...
Blood and liver tissue levels of nitrite, RSNO, and RxNO. (A) Liver nitrite, RSNO, and RxNO levels (μmol/l) in animals (n = 3–5 per group) subjected to sham hepatic I/R (Sham) or to hepatic ischemia plus either 1 minute (1 Rep) or 30 minutes (30 Rep) of reperfusion. Experiments are saline-treated controls without nitrite. **P < 0.001 vs. baseline. (B) Liver tissue nitrite levels in mice (n = 3–5 per group) subjected to hepatic I/R injury. (C) Liver tissue RSNO levels (μmol/l) in mice (n = 3–5 per group) subjected to hepatic ischemia and varying periods of reperfusion. (D) Hepatic tissue RxNO levels (μmol/l) after hepatic ischemia and reperfusion in mice (n = 3–5 per group). Experiments in B–D compare saline-treated controls to those with nitrite treatment (48 nmol). Numbers inside bars indicate the number of mice investigated in each group.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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