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Published Online
on July 30, 2007

Hypertension. 2007
Published online before print July 30, 2007, doi: 10.1161/HYPERTENSIONAHA.107.094458
A more recent version of this article appeared on October 1, 2007
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Submitted on May 18, 2007
Revised on June 11, 2007

Nebivolol Induces Nitric Oxide Release in the Heart Through Inducible Nitric Oxide Synthase Activation

Angelo Maffei; Alba Di Pardo; Rosa Carangi; Pierluigi Carullo; Roberta Poulet; Maria T. Gentile; Carmine Vecchione; and Giuseppe Lembo*

From the Department of AngioCardioNeurology (A.M., A.D.P., R.C., P.C., R.P., M.T.G., C.V., G.L.), IRCCS Neuromed, Pozzilli, Italy; and the Department of Experimental Medicine (G.L.), La Sapienza University of Rome, Rome, Italy.

* To whom correspondence should be addressed. E-mail: lembo{at}neuromed.it.

Abstract—Nebivolol is a {beta}1-adrenergic receptor antagonist that also reduces blood pressure by evoking endothelial NO production and vasodilation. We aimed at assessing whether nebivolol induces NO production also in the heart and delineating the molecular mechanisms involved. Using the fluorescent probe diaminofluorescein, we found that nebivolol induces a dose-dependent NO production in the heart, statistically significant already at 10-7 mol/L. It is not an effect because of the blockade of {beta}1-adrenergic receptor, because this effect is not shared by another drug of the same class, atenolol. Because nebivolol has been reported to act as an agonist on other {beta}-adrenergic receptors, we tested NO production in the presence of receptor antagonists. Nebivolol was not able to induce NO production in presence of the {beta}3-antagonist SR59230A, indicating a fundamental role for {beta}3-adrenergic receptors in cardiac NO production by nebivolol. Moreover, inducible NO synthase inhibition abolishes NO release in the heart, indicating that nebivolol induces NO production by acting on the inducible isoform of the enzyme. The action of nebivolol on inducible NO synthase was confirmed by real-time PCR experiments, showing cardiac overexpression of inducible NO synthase but not neuronal NO synthase or endothelial NO synthase, after 5 hours of treatment with nebivolol. In conclusion, our study demonstrates that nebivolol also stimulates NO production in the heart. This action of nebivolol is exerted via a signaling pathway starting from the activation of {beta}3-adrenergic receptors and leading to overexpression of inducible NO synthase. Cardiac NO production by nebivolol could participate in the cardiovascular effects of nebivolol treatment in patients affected by hypertension and heart failure.


Key words: adrenergic agents • adrenergic beta receptors • heart • NO • NO synthase




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