Bradykinin induced concentration-dependent relaxation, which was completely abolished by removal of the endothelium. Moreover, inhibition of NO synthase and cyclooxygenase together with an NO scavenger completely abolished bradykinin-induced relaxation. These findings suggest that endothelium-dependent bradykinin-induced relaxation was mediated by release of the vasodilating agents NO and prostanoids. NO has been reported to play an important role in regulating ocular blood flow.
14 15 16 17 18 In porcine and human ophthalmic arteries, NO synthase inhibition increases basal myogenic tone and decreases acetylcholine- and bradykinin-induced vasodilation, indicating that NO regulates both basal tone and agonist-induced vasodilation.
14 15 Furthermore, altered NO bioavailability has been associated with ischemia–reperfusion injury,
19 20 21 and the diseases primary open-angle glaucoma
22 23 and diabetic retinopathy.
24 25 26 27 In ischemia–reperfusion injury, administration of either NO donors or
l-arginine at the time of retinal ischemia improves retinal function after ischemia, presumably due to enhanced retinal blood flow,
19 20 whereas postischemic treatment with NO synthase inhibitors seems to improve retinal function.
21 In patients with normal-pressure glaucoma, acetylcholine-induced, NO-mediated forearm vasodilation is reduced compared with that in healthy volunteers, suggesting a general endothelial dysfunction in these patients,
22 which is suggested to be due to impaired NO formation.
23 Moreover, in eyes from patients with primary open-angle glaucoma, during NO synthase inhibition the decrease of optic nerve head blood flow is less pronounced than that in healthy control eyes.
28 However, in subcutaneous resistance arteries of patients with normal-pressure glaucoma, the endothelium-dependent relaxation is not altered compared with that in subcutaneous resistance arteries of healthy subjects.
29 In patients with type I diabetes mellitus, NO synthase inhibition decreases blood flow velocity in the ophthalmic artery and increases blood pressure less than in healthy subjects. These results suggest that either basal NO release is decreased or NO sensitivity is impaired in patients with type I diabetes mellitus, leading the authors to propose that the
l-arginine-NO system is involved in the pathophysiology of diabetic retinopathy.
24 Moreover, NO formation is decreased in insulin resistant states,
26 which may relate to a decreased activity due to inactivation of NO by free radicals.
27 However, no difference in the ocular and systemic effects of NO synthase inhibition was observed between patients with type I diabetes and control subjects, indicating that responsiveness to NO of the choroidal vasculature and the ophthalmic artery is not altered in early type I diabetes.
25