Hypoxia, red blood cells, and nitrite regulate NO-dependent hypoxic vasodilation
Open accessAbstract
Local vasodilation in response to hypoxia is a fundamental physiologic response ensuring oxygen delivery to tissues under metabolic stress. Recent studies identify a role for the red blood cell (RBC), with hemoglobin the hypoxic sensor. Herein, we investigate the mechanisms regulating this process and explore the relative roles of adenosine triphosphate, S-nitrosohemoglobin, and nitrite as effectors. We provide evidence that hypoxic RBCs mediate vasodilation by reducing nitrite to nitric oxide (NO) and ATP release. NO dependence for nitrite-mediated vasodilation was evidenced by NO gas formation, stimulation of cGMP production, and inhibition of mitochondrial respiration in a process sensitive to the NO scavenger C-PTIO. The nitrite reductase activity of hemoglobin is modulated by heme deoxygenation and heme redox potential, with maximal activity observed at 50% hemoglobin oxygenation (P(50)). Concomitantly, vasodilation is initiated at the P(50), suggesting that oxygen sensing by hemoglobin is mechanistically linked to nitrite reduction and stimulation of vasodilation. Mutation of the conserved beta93cys residue decreases the heme redox potential (ie, decreases E(1/2)), an effect that increases nitrite reductase activity and vasodilation at any given hemoglobin saturation. These data support a function for RBC hemoglobin as an allosterically and redox-regulated nitrite reductase whose "enzyme activity" couples hypoxia to increased NO-dependent blood flow.
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Accumulating studies demonstrate production of bioavailable NO from incubation of erythrocytes with nitrite.
“Although theoretical calculations suggest that this type of NO escape should be limited, accumulating studies by many research groups now demonstrate the production of bioavailable NO generated from the incubation of erythrocytes with nitrite (185, 196, 883, 975).”
From Sources of Vascular Nitric Oxide and Reactive Oxygen Species and Their Regulation (2019) · cites this paper as [196]
Relaxation by nitrite and red blood cells was associated with cGMP formation and dependent on Hb oxygen affinity, with maximal effect occurring near the Hb p50, consistent with the notion that R-state Hb reduces nitrite more effectively than T-state Hb.
“Relaxation by nitrite and red blood cells was associated with cGMP formation and dependent on Hb oxygen affinity, with maximal effect occurring near the Hb p50, consistent with the notion that R-state Hb reduces nitrite more effectively than T-state Hb [109].”
From Mechanisms of nitrite bioactivation (2014) · cites this paper as [109]
At oxygen tensions of 15 and 25 mmHg as little as 200 nM nitrite was subsequently shown to effect relaxation in aortic rings in the presence of red blood cells and relaxation was abrogated by the NO scavenger CPTIO.
“At oxygen tensions of 15 and 25 mmHg as little as 200 nM nitrite was subsequently shown to effect relaxation in aortic rings in the presence of red blood cells and relaxation was abrogated by the NO scavenger CPTIO [109].”
From Mechanisms of nitrite bioactivation (2014) · cites this paper as [109]
Differential reactivity of nitrite reduction versus oxidation controlled by oxygen tension underlies the model in which nitrite selectively produces NO during graded hypoxia.
“This differential reactivity of nitrite reduction versus oxidation being controlled by oxygen tension (i.e. presence of deoxygenated vs oxygenated hemoglobin / myoglobin) illustrates the biochemical mechanism underlying the proposed model in which nitrite can selectively produce NO during graded hypoxia [5, 25-28].”
From Current perspectives and challenges in understanding the role of nitrite as an integral player in nitric oxide biology and therapy (2011) · cites this paper as [26]
Evidence for a role for NO is dependent largely on attenuation of responses by the NO-scavenger CPTIO and measurement of nitrite-dependent increases in cGMP levels.
“Evidence for a role for NO is dependent largely on attenuation of responses by the NO-scavenger CPTIO [25, 26, 52, 100] and measurement of nitrite-dependent increases in cGMP levels[26, 101].”
From Current perspectives and challenges in understanding the role of nitrite as an integral player in nitric oxide biology and therapy (2011) · cites this paper as [26]
Deoxygenated red cells are able to reduce nitrite to NO which mediated vessel ring dilation.
“Lastly, Crawford et al further demonstrated that deoxygenated red cells were able to reduce nitrite to NO which mediated vessel ring dilation, solidifying the biological importance of deoxyhemoglobin reduction of nitrite [109].”
From Inorganic nitrite therapy: historical perspective and future directions (2011) · cites this paper as [109]
Human and animal studies of NO gas inhalation suggest that nitrite mediates many of the systemic therapeutic effects of inhaled NO, including peripheral vasodilation and prevention of ischemia-reperfusion-mediated tissue infarction.
“Human and animal studies of NO gas inhalation suggest that nitrite mediates many of the systemic therapeutic effects of inhaled NO, including peripheral vasodilation and prevention of ischemia-reperfusion-mediated tissue infarction [19, 109, 148, 151, 152].”
From Inorganic nitrite therapy: historical perspective and future directions (2011) · cites this paper as [109]
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- Authors
- Crawford, J. H.
- Affiliations
- University of Alabama at Birmingham (US)
- Corresponding author
- Crawford, J. H.
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2006-01-15
- Volume
- 107
- Issue
- 2
- Pages
- 566-574
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- PMC
- PMC1895612
- OpenAlex
- W2138011583
- Cited by
- 497
- References
- 60
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 12 · 2023: 13 · 2022: 7 · 2021: 24 · 2020: 16 · 2019: 13 · 2018: 24 · 2017: 27 · 2016: 17 · 2015: 28 · 2014: 24 · 2013: 34 · 2012: 39
- FWCI
- 14.51
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Blood (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Heart Association
- National Institutes of Health (HL70146)
- National Heart, Lung, and Blood Institute (R01HL070146, HL 70146, HL24525)
- National Institute of General Medical Sciences (T32GM008361, T32 GM 08361)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Hemoglobin structure and function
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Heme Oxygenase-1 and Carbon Monoxide
- Keywords
- hypoxic vasodilation, erythrocytes, nitrite, nitric oxide, hemoglobin, nitrite reductase, heme redox potential, ATP release, cyclic GMP, mitochondrial respiration, oxygen sensing, oxygen delivery
- MeSH terms
- Adenosine Triphosphate, Allosteric Regulation, Erythrocytes, Cyclic GMP, Heme, Hemoglobins, Humans, Mitochondria, Mutation, Nitric Oxide, Nitrite Reductases, Nitrites, Oxidation-Reduction, Oxygen, Respiration, Vasodilation, Cell Hypoxia
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