Nitric Oxide Flashcards

1
Q

Why are the diverse biological functions of NO surprising?

A

NO is also an atmospheric pollutant and a free radical.

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2
Q

How is NO found naturally?

A

NO is formed in the soil by denitrifying bacteria, and is a major component of cigarette smoke.

NO is part of the series of oxides of nitrogen, including nitrous oxide (N2O), nitrogen dioxide (NO2), nitrite (NO2-) and nitrate (NO3-).

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3
Q

How is NO broken down in the body non-catalytically?

A

Nitric oxide is converted to nitrogen dioxide by reaction with molecular oxygen (O2). Within the body this is a very slow reaction due to the stoichiometry.

The requirement for two NO molecules to simultaneously interact with dioxygen means that solubilised NO is stable at concentrations below 1M.

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4
Q

What kind of half life does NO have in the body and why?

A

In the body, the lifespan of NO is very low due to its high-affinity association for haem-compounds, particularly haemoglobin.

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5
Q

How was NO’s biological relevance discovered?

A

NO was first known by its function before chemical characterisation, initially being designated endothelium dependent relaxing factor (EDRF).

Isolated EDRF was identified as being NO by the unique spectrum of the nitrosylhaemoglobin it formed as well as the distinctive chemiluminescence produced by its reaction with ozone.

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6
Q

How is NO biosynthesised?

A

This is done by Nitric Oxide Synthase (NOS) using L-arginine as a substrate. This amino acid is in high concentration within cells in the form of its intermediate N-hydroxyarginine. The conversion of L-arginine to L-citrulline allows nitration of O2.

This reaction forms part of a cycle of deamination and re-amination of L-arginine, which involves the Krebs cycle and is linked to the ornithine cycle.

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7
Q

What factors are required for NOS?

A

Several cofactors are required for this, including NADPH (two of which are oxidised to NADP+), calmodulin/Ca2+, tetrahydrobiopterin, Haem, FMN and FAD.

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8
Q

Describe the NOS family.

A

There are three NOS isoforms, designated I, II and III, which serve different biological roles.

All have significant homology with Cytochrome P450 Reductase enzyme, but this is unable to make NO as it lacks the specific reductase domain required.

All three genes are present on different chromosomes.

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9
Q

Describe the features of NOS I

A

Neuronal NOS shares most with NOS III, but differs in its acquisition of a PDZ domain which targets the protein to neuronal synapses and its lack of plasma membrane anchoring sites.

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10
Q

What is the role of NOS I?

A

NOS I produces NO as a neurotransmitter at low levels constitutively (though is calcium-dependent), and is involved in many responses, including in the GI tract, penile erection, sphincter relaxation, and blood flow.

It is also known to be involved with synaptic plasticity and modulation of cellular response to glutamate.

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11
Q

What is the role of NOS II?

A

Inducible NOS is activated as part of the non-specific immune response to micro-organisms and the inflammatory response.

It is induced to great levels of activity by various pathogenic stimuli, including bacterial lipopolysaccharides, reaching its maximum activity levels after 24hrs – after which is it not further activates by increased calcium.

Like NOS I, it lacks plasma membrane anchoring sites.

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12
Q

What are the features and roles of NOS III?

A

Endothelial NOS, like NOS I, produces low levels of NO constitutively though calcium-dependently, and is activated in response to a variety of stimuli. Uniquely, eNOS is anchored to the plasma membrane by myristoylation and palmitoylation.

NOS III is involved in blood flow and pressure, as well as inhibiting platelet activation. Thus it is the one important in the context of CVD.

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13
Q

How is the baseline NO level maintained and what effect does it have?

A

The gene expression and enzymatic activity both being constitutive, eNOS produces low levels of NO constantly within the endothelium, where it diffuses both into the lumen and into the vessel wall, leading to inhibition of platelet activation and smooth muscle cell relaxation in those places respectively.

NOS III is directly activated primarily by two pathways, each of which are sensitive to a number of stimuli.

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14
Q

What pathways directly regulate eNOS?

A

Activation of the PI3K/Akt pathway by oestrogens and pulsatile shear stress leads Akt phosphorylating a serine in the calcium-binding domain of eNOS, activating it.

NOS III is also activated by increased calcium concentration, which results from increased levels of ATP and acetylcholine, amongst others.

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15
Q

How is eNOS indirectly upregulated?

A

NOS III can also be upregulated indirectly by the availability of L-arginine and its cofactors. The cofactor availability can also affect the reaction performed by eNOS – it is also prone to production of superoxide anions and hydrogen peroxide.

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16
Q

What is the effect of the hydrogen peroxide by product?

A

The production of H2O2 may be part of the biological function; it is believed to be one of the endothelium-dependent hyperpolarising factors that relax the resistance vessels that are insensitive to NO.

Vessel relaxation is in fact controlled by a wide variety of regulators, including prostaglandin, endothelin and thromboxane (see endothelial dysfunction lecture).

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17
Q

What inhibits NOS?

A

Experimentally, L- N methyl arginine is used as a competitive inhibitor.

There are however two natural inhibitors, produced from L-arginine, that are found in blood and tissues: asymmetric and symmetric dimethyl arginine (ADMA and SDMA).

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18
Q

What controls the production of natural NOS inhibitors?

A

ADMA and SDMA are competitive inhibitors produced from L-arginine by protein-arginine methyltransferases (PRMTs), and are themselves converted to citrulline by dimethylarginine dimethylaminohydrolase (DDAH).

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19
Q

Describe the NO receptor.

A

Nitric oxide exerts its affects by activating soluble guanylyl cyclase (sGC), which produces cGMP.

This is a heterodimeric protein formed of an α and β subunit, binding a single ferroprotoporphyrin IX; an immediate precursor of haem that tetra-coordinates the iron with an axial histidine.

20
Q

How does NO activate sGC?

A

NO is believed to activate sGC by binding to this prosthetic haem to form a ferrous-nitrosyl haem complex, which leads to a change in conformation of the rest of the protein.

While this greatly upregulates it, the haem group is not actually even required for basal activity.

21
Q

How does sGC signal to produce an effect when stimulated by NO?

A

The activation of sGC leads to a huge increase in its production of the cGMP second messenger from GTP. Like cAMP, this activates specific kinases dependent upon the cyclic nucleotides that facilitate the signalling, specifically cGMP-dependent Protein Kinases (cGPK).

22
Q

How does NO affect smooth muscle?

A

The vasodilation (and resulting decrease in blood pressure, increase in flow) stimulated by NO is effected by the active cGPK phospho-inhibiting Rho A within the contraction signalling pathway.

23
Q

How does active cGPK stimulate vasodilation?

A

cGPK phospho-inhibits Rho A, preventing it from activating Rho-kinase.

Rho kinase would otherwise inactivate myosin light chain kinase phosphatase (MLCP) which opposes the myosin phosphorylation action of myosin light chain kinase (MLCK).

Since myosin phosphorylation leads to actin binding and contraction, preventing Rho kinases’ inhibition of MLCP and thus preventing the contraction that would cause vasoconstriction.

24
Q

How does NO signal to platelets?

A

The inhibition of platelet activation is facilitated by cGPK phospho-inactivation via Ser-238 of vasodilator sensitive phosphoprotein (VASP).

This normally interacts with other cytoskeletal proteins to permit the shape changes associated with platelet activation.

25
Q

What do mutation studies imply about the function of VASP?

A

VASP-knockout mice have impaired platelet function but normal smooth muscle relaxation, underscoring the separation of the two pathways.

However, that the platelet activation was not totally lost implies some redundancy within the protein family.

26
Q

How is VASP regulated other than by NO?

A

VASP has two other phosphorylation sites, a threonine and another serine; Ser-157. This site is sensitive to phosphorylation by the cAMP activated protein kinase A – a response stimulated by prostacyclin signalling.

Hence VASP is downregulated by both of the similarly-stimulated endothelial signals. The Ser-157 phosphorylation appears to lead to an increase in molecular weight of VASP from 47 to 50kDa, perhaps indicating a recruitment occurrence.

27
Q

How is NO signalling terminated?

A

This is common to all affected cells. cGPK phosphoactivates PDE V, an enzyme which degrades cGMP, creating a negative feedback loop.

This is the process inhibited by Viagra, allowing for continued vasodilation and old people sex.

28
Q

How can NO act as a regulator other than through sGC?

A

As well as acting through cGMP as a second messenger, NO can regulate proteins through direct interaction, including through nitrosation of proteins or nitrosothiol production.

29
Q

What is nitrosation and what are nitrosothiols?

A

Here the NO is being used to add a post-translational modification to the protein, specifically adding to the cysteine, histidine or glutamate on proteins (Nitrosation) or formation of free nitrosothiols by reaction with free cysteine.

30
Q

How are nitrosothiols produced?

A

Nitrosothiols are formed normally by the reaction of NO with NO2, in a 2:2 stoichiometry, to produce two dinitrogen trioxide (N2O3).

This then reacts with the thiol group to leave an NO group attached, releasing a proton and NO2.

2(NO) + 2(NO2) -> 2(N2O3)

N2O3 + HS-Prot -> Prot-S-NO + H+ + NO2-

31
Q

How can nitrosothiols increase NO stability?

A

This can produce free S-nitrocysteine, S-nitroglutathione or S-nitrosoalbumin, which actually are more stable than free NO – having a total blood concentration of 15-30nM.

32
Q

How is nitrosation used as a regulator?

A

Nitrosation of haemoglobin is thought to play an important part in oxygen delivery, by modifying the binding between O2 and Hb. Nitrosation of the aconitase Fe-S cluster produces iron-response element binding protein, which regulates iron metabolism.

NO also regulates the ETC by interaction with the various haem groups, including inhibition of cytochrome c oxidase. However, the overall effect of protein nitrosation is largely unknown.

33
Q

What can excess NO lead to?

A

Excess NO can, due to both over-production of nitrosated proteins and nitrosothiols, lead to nitrosative stress. Neurones are particularly sensitive to this.

34
Q

How can NO interact with ROS?

A

NO can react with superoxide anions to produce peroxynitrite (ONOO-), a powerful oxidant and nitrating agent capable of damaging a wide range of molecules.

35
Q

How does peroxynitrite cause damage?

A
  • DNA base oxidation
  • Nitration of Tyr, Trp, Phe
  • Cysteine oxidation to sulphoximes
  • Lipid oxidation
36
Q

How can peroxynitrites interfere with signalling?

A

In large amounts peroxynitrite inhibits the activities of many enzymes.

This may be due to tyrosine nitration preventing phosphorylation, hence interfering with signalling pathways.

Hormones such as angiotensin II and insulin can lead to nitration of proteins within the cells.

37
Q

What does iNOS overactivity cause?

A

Although eNOS is the primary NOS for affecting the vasculature, heightened iNOS activity – as seen in toxic shock – does lead to decreased blood pressure. This can be treated using N-monomethyl arginine NOS inhibitors.

38
Q

How does hyperlipidaemia affect NO signalling?

A

Atherosclerosis affects NO signalling, particularly through the impairment of acetylcholine induced relaxation. This is caused by several factors at play in atherosclerosis, including high plasma LDL concentration.

This however is reversible; drugs such as statins which lover LDL concentration relieve the inhibition of acetylcholine and thus eNOS.

39
Q

How does late stage atherosclerosis affect NO-mediated relaxation? How can this be protected against?

A

In later stages oxLDLs can permanently impair the NO-dependent relaxation.

HDL appears to be able to protect arteries from this, likely by binding the oxLDLs in such a manner that prevents its effecting interaction.

HDLs also stimulate the NO pathway directly, in a somewhat unclear mechanism involving ApoA1, SR-B1 and activation of the PI3K pathway.

40
Q

How is NO biosynthesis regulated in macrophages, and for what use?

A

Atherosclerotic plaques produce large amounts of NO due to the activation of NOS in macrophages by γ-interferon.

However, through their role in first-line-of-defence immune response, they also produce superoxide anions in order to combine with NO to produce peroxynitrite in a controlled manner for use in pathogenic destruction – though some pathogens possess peroxynitrite reductase activity to combat this.

41
Q

What effect does the production of peroxynitrite by macrophages in lesions have?

A

This high level of peroxynitrite can lead to protein nitration, particularly of LDL tyrosines. This encourages their uptake by macrophages as they are more readily recognised by scavenger receptors. Peroxynitrite also further oxidises lipids, contributing to LDL oxidation.

Nitrated proteins have also been suggested to enhance the differentiation of monocytes into macrophages, and induce them to release inflammatory cytokines including TNFα.

The peroxynitrite is also believed to oxidise HDL ApoA1 at specific tyrosine residues very readily, disrupting its interaction with the ABC proteins and thus cholesterol efflux. This too is thought to be mediated by myeloperoxidase.

42
Q

What other process is NO involved in that can ameliorate CVD?

A

NO acts to upregulate angiogenesis. This can be hugely beneficial in atherosclerosis due to its ability to bypass blockages in vessels by creating new ones around it.

It begins with the formation of a tube of endothelial cells which are then coated in pericytes, or SMCs in larger vessels. For way too much more information see 3013.

43
Q

How is NO involved in the angiogenesis regulatory network?

A

This is stimulated by VEGF, which is secreted by various cell – particularly in inflammation – and also has the effect of stimulating NO production. This creates a positive feedback loop, as NO also increases VEGF production.

VEGF works in concert with tissue factor, which in turn binds to factor X and VII to increase NO biosynthesis further. Hence increased NO signalling may be beneficial for inducing vessel growth (restenosis) as a therapy, especially in transplant therapy.

44
Q

Describe notable SNPs of NOS.

A

The vast majority of SNPs identified are of no effect on CVD risk, but one more common eNOS exon 7 Glu-298-Asp mutation (chromosome 7) increases CVD risk.

Despite the similarity of the substituted residue, this appears to decrease NO production and increase CVD risk 2-4 fold, especially in the homozygotes (10% of the population).

45
Q

What additional risk is often associated with the E298D eNOS mutation?

A

This SNP is associated with a second one within the promoter region, T786C, which when present appears to further enhance risk. It is notable that the eNOS gene is by a number of transcription factors which bind close to the oestrogen response elements.