Mode of action of nitrates at the cellular level

Nitrates probably induce vasorelaxation via a rise of cytosolic cGMP, and subsequent phosphorylation of target proteins by cGMP-dependent protein kinase. A dual type of action by this mechanism seems likely: cGMP-dependent protein kinase relaxes chemically skinned vascular smooth muscle which has no functioning cell membrane. Thus, the contractile apparatus with its regulatory and contractile proteins may be one of the targets for their action. Calcium visualization techniques using aequorin or quin-2, and ion flux studies showing suppression of Ca2+-dependent 86Rb efflux by nitrates and 8-Br-cGMP suggest that the cytosolic calcium level is another target for their action. Whether this lowering of intracellular calcium occurs via cGMP-dependent activation of the sarcolemmal Ca2+ extrusion ATPase, requires confirmation.