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Blood, 1 April 2006, Vol. 107, No. 7, pp. 2943-2951.
Prepublished online as a Blood First Edition Paper on December 20, 2005; DOI 10.1182/blood-2005-10-3992.


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Submitted October 6, 2005
Accepted November 14, 2005

Red blood cells express a functional endothelial nitric oxide synthase

Petra Kleinbongard, Rainer Schulz, Tienush Rassaf, Thomas Lauer, Andre Dejam, Thomas Jax, Intan Kumara, Putrika Gharini, Svetlana Kabanova, Burcin Oezueyaman, Hans-Georg Schnurch, Axel Godecke, Artur-Aron Weber, Mirko Robenek, Horst Robenek, Wilhelm Bloch, Peter Rosen, and Malte Kelm*

Department of Medicine, Medical Clinic I, University Hospital RTWH Aachen, Aachen, Germany
Institute of Pathophysiology, Medical School, University of Essen, Essen, Germany
Department of Medicine, Division of Cardiology, Pulmonary Diseases and Angiology, Heinrich-Heine-University, Duesseldorf, Germany
Department of Gynaecology and Obstetrics, Lukas Hospital, Neuss, Germany
Department of Cardiovascular Physiology, Heinrich-Heine-University, Duesseldorf, Germany
Department of Pharmacology, Heinrich-Heine-University, Duesseldorf, Germany
Department of Cell Biology and Ultrastructure Research, Leibniz-Institute of Artheriosclerosis Research, Munster, Germany
Department of Molecular and Cellular Sport Medicine, Sport University Cologne, Cologne, Germany
Department of Clinical Biochemistry, German Diabetes Research Institute, Heinrich-Heine-University, Duesseldorf, Germany

* Corresponding author; email: kelm{at}uni-duesseldorf.de.

The synthesis of nitric oxide (NO) in the circulation has been attributed exclusively to the vascular endothelium. Red blood cells (RBC) have been demonstrated to carry a non-functional NO synthase (NOS) and, due to their huge hemoglobin content, have been assumed to metabolize large quantities of NO. More recently, however, RBC have been identified to reversibly bind, transport, and release NO within the cardiovascular system. We now provide evidence that RBC from humans express an active and functional endothelial type NOS (eNOS), which is localized in the plasma membrane and the cytoplasm of RBC. This NOS is regulated by its substrate L-arginine, by calcium and by phosphorylation via PI3 kinase. RBC-NOS activity regulates deformability of RBC-membrane, and inhibits activation of platelets. The NOS dependent conversion of L-arginine in RBC is comparable to that of cultured human endothelial cells. RBC in eNOS-/- mice in contrast to wild-type mice lack NOS protein and activity strengthening the evidence of an eNOS in RBC. These data show an eNOS like protein and activity in RBC serving regulatory functions in RBC and platelets, which may stimulate new approaches in the treatment of NO deficiency states inherent to several vascular and hematologic diseases.


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