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Originally published In Press as doi:10.1074/jbc.M203236200 on May 21, 2002

J. Biol. Chem., Vol. 277, Issue 31, 27818-27828, August 2, 2002
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S-Nitrosohemoglobin Is Unstable in the Reductive Erythrocyte Environment and Lacks O2/NO-linked Allosteric Function*

Mark T. GladwinDagger §, Xunde WangDagger §, Christopher D. ReiterDagger §, Benjamin K. YangDagger , Esther X. VivasDagger §, Celia Bonaventura||, and Alan N. Schechter§

From the Dagger  Critical Care Medicine Department, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, the § Laboratory of Chemical Biology, NIDDK, National Institutes of Health, Bethesda, Maryland 20892, and the || Marine/Freshwater Biomedical Center, Duke University, Beaufort, North Carolina 28516

Received for publication, April 4, 2002, and in revised form, May 17, 2002

    ABSTRACT
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES

Our previous results run counter to the hypothesis that S-nitrosohemoglobin (SNO-Hb) serves as an in vivo reservoir for NO from which NO release is allosterically linked to oxygen release. We show here that SNO-Hb undergoes reductive decomposition in erythrocytes, whereas it is stable in purified solutions and in erythrocyte lysates treated with an oxidant such as ferricyanide. Using an extensively validated methodology that eliminates background nitrite and stabilizes erythrocyte S-nitrosothiols, we find the levels of SNO-Hb in the basal human circulation, including red cell membrane fractions, were 46 ± 17 nM in human arterial erythrocytes and 69 ± 11 nM in venous erythrocytes, incompatible with the postulated reservoir function of SNO-Hb. Moreover, we performed experiments on human red blood cells in which we elevated the levels of SNO-Hb to 10,000 times the normal in vivo levels. The elevated levels of intra-erythrocytic SNO-Hb fell rapidly, independent of oxygen tension and hemoglobin saturation. Most of the NO released during this process was oxidized to nitrate. A fraction (25%) was exported as S-nitrosothiol, but this fraction was not increased at low oxygen tensions that favor the deoxy (T-state) conformation of Hb. Results of these studies show that, within the redox-active erythrocyte environment, the beta -globin cysteine 93 is maintained in a reduced state, necessary for normal oxygen affinity, and incapable of oxygen-linked NO storage and delivery.

    INTRODUCTION
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES

Nitric oxide (NO) is a soluble gas that is continuously synthesized in endothelial cells and is a critical endogenous vasodilator (1-3). Although it is generally believed that endothelium-derived NO is the primary determinant of NO-mediated control of basal blood flow in humans (4, 5), considerable recent interest and controversy have focused on the role of intravascular NO-derived molecules that could stabilize NO bioactivity and contribute to blood flow and oxygen delivery. Such molecules include high and low molecular weight S-nitrosothiols in plasma (6-10) and nitrite (4, 11). In addition, NO reacts reversibly with hemoglobin to form an NO-heme adduct, iron-nitrosyl-hemoglobin (HbFeIINO),1 and can also nitrosate a surface thiol on cysteine 93 of the beta -globin chain to form S-nitrosohemoglobin (SNO-Hb). The potential role of S-nitrosated hemoglobin as an NO transporter is particularly appealing, because the environment of beta -cysteine 93 is sensitive to the R left-right-arrow T conformational equilibrium of hemoglobin. The conformational transition from the R- to T-state could thus promote the allosteric delivery of both oxygen and NO to regions with low oxygen tension. Two central observations supporting this SNO-Hb hypothesis are reports of observed arterial-venous gradients of SNO-Hb in the rat (suggesting a dynamic cycle) and evidence that delivery of oxygen and NO are allosterically coupled events (12-14).

However, the evidence for a dynamic cycle is brought into question by widely varying reports for the basal levels of intracellular SNO-Hb in arterial and venous blood. The reported levels vary from 200 nM to 5 µM. These levels were determined using a variety of different assays, mostly based on photolysis or chemically mediated release of NO gas and subsequent detection by the ozone-based chemiluminescent analyzer (8, 9, 12, 15). We have developed methodologies to selectively oxidize the NO first from iron-nitrosyl-hemoglobin followed by reduction of the S-NO bond from hemoglobin in solutions of I3-, releasing NO gas from the cysteine for ozone-based chemiluminescent detection (4, 5, 8), whereas other laboratories first cleave the S-NO linkage with mercury and then measure the NO levels (with and without mercury) using ultraviolet light photolysis (12, 16). In addition to liberating NO gas from both S-nitrosothiols and iron-nitrosyls, both systems reduce nitrite to NO, requiring extensive treatment of samples through molecular sizing columns. However, hemoglobin possesses anion binding sites that may retain nitrite, raising concerns that the measured NO levels may be overestimated as a result of conversion of hemoglobin-bound nitrite to NO (17). In addition, there have been a number of challenges to the second core principle of the SNO-Hb hypothesis, that NO is released during the oxygen-linked conformational shift of hemoglobin from its R- to T-state. Although both kinetic and thermodynamic arguments have been made to support the allosterically mediated release of NO from SNO-Hb (12, 14, 16), the physiological relevance of this possible linkage has been challenged on the basis of the very high oxygen affinity of SNO-Hb, potentially limiting its role in basal regulation of NO/oxygen delivery (18-20), and the oxygen-independent kinetics of the reaction of SNO-Hb with millimolar levels of glutathione, present at such concentration in erythrocytes (16, 19-21).

In the present studies we present a methodology for the stabilization SNO-Hb in red cell lysates, the elimination of all background nitrite signal, and the specific detection of SNO-Hb in human blood down to 5 nM concentration (0.00005% SNO/heme). Very low levels of SNO-Hb were found in both arterial and venous erythrocytes with this improved detection method, and no significant arterial-venous gradients were observed. To evaluate the allosteric properties of SNO-Hb within intact erythrocytes, we modified human red cells so that they contained up to 10,000 times the normal in vivo levels of SNO-Hb and evaluated the effects of hemoglobin oxygen saturation on its levels and on NO export. In these experiments we found that, within the redox-active erythrocyte environment, the beta -globin cysteine 93 is maintained in a reduced state, which may be necessary for normal oxygen affinity, and that SNO-Hb is rapidly degraded independent of hemoglobin oxygen saturation. The reductive decomposition of SNO-Hb in the erythrocytes provides an explanation for why SNO-Hb levels in human blood are low. Because the lifetime of SNO-Hb in erythrocytes is both transient and insensitive to oxygen tension, its participation in NO storage, delivery, and regulation of human blood flow under normal physiological conditions appears unlikely. It remains possible that SNO-Hb may participate in NO-dependent events in vivo during pathological conditions associated with red cell oxidation or under circumstances where NO generation is increased in response to infection or pharmacological NO treatment.

    EXPERIMENTAL PROCEDURES
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES

Human Subjects-- All protocols were approved by the Institutional Review Board of the NHLBI (National Institutes of Health, Bethesda, MD) following formal scientific review. All subjects signed an informed consent.

Materials-- All chemicals and NO gas, unless otherwise stated, were obtained from Sigma-Aldrich. Hemolysates of cells containing native human hemoglobin (Hb A0) were used to prepare purified Hb by the ammonium sulfate method with chromatographic purification with a fast protein liquid chromatography system. Pure red cell lysates from freshly obtained venous or arterial blood were used when indicated.

Synthesis of S-Nitrosothiol NO Donors-- S-Nitrosothiol reagents were prepared by reaction of the acidified amino acid with nitrite, neutralized to pH 7.4 using 5 N NaOH and measured by both the I3- (22) and Cu+/L-cysteine (7) chemiluminescence assays, and compared with SNO-glutathione (Calbiochem) and nitrite standards.

Synthesis of SNO-Hb-- Oxyhemoglobin was equilibrated in 2% borate buffer at pH 9.2 or in PBS at pH 7.4, temperature 4 °C, and then treated with S-nitrosocysteine at a ratio of 10:1 (CysNO to heme) for 30 min, followed by extensive dialysis or Sephadex G25 desalting (8, 18, 23).

Synthesis of SNO-Albumin-- Human and bovine albumin (Sigma; 40 mg/ml with 0.5 µM EDTA in PBS) was reduced with dithiothreitol (3-5 mM); passed through Sephadex G25 columns to remove dithiothreitol, nitrite, and small thiols; and incubated with S-nitrosocysteine (final concentration at 2 mM) for 30 min at room temperature in the dark to form SNO-albumin. This solution was then dialyzed at 4 °C against 3 × 3 liters of 0.5 µM diethylenetriaminepentaacetic acid (DTPA) in PBS for 24 h.

Synthesis of SNO-Hb-containing Erythrocytes-- Whole blood was collected from normal volunteers in EDTA followed by an overnight incubation in room air with a 10% volume of 100 ml of phosphate-buffered saline with citrate, dextrose, and adenine (CPD-A solution; Baxter, Covina, CA). Blood samples were centrifuged at 750 × g for 5 min and adjusted to a 50% hematocrit by removal of small amounts of plasma. To elevate intra-erythrocytic SNO-Hb levels, S-nitrosocysteine (10 mM final concentration) was incubated with these whole blood samples for 3 h at 4 °C (on ice). To ensure the removal of all of the S-nitrosocysteine, the cells were centrifuged, plasma and buffy coat discarded, and cells then washed with a 25-fold excess 4 °C PBS for 5 min. The PBS was removed and the wash repeated for a total of five 5-min washes. The final wash PBS was collected, and the residual S-nitrosothiol in the wash was less than 50 nM. Red blood cells prepared by this methodology contained 1.1 ± 0.2% SNO/heme (220 µM intracellular SNO-Hb), 0% iron-nitrosyl-hemoglobin, and 8.7% methemoglobin.

Griess-Saville Assay for SNO-Hb and SNO-Albumin-- To measure S-nitrosothiol and nitrite levels, standards of SNO-Hb or SNO-albumin (prepared as described above) were added to 1.7-ml reaction tubes cooled on ice. After cooling, 100 µl of sulfanilamide/HgCl2 solution (16% sulfanilamide, 0.2% HgCl2 in 2 M HCl), or sulfanilamide alone, was added to the reaction mixtures followed by a balance of PBS/DTPA (100 µM) to make a final volume of 1100 µl. After 5 min of incubation in the dark at room temperature, 100 µl of 1.6% N-(1-naphthyl)ethenediamine in 2 M HCl was added to the reaction mixture and again the sample was allowed to incubate in the dark for 5 min. Following the second incubation, the reaction mixtures were centrifuged at 17,900 × g for 5 min, and 1 ml of supernatants were transferred to optical cuvettes to measure absorbance at 540 nm. Subtraction of appropriate blanks and of values for samples treated without HgCl2 determined the levels of S-nitrosothiol without nitrite. The concentration of S-nitrosothiol or nitrite was calculated using the extinction coefficient of 50,000 M-1 cm-1 and with standards of known concentrations of GSNO.

Ozone-based Chemiluminescent Assays-- Different chemical reagents are mixed in a glass purge vessel. Helium gas is bubbled sequentially through the purge vessel, through 15 ml of 1 M NaOH, and then into the chemiluminescent nitric oxide analyzer (model 280 NO analyzer; Sievers, Boulder, CO), which can detect upward from 0.3 pmol of NO gas. The following chemicals were placed in the purge vessel for the experiments described herein.

I3- Reagent-- The method for the measurement of nitrite and S-nitrosothiols by reaction with I3- to release NO gas (22) was applied to hemoglobin (8). In brief, 7 ml of glacial acetic acid and 2 ml of distilled water were mixed with 100 mg of KI. A crystal of I2 was added to yield a concentration of ~20-30 mM. Alternatively, to allow for the injection of large volumes of solutions with high protein concentration, a stock solution of I3- was prepared each day. Serial injections of S-nitrosoglutathione and nitrite were used over 4 h to document the stability of the I3- stock solution exposed to air. There was no decrease in NO release from S-nitrosothiols over this time period. This allowed us to change the reagent prior to each injection of hemoglobin solutions and removed variability produced by increasing protein concentrations and foaming. To specifically identify nitrite versus S-nitrosothiol, samples were incubated with and without acidified sulfanilamide (as described below) and reacted in the I3- reductant. Specific treatment of red cell and hemoglobin samples prior to reaction in the I3- reductant is described below.

Vanadium HCl Reagent-- Nitrate was measured by reduction in vanadium(III) at 90 °C (24). To reduce foaming during the analysis of nitrate levels in plasma, the samples were treated with a 2:1 volume of cold ethanol and centrifuged at 17,900 × g for 5 min. The value for nitrate was determined by subtraction of the nitrite and S-nitrosothiol values, derived by I3- assay, from the result derived from vanadium assay.

Reaction of NO-modified Hemoglobin with Acidified Sulfanilamide to Eliminate Nitrite Contamination-- To eliminate nitrite contamination from human hemoglobin samples, Sephadex G25 desalted samples were reacted with and without 5 mM HgCl2 and then treated with a 10% volume of 5% sulfanilamide in 1 N HCl as described under "Results" (10). These solutions completely abolished contaminating nitrite signal, whereas purified SNO-Hb was completely stable. The levels of SNO-Hb after acidified sulfanilamide treatment as measured by the I3- chemiluminescent assay were the same as the levels measured by the Griess-Saville assay after subtraction of the nitrite background, suggesting that some nitrite is associated with preparations of SNO-Hb even after extensive dialysis or column separation.

Stabilization and Measurement of SNO-Hb in Erythrocytes with Elimination of Background Nitrite Signal-- Red blood cell pellet samples (100 µl) were lysed in 900 µl of PBS with KCN/K3FeIII(CN)6 (4 mM), NEM (10 mM), DTPA (100 µM), and 1% Nonidet P-40 (to solubilize membrane, which may contain S-nitrosated anion exchange protein 1 (Ref. 25)). The pH of this solution was 7.2. Lysed red blood cell samples were incubated in this solution at room temperature for 5 min and 500 µl passed through a prerinsed 9.5-ml bed volume Sephadex G25 column. The hemoglobin aliquots from 3-3.7 ml were collected, separated into two fractions (270 µl each), and reacted with and without HgCl2 (final concentration 5 mM) for 2 min. 10% volume of 5% sulfanilamide in 1 N HCl was added to the hemoglobin solutions and incubated for 5 min (final concentration of 0.5% sulfanilamide in 0.1 N HCl). 300-µl volumes of the hemoglobin solutions, with and without HgCl2 treatment (to specify S-nitrosothiol), were injected into 8 ml of I3- solution in the reaction chamber (see "I3- Reagent"). The I3- was replaced for each injection from a stock solution prepared fresh each day and no antifoam agent was used. The quantity of NO released was determined by calculation of the area under the curve (see "Statistical Analysis"), corrected for the dilution of added HgCl2 and acidified sulfanilamide, and the value divided by the concentration of heme measured spectrally in Drabkin's reagent (prior to addition of HgCl2 and acidified sulfanilamide).

Measurement of the Basal Levels of S-Nitrosohemoglobin in the Human Circulation-- For the determination of the in vivo levels of red blood cell SNO, whole blood was drawn from 8 normal volunteers from the artery and vein into vacuum containers with sodium heparin (to preserve physiological arterial and venous hemoglobin oxygen saturations). Samples were spun at 750 × g for 5 min and plasma discarded. 100 µl of the red cell pellet below the buffy coat was removed and immediately lysed in 900 µl of PBS with 1% Nonidet P-40, KCN/K3FeIII(CN)6 (4 mM), NEM (10 mM), and DTPA (100 µM). The pH of this solution was 7.2. Following Sephadex G25 desalting, hemoglobin concentration was measured in Drabkin's reagent, and samples were reacted with and without 5.0 mM HgCl2 for 2 min, then with 10% volume of 5% sulfanilamide in 1 N HCl for 3 min, followed by NO measurement by I3- chemiluminescent assay.

Stability and Oxygenation Studies of SNO-Hb-containing Red Blood Cells-- Erythrocytes containing elevated levels of SNO-Hb were prepared as described above. Only samples with less than 10% methemoglobin were used. One ml of pre-agitated (to ensure mixing) erythrocyte suspension was added to 9 ml of buffer in two tonometers. As described under "Results," the tonometers alternatively contained human plasma collected from the same individual who donated the red cells, PBS with 24 mM NaHCO3 (distilled water added to keep sodium concentration 140 mM), and PBS with 24 mM NaHCO3 and 400 µM GSH. GSH was added as a thiol acceptor for potential erythrocyte-derived trans-nitrosation reactions (26). One tonometer was pre-equilibrated for 60 min with 21% oxygen and 5% CO2 gases and the second tonometer with 0% oxygen and 5% CO2. The tonometers were protected from light and agitated on a rocker platform. Following the addition of cells, 1-ml samples were withdrawn every 5 min using Hamilton syringes. Samples were added to 8 mM NEM and 100 µM DTPA to stabilize S-nitrosothiols (10) and centrifuged at 750 × g for 5 min. The cells and buffer were separated and flash-frozen on dry ice. The buffer nitrite, nitrate, and S-nitrosothiol content and red cell SNO-Hb was subsequently measured by chemiluminescence (as described above). Samples were also withdrawn at the same 5-min intervals for determination of hemoglobin saturation (by co-oximetry), pO2, pCO2, and pH (i-STAT Corp., East Windsor, NJ). Methemoglobin concentrations were measured by absorption spectroscopy at 700, 630, 576, and 560 nm using the Winterbourn relationship (27). Oxygen dissociation curve measurements of SNO-Hb-containing red blood cells were performed using the Hemox-Analyzer (TCS Scientific Corp., New Hope, PA) (28).

Statistical Analysis-- We have found that the Sievers analytical software (model 280 NO analyzer) produces some error when measuring the area under the curve for samples with 0.3-5 pmol of NO. We therefore transferred raw data from the Sievers program to Origin (Microcal Software, Inc., Northampton, MA). The data were smoothed using the Savitzky-Golay filter method provided with the software (symmetric, 21-point window; polynomial degree = 2). Two-tailed paired t tests were used to analyze differences in the values of paired samples before, during, and after experiments. For time-course experiments, the data were analyzed by repeated measures analysis of variance (ANOVA). Data are reported as the mean ± the standard error of the mean.

    RESULTS
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES

Reduction of S-Nitrosothiols Results in Rapid and Complete Release of NO from SNO-Hb in Solutions of I3--- To validate our standards and improved chemiluminescent methodologies, preparations of SNO-Hb and SNO-albumin were analyzed by both the I3- chemiluminescent assay and by the Griess-Saville assay. As shown in Fig. 1 (A and B), the I3- chemiluminescent assay compared favorably with the well established Griess-Saville assay over a wide range of concentrations for both SNO-Hb and SNO-albumin. To determine the limits of sensitivity, purified samples of synthesized SNO-Hb were added to freshly drawn, washed (in PBS), lysed erythrocyte pellets at concentrations from 200 nM (0.002% S-NO/heme) to 3,200 nM (0.032% S-NO/heme). Following treatment with ferricyanide and cyanide (described below) to eliminate iron-nitrosyl signal and to stabilize SNO-Hb in red blood cell lysates, the hemoglobin samples were passed through a prerinsed G25 Sephadex sizing column and injected into the I3- reagent. The NO recovery was stoichiometric with an r2 value of 0.996 (Fig. 1, C and D; p < 0.001; n = 4). Levels of SNO-Hb measured by other laboratories using UV photolysis have been reported to be as high as 0.001/hemoglobin tetramer or 2.5 µM in whole blood. As can be seen in Fig. 1 (C and D), such levels would be readily measured using our assay.


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Fig. 1.   Reduction of S-nitrosothiols result in rapid and complete release of NO from S-nitrosohemoglobin in solutions of I3-. Preparations of SNO-Hb (panel A) and SNO-albumin (panel B) analyzed by I3- chemiluminescent assay (closed circles) and by the Griess-Saville assay (open squares). Panel C, SNO-Hb standards in lysed red cell pellet at concentrations from 200 nM (0.002% S-NO/heme) to 3,200 nM (0.032% S-NO/heme); n = 4. Panel D, a representative set of nitric oxide analyzer readouts from one experiment is shown.

Stability of SNO-Hb in KCN and K3FeIII(CN)6-- We have used solutions of KCN and K3FeIII(CN)6 to selectively oxidize the NO from the heme while preserving the S-nitrosothiol linkage. This sample treatment allows us to first remove the NO bound to the heme group so that we can specifically measure the NO release from cysteine 93 in the I3- chemiluminescence-based assay. The standards of SNO-Hb shown in Fig. 1 (C and D) were pretreated with KCN/K3FeIII(CN)6 prior to reaction in the I3- chemiluminescence-based assay (8). SNO-Hb is stable in a large molar excess of KCN and K3FeIII(CN)6. This was shown using three approaches. In the first experiment (Fig. 2A), 10-µl volumes of solutions containing SNO-Hb (0.9 mM SNO), nitrite (10 mM), nitrate (10 mM), and HbFeIINO (0.67 mM) were injected into a purge vessel containing 0.2 M KCN/K3FeIII(CN)6 in PBS. The reaction chamber was purged with helium in-line with the chemiluminescent NO analyzer to detect released NO gas. As shown in Fig. 2A, SNO-Hb, nitrite, and nitrate are stable in this solution (i.e. do not release appreciable amounts of NO), whereas NO gas is released from HbFeIINO. The small NO signal from the injection of SNO-Hb derives from small amounts of iron-nitrosyl-hemoglobin formed in the synthesis of SNO-Hb (see small mercury-stable peak in Fig. 2B). In the second set of experiments, SNO-Hb was measured using the I3- chemiluminescence-based assay with and without cyanide/ferricyanide and HgCl2 pretreatments. Briefly, 10 µl of 0.9 mM SNO-Hb was incubated for 30 min in 90 µl of PBS, 90 µl of 0.2 M KCN/K3FeIII(CN)6 in PBS, or 90 µl of 0.5 mM HgCl2 and then passed through a Sephadex G25 sizing column. The samples were then injected into a reaction vessel containing the I3- reagent. The reaction chamber was purged with helium in-line with the chemiluminescent NO analyzer to detect released NO gas. As shown in Fig. 2B, there is no loss of SNO-Hb that has been incubated in a large molar excess of KCN/K3FeIII(CN)6, in the absence of HgCl2, whereas it is completely decomposed by incubation with HgCl2. In the final experiment, SNO-Hb was measured using the Griess-Saville assay, incubated for 2 h in PBS, 0.2 M K3FeIII(CN)6 or 0.2 M KCN/K3FeIII(CN)6, passed through a Sephadex G25 sizing column to remove CN (which interferes with the Saville assay), and then measured again by the Saville assay (Fig. 2C). The slight reduction in SNO-Hb signal (5.7%) with KCN is a result of KCN interference with the Saville methodology, which is largely prevented by passing samples through sizing columns and is not observed with the I3- chemiluminescence-based assay.


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Fig. 2.   Stability of SNO-Hb in KCN/K3FeIII(CN)6. Panel A, standard samples of SNO-Hb, nitrite, nitrate, and HbFeIINO were injected into a purge vessel with 0.2 M KCN/K3FeIII(CN)6 in PBS. The reaction chamber was purged with helium in-line with the chemiluminescent NO analyzer to detect released NO gas. Panel B, SNO-Hb was incubated for 30 min in PBS, 0.2 M KCN/K3FeIII(CN)6 in PBS, or 0.5 mM HgCl2 and then passed through a Sephadex G25 sizing column. The samples were then injected into a reaction vessel containing the I3- reagent in-line with the chemiluminescent NO analyzer to detect released NO gas. Panel C, SNO-Hb was measured using the Saville assay, incubated for 2 h in 0.2 M K3FeIII(CN)6 and 0.2 M KCN/K3FeIII(CN)6, passed through a Sephadex G25 sizing column to remove KCN/K3FeIII(CN)6, and then measured again by the Saville assay.

Stabilization and Protection of SNO-Hb in Red Cell Lysates and under denaturing Conditions by Reaction with Solutions of K3FeIII(CN)6 with and without KCN-- Not only is SNO-Hb not degraded in solutions of KCN/K3FeIII(CN)6, it appears that the oxidation of hemoglobin and red blood cell lysates protects SNO-Hb from degradation in red blood cell lysates and under denaturing conditions. To illustrate the effects of denaturing conditions, such as detergent treatment, on SNO-Hb stability, samples of purified SNO-Hb were incubated in 1% SDS for 30 min with and without KCN/K3FeIII(CN)6 pretreatment and measured by the I3- chemiluminescent assay. As shown in Fig. 3A, SNO-Hb levels are decreased by exposure to the denaturing effects of SDS, an effect that is prevented by oxidation of the hemoglobin. Although we have used a mixture of K3FeIII(CN)6 and KCN to discriminate between NO at heme and SH groups (by eliminating signals from NO liganded to the heme group), it is apparent from these experiments that the critical reagent required to stabilize the S-nitrosothiol bond on hemoglobin is K3FeIII(CN)6. Similar results are observed in the mass spectrometry fragmentor, where SNO-Hb is more stable in this oxidizing environment than in its absence (spectra obtained at 30 HPLC electrospray ionization mass spectrometry; data not shown).


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Fig. 3.   Stability of SNO-Hb under denaturing (detergent treatment) conditions and in red cell lysates. Panel A, standards of SNO-Hb were incubated for 30 min in 1% SDS and SDS/NEM with and without K3FeIII(CN)6 or KCN/K3FeIII(CN)6 pretreatment. Panel B, electrical signal from NO analyzer when SNO-Hb was incubated in fresh red blood cell lysates to a final concentration of 0.02% SNO/heme with 1) KCN/K3FeIII(CN)6 with NEM and DTPA, 2) KCN/K3FeIII(CN)6 with NEM, 3) KCN/K3FeIII(CN)6 alone, 4) NEM alone, 5) DTPA alone, or 6) NEM and DTPA. The decrease in signal with HgCl2 pretreatment indicates SNO-Hb specificity. Panel C, mean values and S.E. for three experiments as shown in panel B.

Fig. 3 (B and C) shows results of additional studies carried out to determine the stability of SNO-Hb in erythrocyte lysates and the effects of oxidation (with K3FeIII(CN)6), thiol sequestration (with NEM), and copper chelation (with DTPA) on this stability. In these studies purified SNO-Hb was added to fresh red blood cells lysed with 1% Nonidet P-40 to give a final concentration of 0.02% SNO/heme. This solution was incubated with 1) KCN/K3FeIII(CN)6 with NEM and DTPA, 2) KCN/K3FeIII(CN)6 with NEM, 3) KCN/K3FeIII(CN)6 alone, 4) NEM alone, 5) DTPA alone, or 6) NEM and DTPA. The concentration of KCN (4 mM) used in these experiments had minimal effect on the pH of the phosphate-buffered solution (see "Experimental Procedures"). Similar experiments were performed with K3FeIII(CN)6 without KCN, as well as with red blood cell lysates without added Nonidet P-40 (data not shown). As shown in Fig. 3 (B and C), the critical inclusion of KCN/K3FeIII(CN)6 protects the SNO-Hb from decomposition. Similar results were obtained using only K3FeIII(CN)6 without KCN. Although the critical reagent appears to be ferricyanide, an additional small albeit nonsignificant effect of KCN, NEM, and DTPA on SNO-Hb stabilization was observed consistent with the further inactivation of redox active methemoglobin and CuI/thiol. The stability of SNO-Hb in the presence of oxidants suggests that it is the reductive environment of the red blood cell cytoplasm that renders SNO-Hb unstable in vivo. Clearly, oxidation with ferricyanide of materials in the cell lysate stabilizes added SNO-Hb. We conclude from these studies that a reagent mixture containing K3FeIII(CN)6 as a primary ingredient, fine-tuned by addition of KCN, NEM, and DTPA, allows for the preservation and measurement of SNO-Hb within the complicated redox-active red cell environment.

Treatment of SNO-Hb with Acidified Sulfanilamide to Eliminate Background Nitrite Signal-- It should be noted that the concentrations of SNO-Hb in human erythrocytes as previously measured by our laboratory are at the limits of detection (<200 nM in whole blood) of our published protocol (5, 8). To precisely measure concentrations lower than 100-200 nM (equivalent to 0.001-0.002% SNO/heme in whole blood), a technique was needed to reduce the background signal, likely derived from nitrite. We introduced such a technique by employing the first step of the classic Griess assay, in which nitrite reacts with acidified sulfanilamide to form a diazonium complex. Marley and colleagues (10) have demonstrated that this reaction product has no signal in I3--based chemiluminescent assays (10). To determine whether acidified sulfanilamide can be used to eliminate background nitrite signal from SNO-Hb, solutions of purified SNO-Hb were incubated with and without a molar excess of HgCl2, treated with NEM to block free thiol groups, reacted with acidified sulfanilamide; the SNO-Hb in these treatments was then measured by I3- chemiluminescent assay.

As shown in Fig. 4A, SNO-Hb is stable in acidified sulfanilamide. Interestingly, even though our purified SNO-Hb standards have been extensively Sephadex desalted and dialyzed, these samples still have some nitrite contamination as shown by a reduction in signal with acidified sulfanilamide treatment, suggesting an anionic interaction of nitrite with hemoglobin (Fig. 4A). The levels of SNO-Hb measured by the I3- methodology, after treatment with acidified sulfanilamide, are in agreement with measured levels by the Griess-Saville methodology after nitrite subtraction. Although our reagent mixture includes NEM to block free thiols, we found that the reaction of acidified nitrite with sulfanilamide is sufficiently fast that no S-nitrosothiol formation occurs in this reaction even without NEM pretreatment (Fig. 4A). In additional experiments purified SNO-Hb was incubated with a millimolar excess of nitrite and then treated with acidified sulfanilamide. The nitrite signal was completely eliminated, whereas the SNO-Hb signal was intact as measured by I3- chemiluminescent assay, suggesting that no artifactual S-nitrosation occurs following the addition of acid in the presence of sulfanilamide (data not shown). Finally, pretreatment of SNO-Hb with a molar excess of HgCl2 converts the SNO-Hb to nitrite, which is completely eliminated by treatment with acidified sulfanilamide. The elimination of nitrite from SNO-Hb, with and without mercury pretreatment, thus creates a zero-background assay for maximal sensitivity and specificity in measurements of SNO-Hb in vivo.


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Fig. 4.   Stability of SNO-Hb in solutions of acidified sulfanilamide and/or mercury allow for the specific and sensitive detection of SNO-Hb in red cells with no background. Panel A, SNO-Hb standards were incubated with acidified sulfanilamide, with and with- out NEM, HgCl2 or both, and measured by the I3- chemiluminescent assay. Panel B, the electrical signal from the NO analyzer obtained from standards of SNO-Hb mixed in red cell lysates. The red cell pellet samples were lysed in PBS with 1% Nonidet P-40, KCN/K3FeIII(CN)6, NEM, and DTPA (pH 7.2), passed through a sizing column, reacted with and without HgCl2 for 2 min, followed by reaction with acidified sulfanilamide. 300 µl of the desalted hemoglobin solution was then injected into I3- solution in the reaction chamber in-line with the chemiluminescent NO analyzer to detect released NO gas. Panel C, this assay had no background signal following mercury treatment, achieved a stoichiometric conversion of SNO-Hb to NO gas, and was sensitive down to 0.00005% SNO/heme (5 nM SNO/heme in whole blood).

Processing of Human Blood, Stabilization of SNO-Hb, and Elimination of Background Nitrite for Ozone-based Chemiluminescent Detection of S-Nitrosohemoglobin in the Human Circulation-- To specifically measure the low concentrations of SNO-Hb present in the human circulation, including membrane-bound S-nitrosothiols, we developed and validated an assay to rapidly stabilize and selectively measure SNO-Hb in red blood cell lysates. For validation, standards of purified SNO-Hb were mixed to a ratio of 0.0% to 0.02% mol of SNO/heme (0-2,000 nM SNO in whole blood). These samples were made with a freshly obtained, washed red blood cell pellet from human venous blood (which contains negligible levels of SNO-Hb (Ref. 12)). The cell pellet samples (100 µl) were lysed in 900 µl of PBS with 1% Nonidet P-40, KCN/K3FeIII(CN)6 (4 mM), NEM (10 mM), and DTPA (100 µM) and incubated in this solution for 5 min. As described under "Experimental Procedures," the hemoglobin aliquots containing varied levels of SNO-Hb were passed through a sizing column and reacted with and without HgCl2, then with acidified sulfanilamide. The data shown in Fig. 4 (B and C) indicate that this assay procedure is specific for S-nitrosothiol, has no nitrite-derived background signal, and achieves a stoichiometric conversion of SNO-Hb to NO gas. The improved assay is sensitive down to 0.00005% SNO/heme (5 nM SNO in whole blood).

For the determination of the in vivo levels of red blood cell SNO, whole blood was drawn from 8 normal volunteers from the artery and vein directly into vacuum containers with sodium heparin (filling the vacuum containers ensures that the physiological hemoglobin oxygen saturations are preserved). The freshly drawn blood was centrifuged and the red blood cell pellets were lysed directly in the Nonidet P-40/KCN/K3FeIII(CN)6/NEM/DTPA mixture described above and under "Experimental Procedures." Following Sephadex G25 desalting, samples were reacted with and without 5.0 mM HgCl2 (where the reduction in signal with HgCl2treatment is that of authentic SNO-Hb) and with acidified sulfanilamide (to eliminate nitrite-derived background), and then analyzed by I3- chemiluminescent assay. The results are shown in Fig. 5. The levels of SNO-Hb in the basal human circulation, including red cell membrane fractions, were 46 ± 17 nM (0.00046% SNO/heme) in human arterial erythrocytes and 69 ± 11 nM (0.00069% SNO/heme) in venous erythrocytes.


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Fig. 5.   Arterial and venous red blood cell S-nitrosothiol levels (SNO-Hb and membrane SNO compounds) in the human circulation. Panel A, NO release (in mV) following the injection of 300 µl of red cell lysates treated with Nonidet P-40, KCN/K3FeIII(CN)6, NEM, and DTPA; lysates were from arterial and venous blood obtained from 8 normal volunteers as described under "Experimental Procedures." Panel B, mean of data ± S.E. for arterial and venous red blood cell total S-nitrosothiol levels in 8 normal volunteers.

Temperature Dependence of SNO-Hb Stability in Red Cells-- Red blood cells (with less than 10% methemoglobin) with significantly elevated SNO-Hb levels were synthesized as described under "Experimental Procedures," extensively washed in PBS, and then incubated in PBS for 4 h at either 4 or 37 °C. SNO-Hb levels were then measured by the I3--based chemiluminescent assay (using the protocols described above to stabilize and measure the SNO-Hb). SNO-Hb levels in the erythrocytes in this series of experiments (2.72 ± 1.72% SNO/heme) were stable at 4 °C for the entire 4 h, whereas levels dropped to 0.17 ± 0.01% SNO/heme after 1 h and to zero at 2, 3, and 4 h at 37 °C (n = 3; p < 0.01 for 4 °C versus 37 °C by repeated measures ANOVA). The stability of SNO-Hb in these cells was then evaluated at 30 and 60 min at 25 and 37 °C. At 25 °C the SNO-Hb levels dropped from 1.48 ± 0.17% to 1.17 ± 0.20% at 30 min and 0.87 ± 0.30% SNO/heme at 60 min. SNO-Hb was less stable at 37 °C, dropping to 0.22 ± 0.04% SNO/heme at 60 min (n = 5; p < 0.05 for 25 °C versus 37 °C at 60 min by repeated measures ANOVA). The instability at 37 °C is consistent with reductive decomposition of S-nitrosothiol in erythrocyte lysates and the low levels found in vivo. Purified SNO-Hb is stable outside the cell at similar temperatures, or in lysates containing our oxidative mixture, strongly suggesting that intracellular reductants are responsible for decomposing the S-nitroso linkage at physiological temperatures. Additionally, solution studies revealed that the red blood cell reductant NADPH greatly decreases the lifetime of both S-nitrosocysteine and SNO-Hb (data not shown). The stability of SNO-Hb in red blood cells maintained at 4 °C allows for extensive washing of the cells at low temperature, to remove excess S-nitrosocysteine, for subsequent oxygenation studies of red blood cells containing SNO-Hb presented in the following section.

Effects of Oxygen Tension on Stability of Intra-erythrocytic SNO-Hb and on NO Export-- To determine the effects of oxygen tension on SNO-Hb stability in red blood cells and on NO export from these cells, erythrocytes containing elevated SNO-Hb levels (prepared as described previously) were incubated in a variety of normoxic and deoxygenated buffers at 25 °C (Fig. 6). The levels of S-nitrosated species in sample aliquots within and outside of cells were periodically assayed. The overall oxygen affinity of the SNO-Hb-containing erythrocytes was normal (~27 mm Hg at pH 7.4), consistent with the low overall percentage of S-nitrosation. Similar rates of SNO-Hb decomposition occurred during the incubation of these SNO-Hb-containing cells (10% hematocrit in PBS with 24 mM NaHCO3 and 400 µM GSH) during exposure to either 21% O2, 5% CO2, 74% N2 or 0% O2, 5% CO2, 95% N2. Hemoglobin saturations in the hypoxic tonometers dropped to 30 ± 0.04% (Fig. 6A) and the mean pO2 at each time point was 48.7, 36.3, 27.5, and 19.3 mm Hg, consistent with a P50 of these red cells of ~30 mm Hg (the pH of the buffers equilibrated with 5% CO2 was 7.2, explaining the slightly higher P50 in this system). Consistent with the instability of SNO-Hb within the red cell, described above, intra-erythrocytic SNO-Hb levels decreased in a time-dependent fashion with similar rates of decrease in both oxygenated and deoxygenated conditions (Fig. 6B). Furthermore, the decomposition of SNO-Hb began immediately in the cells exposed to deoxygenated buffers, prior to 50% hemoglobin desaturation.


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Fig. 6.   Effects of hypoxia on the stability of chemically produced SNO-Hb-containing human erythrocytes and on NO export. Red cells were incubated in tonometers at 10% hematocrit with 21% oxygen and 0% oxygen as described under "Experimental Procedures." Panel A, hemoglobin saturations in normoxia (solid line) and hypoxia (dashed line). Panel B, SNO-Hb levels in normoxia (solid line) and hypoxia (dashed line). Panels C-E, S-nitrosothiol, nitrite, and nitrate export in normoxia (solid lines) and hypoxia (dashed lines). Panel F, total SNO-Hb degradation versus NOx formation during normoxia (open bars) and hypoxia (hatched bars).

Nitric oxide export was assessed by measuring the extra-erythrocytic NEM stabilized S-nitrosothiol, nitrite, and nitrate levels at selected time points during the process of SNO-Hb decomposition. S-Nitrosothiols were readily detectable in both cases, with no greater export of NO for cells in hypoxic conditions as compared with normoxic conditions (Fig. 6C). Moreover, no significant differences in extracellular nitrite and nitrate levels between normoxic and hypoxic conditions were observed (Fig. 6, D and E, respectively). The net NOx outside of the erythrocytes was only slightly higher than the measured decrease in SNO-Hb concentration, indicating that most but not all of the NOx was derived from intracellular SNO-Hb. No significant net effect of hypoxia on NOx export was observed (Fig. 6F). Similar results to those shown in Fig. 6 were obtained with red blood cells incubated in normal human plasma and in PBS without GSH (n = 5 and n = 2, respectively) and at pH 6.5 (n = 3, data not shown).

    DISCUSSION
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES

Measured levels of S-nitrosated hemoglobin and plasma albumin in the human circulation vary enormously in the published literature from 50 nM to 2.5 µM and from 30 nM to 7 µM, respectively (4, 6, 8-10, 12, 29, 30). An understanding of the true levels of S-nitrosated proteins in human blood will help clarify their role in blood flow regulation. There exist three significant obstacles to the accurate measurement of these species: 1) the levels of nitrite in blood and in reagent solutions and labware (4, 10, 31), 2) the instability of SNO-Hb in the presence of millimolar glutathione (which will be present within the erythrocyte) (16, 18, 19, 21), and 3) the difficulty of distinguishing NO derived from two distinct sites on hemoglobin, the heme group and beta -cysteine 93. In the present work, we have addressed all three obstacles and present an improved strategy for SNO-Hb measurement, its validation, and results of the methodologies employed, which help establish the true levels of S-nitrosated species in human erythrocytes.

We have previously reported (and further extensively validate here) that I3- will rapidly release NO gas from both SNO-Hb and HbFeIINO (8). I3- will also reduce nitrite (but not nitrate) to NO gas. A similar assay has been developed for the measurement of plasma S-nitrosothiols using KI/CuII/acetic acid to generate I3- and has similar sensitivity and specificity (10). To eliminate the micromolar nitrite background present in plasma, which has contributed to an overestimation of the levels of SNO-albumin, these authors first treated plasma samples with acidified sulfanilamide, recapitulating the first step of the classic Griess reaction to form a diazonium complex, which does not release NO gas in the I3- reductant. Akin to removing the haystack to find the needle, such pretreatment eliminates the micromolar nitrite background and allows for accurate measurement of the low nanomolar concentrations of plasma S-nitrosothiols. Nitrite, which is reduced to NO by both the I3-- and UV photolysis-based chemiluminescent methodologies, can contaminate hemoglobin by binding to anionic binding cavities, which prevents its separation from hemoglobin on Sephadex G25 sizing columns (17). Therefore, we hypothesized that published levels of SNO-Hb might be overestimated, and evaluated the effects of nitrite elimination by acid-sulfanilamide treatment of SNO-Hb and of red blood cell solutions containing SNO-Hb. We found that SNO-Hb was stable in this solution and that nitrite-derived signals were completely eliminated, with no artifactual S-nitrosothiol formation. Because HgCl2 converts S-nitrosothiol, but not iron-nitrosyl derivatives, to nitrite, this treatment can be used prior to addition of acidified sulfanilamide to discriminate between S-nitrosothiols and other sources of NO (i.e. for specific determination of whether the NO measured by I3- is derived from SNO-Hb or from iron-nitrosylhemoglobin).

The analysis of SNO-Hb in red blood cells lysates, and presumably its stability in red cells under physiological conditions, is further limited by the rapid decomposition of the S-nitroso linkage by intracellular reductants, such as glutathione, which is normally present at 5 mM concentration in red blood cells. As is clearly demonstrated in the experiments presented here, the decrease of SNO-Hb levels occurs in oxygenated red blood cell lysates (equilibrated with room air) as rapidly as in hypoxic conditions. Although this observation is consistent with the published oxygen-independent decrease of SNO-Hb levels and associated vasoactivity in the presence of millimolar concentrations of glutathione (16, 20, 21), there had been no consideration of how this would effect intra-erythrocytic SNO-Hb viability. In fact, studies of the cytosolic thiol-disulfide equilibrium in all cells, and in particular the erythrocyte, show this environment to be reducing with rare formation of disulfide bonds (32-34). Such conditions should prohibit the oxidation of beta -cysteine 93 by NO+ to form SNO-Hb and limit the storage of NO in this form.

We therefore hypothesized that oxidation of the heme and ligation of intracellular thiols might stabilize the S-nitrosothiol linkage in the red blood cell. Indeed, we found that SNO-Hb can be stabilized by reaction with ferricyanide (with or without added cyanide) in both SDS, in red blood cell lysates, and in the mass spectrometry fragmentor (the latter data not shown). Treatment of red blood cell lysates with ferricyanide was the critical step for SNO-Hb stabilization; treatment with copper chelators and thiol blocking reagents alone did not prevent the rapid decomposition of the S-nitroso linkage observed in erythrocyte lysates. Although ferricyanide is the critical reagent necessary for SNO-Hb stabilization, we include CN to form redox-inactive cyanomethemoglobin, NEM to block free thiols and prevent ex vivo SNO-Hb formation, DTPA to chelate copper that may potentially contaminate labware and catalyze decomposition of S-nitroso linkages, and 1% Nonidet P-40 to solubilize the red cell membrane to include the detection of S-nitrosated membrane proteins. We provide extensive validation that these reagents stabilize SNO-Hb within red blood cells and lysates. In fact, with the hemoglobin converted to cyanomethemoglobin, SNO-Hb can be denatured, digested for fragment analysis, acidified, or alkalinized with minimal disruption of the S-nitrosothiol linkage.

The basal levels of red cell S-nitrosothiol (SNO-Hb and/or other S-nitrosated proteins) in arterial and venous blood (carefully collected to control the physiological hemoglobin oxygen saturations) were found to be 46 and 69 nM, respectively, and are substantially lower than those previously published (8, 12). We believe this reflects the elimination of nitrite contamination, which produces a signal with both I3- reduction and with ultraviolet light photolysis. The lower levels of SNO-Hb reported here are consistent with 1) a reappraisal of the levels of plasma S-nitroso-albumin (4, 6, 9, 10, 29, 30) 2) data that show SNO-Hb to be unstable in solutions of millimolar reduced glutathione and in red blood cell lysates (16, 19-21), and 3) data showing that SNO-albumin is unstable in the presence of reduced thiols (9, 10).

The low levels of SNO-Hb found in vivo and the lack of dynamic artery-to-vein gradients of red blood cell S-nitrosothiol are consistent with low level NO auto-oxidation reactions rather than complex intramolecular redox-dependent NO transfers. The NO auto-oxidation reaction (forming N2O3) will produce both nitrite and S-nitrosothiols, particularly in lipid membrane compartments where the relative hydrophobicity of NO would increase its local concentration (35). Slowed diffusion of NO across the erythrocyte membrane and the submembrane protein matrix reduces the rate of reaction between Hb(O2) and NO, possibly promoting S-nitrosation reactions within the "protected" red blood cell membrane (36). Such formation of membrane S-nitrosothiols does not require a hemoglobin-derived allosteric function but rather a temporal and spatial promotion of the NO-autooxidation reaction, which could be driven by regional NO and oxygen concentrations.

In unmodified human hemoglobin, the environment of beta -cysteine 93 is greatly altered by the transition between the oxy (R-state) conformation and the deoxy (T-state) conformation. This oxygen-linked conformational change is the basis for the large difference in rate of SNO-Hb formation in oxy and deoxy conditions (12). This oxygen-linked conformational change has other consequences, such as the increase in oxygen affinity that occurs when ligands (sulfhydryl reagents) bind to beta -cysteine 93. The increased oxygen affinity results from disruption of the important salt bridge from beta -aspartate 94 to beta -histidine 146 that normally stabilizes the T-state (37-39). Such ligands include many thiol compounds, NEM, and NO (16, 18, 19, 40, 41). Similarly, amino acid substitutions at beta -cysteine 93 can lead to increased oxygen affinity, suggesting that a reduced cysteine residue at this position is critical for normal allosteric control of oxygen binding and release from hemoglobin (42, 43).2 Such a conserved function would not invoke an NO transport mechanism. In fact, robust in vivo mechanisms to remove beta -cysteine 93 ligands by reduction would be necessary to maintain normalcy of physiological oxygen binding and release. The existence of such mechanisms is supported by our observations of rapid SNO-Hb degradation in erythrocytes and the limited S-nitrosation and S-thiolation (44) of this residue we observe in vivo.

Allosteric coupled release of NO and oxygen from SNO-Hb has been suggested based on the thermodynamic linkage between hemoglobin (heme) oxygenation and S-nitrosation of beta -cysteine 93 (12-14, 16, 18, 19). A kinetic mechanism to allow physiological linkage was initially postulated to involve an O2-sensitive trans-nitrosation reaction between SNO-Hb and glutathione forming S-nitrosoglutathione (12, 16). However, such mechanisms do not consider all the reactions between SNO-Hb and intra-erythrocytic reductants such as NADPH, glutathione (in mM concentration), glutathione reductase, superoxide dismutase, and other reducing components. Additionally, the kinetics of trans-nitrosation between SNO-Hb and GSH apparently conform to a second order reversible reaction with a rate constant that is not sensitive to the oxygenation state of SNO-Hb (19). We hypothesize that intra-erythrocytic reductants greatly limit the build-up of SNO-Hb in red blood cells. This hypothesis and the data supporting it reported herein run counter to the postulated role of SNO-Hb as a reservoir for bioactive NO.

Previous experiments designed to test the role of SNO-Hb as a reservoir for bioactive NO have evaluated the effects of cell-free SNO-Hb solutions on aortic ring vasodilation (12). Such experiments are difficult to perform with isolated hemoglobin, particularly S-nitrosated hemoglobin, because of the very high oxygen affinity of cell-free hemoglobin (P50 of 5-7 mm Hg and <4 mm Hg for SNO-Hb; Refs. 16, 18, and 19) and its tendency to dissociate into two alpha beta chain dimers, which lack cooperative behavior. The low oxygen tensions required to deoxygenate cell free hemoglobin are known to alter the vasodilatory profile of S-nitrosothiols on vessel preparations, potentially creating artifactual evidence for the oxygen-linked delivery of NO from SNO-Hb (20).3 To circumvent these problems, we developed a methodology to elevate the levels of SNO-Hb in red blood cells without formation of nitrosylated heme groups or large concentrations of methemoglobin. We made use of these erythrocytes with appreciably elevated SNO-Hb levels as physiological models for the measurement of SNO-Hb stability at normal and reduced oxygen tensions. These models are appealing because intracellular hemoglobin is almost entirely tetrameric and in equilibrium with 2,3-diphosphoglycerate, resulting in a normal oxygen affinity and facile deoxygenation under hypoxia. To avoid the confounding effects of oxygen tension on blood vessel preparations, we directly measured SNO-Hb decay and NO export in these model red blood cells. In these experiments the concentrations of intra-erythrocytic SNO-Hb decrease independent of oxygen tension and can be successfully fit to a single exponential decay equation. We believe this is consistent with pseudo-first order kinetics controlled by limiting amounts of SNO-Hb and excess reductant, with reduced S-nitrosothiol forming NO that is largely oxidized to nitrate. As we have not measured the reaction kinetics at multiple SNO-Hb concentrations and cell lysate concentrations, we cannot distinguish between mechanisms.

NO released from beta -cysteine 93 would form four potential reaction products that can be measured: iron-nitrosyl-hemoglobin, S-nitrosothiol, nitrate, and nitrite. No significant formation of iron-nitrosyl-hemoglobin was observable spectrally or by chemiluminescence, and ~75% of the NO released from SNO-Hb was oxidized to nitrate, without appreciable oxygen dependence, consistent with a reaction of NO with residual oxyhemoglobin within the red blood cell. The second reaction would require trans-nitrosation reactions with reduced glutathione or membrane protein thiols. Such an event has been proposed by Gaston and colleagues (26), who described an increase in S-nitrosoglutathione following incubation of rat venous blood at low oxygen tensions with 400 µM glutathione and no increase with incubations with arterial blood at higher oxygen tensions. We evaluated this mode of release by incubating the SNO-Hb-containing red blood cells with 400 µM glutathione. Although significant extracellular accumulation of S-nitrosothiol was observed, there was no observed oxygen dependence. In fact the levels were slightly higher under oxygenated conditions, suggesting that some of the S-nitrosothiol formed is via the NO auto-oxidation reaction (N2O3 pathway) rather than pure trans-nitrosation. These experiments are consistent with effective trans-nitrosation-mediated and low molecular weight S-nitrosothiol diffusion-mediated transport of NO into and out of erythrocytes. However, the appearance of extracellular S-nitrosothiols and the decomposition of intracellular SNO-Hb have time courses that are largely independent of oxygen tension. The observed export of S-nitrosothiols, which are known to be vasoactive, is consistent with observations that NO-treated red blood cells can dilate blood vessels (25). However, evidence reported herein suggests that the oxygen dependent vasoactivity reported by other laboratories is likely secondary to hypoxic effects on vessel responsiveness, rather than on the proposed allosteric linkage of oxygen and NO release from SNO-Hb.

In conclusion, we show herein that SNO-Hb is intrinsically unstable in the reductive erythrocytic environment, but that ferricyanide treatment of lysates offsets this reductive decomposition of SNO-Hb. Consistent with the observed instability and lack of allosteric NO/O2-linked behavior of SNO-Hb in red blood cells, we found that SNO-Hb levels in human blood are in the low nanomolar range, much lower than previously reported, without significant arterial-venous gradients. These results suggest that, within the redox-active erythrocyte environment, beta -cysteine 93 is maintained in a reduced state, allowing for normal allosteric control of oxygen binding and release. Although trans-nitrosation reactions can pass NO into and out of erythrocytes, the reductive intra-erythrocytic environment decomposes SNO-Hb and prevents its accumulation as a reservoir of bioactive NO. Such data suggest that SNO-Hb does not play a role in the regulation of blood flow during normal physiology. The observations that SNO-Hb can be stabilized in oxidized erythrocytes in which SNO-Hb levels are elevated, and that S-nitrosothiols can be readily exported from these cells, suggests a potential role for SNO-Hb in NO-dependent events in vivo during pathological conditions associated with red blood cell oxidation or under circumstances where NO generation is increased in response to infection or pharmacological NO treatment.

    ACKNOWLEDGEMENTS

We gratefully acknowledge Drs. Rakesh Patel, Neil Hogg, Daniel Kim-Shapiro, and Jose Tanus-Santos for critical review and helpful suggestions.

    FOOTNOTES

* The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

To whom all correspondence and reprint requests should be addressed: Warren G. Magnuson Clinical Center, Critical Care Medicine Dept., Bldg. 10, Rm. 7D43, 10 Center Dr., MSC 1662, Bethesda, MD 20892-1662. Tel.: 301-496-9320; Fax: 301-402-1213; E-mail: mgladwin@nih.gov.

Published, JBC Papers in Press, May 21, 2002, DOI 10.1074/jbc.M203236200

2 C. Ho, personal communication.

3 R. P. Patel, personal communication.

    ABBREVIATIONS

The abbreviations used are: HbFeIINO, iron-nitrosyl-hemoglobin; SNO, S-nitroso; Hb, hemoglobin; NEM, N-ethylmaleimide; PBS, phosphate-buffered saline; ANOVA, analysis of variance; NOx, nitrite and nitrate; DTPA, diethylenetriaminepentaacetic acid.

    REFERENCES
TOP
ABSTRACT
INTRODUCTION
EXPERIMENTAL PROCEDURES
RESULTS
DISCUSSION
REFERENCES

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