Genders AJ, Bradley EA, Rattigan S, Richards SM. cGMP phosphodiesterase inhibition improves the vascular and metabolic actions of insulin in skeletal muscle. Am J Physiol Endocrinol Metab 301: E342-E350, 2011. First published June 7, 2011; doi:10.1152/ajpendo.00691.2010.-There is considerable support for the concept that insulin-mediated increases in microvascular blood flow to muscle impact significantly on muscle glucose uptake. Since the microvascular blood flow increases with insulin have been shown to be nitric oxide-dependent inhibition of cGMP-degrading phosphodiesterases (cGMP PDEs) is predicted to enhance insulinmediated increases in microvascular perfusion and muscle glucose uptake. Therefore, we studied the effects of the pan-cGMP PDE inhibitor zaprinast on the metabolic and vascular actions of insulin in muscle. Hyperinsulinemic euglycemic clamps (3 mU·min Ϫ1 ·kg Ϫ1 ) were performed in anesthetized rats and changes in microvascular blood flow assessed from rates of 1-methylxanthine metabolism across the muscle bed by capillary xanthine oxidase in response to insulin and zaprinast. We also characterized cGMP PDE isoform expression in muscle by real-time PCR and immunostaining of frozen muscle sections. Zaprinast enhanced insulin-mediated microvascular perfusion by 29% and muscle glucose uptake by 89%, while whole body glucose infusion rate during insulin infusion was increased by 33% at 2 h. PDE2, -9, and -10 were the major isoforms expressed at the mRNA level in muscle, while PDE1B, -9A, -10A, and -11A proteins were expressed in blood vessels. Acute administration of the cGMP PDE inhibitor zaprinast enhances muscle microvascular blood flow and glucose uptake response to insulin. The expression of a number of cGMP PDE isoforms in skeletal muscle suggests that targeting specific cGMP PDE isoforms may provide a promising avenue for development of a novel class of therapeutics for enhancing muscle insulin sensitivity. cyclic guanosine monophosphate; blood flow; insulin and glucose delivery to muscle; microvascular blood flow ENDOTHELIAL DYSFUNCTION ARISING from impaired nitric oxide (NO) signaling underlies a range of cardiovascular conditions including erectile dysfunction, heart failure, and vascular disease in diabetes. Agents such as cinaciguat and sildenfil enhance NO signaling by increasing the formation of cyclic guanosine monophosphate (cGMP) by the NO-sensitive enzyme soluble guanylate cyclase or by reducing its hydrolysis by cGMP-degrading phosphodiesterases (cGMP PDEs), respectively. Cinaciguat, or BAY 58-2667, improves cardiovascular function in patients with acute decompensated heart failure (19) and preferentially vasodilates blood vessels containing a form of soluble guanylate cyclase affected by oxidative stress from human type 2 diabetics (36). In addition to its use for erectile dysfunction, sildenafil treatment has been shown to improve flow-mediated dilatation in brachial arteries of type 2 diabetics (14), and its chronic administration enhances the metabolic actions of insulin in hig...