Ou JS. L-Arginine restores endothelial nitric oxide synthase-coupled activity and attenuates monocrotaline-induced pulmonary artery hypertension in rats. Am J Physiol Endocrinol Metab 298: E1131-E1139, 2010. First published March 9, 2010; doi:10.1152/ajpendo.00107.2010.-L-Arginine can attenuate pulmonary hypertension (PH) by a mechanism that are not fully understood. This study investigated the molecule mechanism of L-arginine attenuating PH. Sprague Dawley rats were treated with monocrotaline (MCT) with or without L-arginine for 3 or 5 wk. Right ventricular systolic pressure (RVSP), right heart hypertrophy, survival rate, pulmonary artery wall thickness, nitric oxide (NO) concentration, and superoxide anion (O2 ·Ϫ ) generation in the lung were measured. Expressions of endothelial nitric oxide synthase (eNOS) and heat shock protein 90 (HSP90), phosphorylation of eNOS at Ser 1177 , and the association of eNOS and HSP90 in the lung were determined by Western blot and immunoprecipitation experiments. MCT increased RVSP, right heart hypertrophy, mortality, pulmonary artery wall thickness, and O2 ·Ϫ generation and decreased eNOS and HSP90 expression and association, phosphorylation of eNOS at Ser 1177 , and NO production. L-Arginine decreased RVSP, right heart hypertrophy, mortality, O2 ·Ϫ generation, and pulmonary artery wall thickness and increased NO production. L-Arginine increased eNOS expression, phosphorylation of eNOS at Ser 1177 , and association of eNOS and HSP90 without significantly altering HSP90 expression. L-Arginine may act through three pathways, providing a substrate for NO generation, preserving eNOS expression/phosphorylation, and maintaining the association of eNOS and HSP90, which allows restoration of eNOS activity and coupling activity, to maintain the balance between NO and O2 ·Ϫ and delay the development of PH.heat shock protein 90; nitric oxide; superoxide anion THERE ARE STILL NO EFFICIENT preventive and therapeutic methods available for pulmonary hypertension (PH) due to the fact that mechanisms, especially the molecular mechanisms of PH, are still not fully understood. Endothelial nitric oxide synthase (eNOS) expression and nitric oxide (NO) production decreases in PH (10,12,14). Daily treatment with an NO donor attenuates monocrotaline (MCT)-induced PH and pulmonary vascular remodeling (23). Furthermore, supplementation with the NO precursor L-arginine (L-Arg) enhances NOS expression within the pulmonary endothelium coincident with elevated NO, increases the plasma level of L-citrulline, and reduces mean pulmonary arterial pressure, pulmonary vascular resistance, and PH mortality in patients and in animal models (4, 5, 8, 26 -29, 38, 46). However, the molecular mechanisms by which L-Arg attenuates PH remain unclear. Previous studies conducted in different animal models demonstrated that L-Arg reduces generation of superoxide anion (O 2 ·Ϫ ) and prevents the reduced expression of eNOS (40, 46). The balance between NO and O 2 ·Ϫ plays an important role in the process of many cardiovascul...