Abstract-One major unresolved issue in muscle blood flow regulation is that of the role of circulating versus interstitial vasodilatory compounds. The present study determined adenosine-induced formation of NO and prostacyclin in the human muscle interstitium versus in femoral venous plasma to elucidate the interaction and importance of these vasodilators in the 2 compartments. To this end, we performed experiments on humans using microdialysis technique in skeletal muscle tissue, as well as the femoral vein, combined with experiments on cultures of microvascular endothelial versus skeletal muscle cells. In young healthy humans, microdialysate was collected at rest, during arterial infusion of adenosine, and during interstitial infusion of adenosine through microdialysis probes inserted into musculus vastus lateralis. Muscle interstitial NO and prostacyclin increased with arterial and interstitial infusion of adenosine. The addition of adenosine to skeletal muscle cells increased NO formation (fluorochrome 4-amino-5-methylamino-2Ј,7-difluorescein fluorescence), whereas prostacyclin levels remained unchanged. The addition of adenosine to microvascular endothelial cells induced an increase in NO and prostacyclin levels. These findings provide novel insight into the role of adenosine in skeletal muscle blood flow regulation and vascular function by revealing that both interstitial and plasma adenosine have a stimulatory effect on NO and prostacyclin formation. In addition, both skeletal muscle and microvascular endothelial cells are potential mediators of adenosine-induced formation of NO in vivo, whereas only endothelial cells appear to play a role in adenosineinduced formation of prostacyclin. keletal muscle blood flow is closely regulated to match O 2 delivery to the metabolic demand of the contracting muscle. 1 This precise regulation of muscle blood flow is believed to be regulated by a balance between vasoconstrictor activity and locally derived vasoactive substances. 2 Three such vasoactive compounds shown to be of importance for muscle blood flow regulation are adenosine, NO, and prostacyclin (PGI 2 ). Accordingly, it has been shown that blockade of adenosine receptors reduces exercise hyperemia by Ϸ15% to 20% 3,4 and simultaneous inhibition of the enzymes NO synthase (NOS), which catalyzes the formation of NO, and cyclooxygenase (COX), which initiates the conversion of arachidonic acid to PGI 2 , reduces exercise hyperemia in both the forearm and leg by Ϸ30%. 3,5-8 Importantly, these 3 vasoactive compounds show a close interaction in that the vasodilator effect of adenosine primarily appears to be mediated via the formation of NO and PGI 2 , as evidenced by markedly reduced vasodilation in response to arterially infused adenosine when NOS 3,9 and COX 3 are inhibited. Moreover, adenosine receptor blockade does not further reduce exercise hyperemia when combined with inhibition of NOS and COX, 3 suggesting that the vasodilator effect of endogenous adenosine is NO and PGI 2 dependent. However, because pharmac...