Defective regulation of platelet activation/ aggregation is a predominant cause for arterial thrombosis, the major complication of atherosclerosis triggering myocardial infarction and stroke. A central regulatory pathway conveying inhibition of platelet activation/aggregation is nitric oxide (NO)/cyclic GMP (cGMP) signaling by cGMP-dependent protein kinase I (cGKI). However, the regulatory cascade downstream of cGKI mediating platelet inhibition is still unclear. Here, we show that the inositol-1,4,5-trisphosphate receptor-
IntroductionPlatelet activation and aggregation at foci of vascular injury is essential for primary hemostasis, but it also initiates arterial thrombosis, the leading cause of myocardial infarction and stroke. 1 The gaseous molecule nitric oxide (NO) is an endogenous platelet antagonist and inhibits platelet activation and aggregate formation both in vitro and in vivo. [2][3][4] NO activates soluble guanylyl cyclases that initiate a subsequent rise in platelet cyclic GMP (cGMP). 2,3 Several mechanisms have been proposed by which NO/cGMP signaling abolishes platelet activation and aggregation, including inhibition of G-proteincoupled receptors and rearrangement of the cytoskeleton. 3,5 In addition, NO/cGMP prevents inositol-1,4,5-trisphosphate (InsP 3 )-mediated intracellular calcium release, 3,5 the critical step in the signal transduction pathway that leads to full platelet activation. 6 The cGMP-dependent protein kinase type I (cGKI) is strictly required for inhibition of platelet activation by NO/cGMP. 2,7 Although cGKI has been reported to inhibit intracellular Ca 2ϩ release in platelets, [8][9][10] the exact molecular targets downstream of cGKI involved in NO/cGMP-dependent inhibition of platelet activation have not been defined.In smooth muscle cells, we have identified the cGKI substrate IRAG 4, ] receptorassociated cGKI substrate protein), a 125-kDa protein which copurifies in a macrocomplex together with cGKI and the InsP 3 receptor type I (InsP 3 RI). 11 IRAG is essential for NO/cGMPdependent smooth muscle cell relaxation, because it negatively regulates InsP 3 -induced calcium release. 11,12 Because of the importance of cGKI signaling in platelets, we studied here the expression and cGKI-dependent phosphorylation of IRAG in platelets and the physiologic relevance of the IRAG-InsP 3 RI interaction for the regulation of platelet function. We provide first evidence that the IRAG-InsP 3 RI interaction mediates NO/cGMP-dependent inhibition of thrombin-induced increases in [Ca 2ϩ ] i in platelets and is the major determinant of NO/cGMPdependent prevention of platelet aggregation in vitro and arterial thrombosis in vivo.
Materials and methods
MaterialsWe used 8-pCPT-cGMP, Rp-8-Br-PET-cGMPS, Sp-5,6-DCl-cBIMPS (cBIMPS), 8-AET-cGMP-agarose, ethanolamine-agarose (Biolog, Bremen, Germany), forskolin (Calbiochem, Darmstadt, Germany), prostacyclin (Sigma, Deisenhofen, Germany), iloprost (Axxora, San Diego, CA), DEA/NO (Axxora), NO-spermine (Axxora), GEA-NO 3162 (Axxora), sodium nitroprusside (...