Inflammatory mediators released by macrophages (M+) are believed to be involved in septic vasoplegia. To investigate the effect of My on vascular reactivity, excised rabbit carotids were exposed intraluminally either to peritoneal rabbit ME, activated by 18 h of incubation with 1 gg/ml lipopolysaccharide, or to the supernatants (SPN) derived from them. The contractile responses to phenylephrine (PE, 10-6 M) were determined by measuring changes in diameter using an ultrasonic microdimensiometer 1, 2, and 3 h after the first control contraction. In control arteries (n = 12), PE-induced contractions were, respectively, 102.9±3.3%, 95.2±4.1%, and 89.7±3.8% of the first contraction, after 1, 2, and 3 h. Activated M4 significantly reduced PE-stimulated contractions after as little as 1 h of carotid exposure (percentage of controls at 1, 2, or 3 h: 74.1±5.6, 57.2±5.2, and 34.2±5.6, n = 10, P < 0.001). The activated macrophage-derived SPN took longer to diminish carotid contractility than the Mt themselves, and became significant only after 2 h. The greater effect of Mt might be due to cooperation between Mt and vascular cells, as suggested by the amplified interleukin-1 release observed after Mt infusion. The presence of the endothelium partially protected carotid contractility from depression by activated Mt. Extraluminal addition of NG-monomethyl-L-arginine, an inhibitor of nitric oxide synthesis prevented this depression in arteries with or without endothelium. No products of the oxidative pathway of L-arginine were detected in rabbit activated Mt. These results suggest that activation of this pathway in smooth muscle cells seems to be involved in vascular hypocontractility. (J. Clin.