Flow-dependent dilation is a fundamental mechanism by which large arteries ensure appropriate blood supply to tissues. We investigated whether or not the vascular kallikrein-kinin system, especially tissue kallikrein (TK), contributes to flow-dependent dilation by comparing wild-type and TK-knockout mice in which the presence or absence of TK expression was verified. We examined in vitro changes in the outer diameter of perfused carotid arteries from TK / and TK / mice. In both groups, exogenous bradykinin caused a similar dilation that was abolished by the B 2 receptor antagonist HOE-140, as well as by the NO synthase inhibitor N-nitro-L-arginine methyl ester. However, purified kininogen dilated only TK / arteries, demonstrating the essential role of TK in the vascular formation of kinins. In TK / arteries, increasing intraluminal flow caused a larger endothelium-dependent dilation than that seen in TK /. In both strains the flow response was mediated by NO and by endothelium-derived hyperpolarizing factor, whereas in TK / vasoconstrictor prostanoids participated as well. HOE-140 impaired flow-dependent dilation in TK / arteries while showing no effect in TK /. This compound reduced the flow response in TK / arteries to a level similar to that in TK /. After NO synthase inhibition, HOE-140 no longer affected the response of TK /. Impaired flow-dependent dilation was also observed in arteries from knockout mice lacking bradykinin B 2 receptors as compared with wild-type animals. This study demonstrates the active contribution of the vascular kallikrein-kinin system to one-third of the flow-dependent dilation response via activation of B 2 receptors coupled to endothelial NO release. (Circ Res. 2001;88: 593-599.) Key Words: bradykinin kininogen flow-dependent vasodilation endothelium bradykinin B 2 receptor L arge arteries accommodate changes in blood flow by increasing their diameter via the release of endothelial factors such as NO, prostacyclin, and endothelium-derived hyperpolarizing factor (EDHF). 1-4 This flow-dependent dila-tion (FDD) response represents a fundamental physiological mechanism that acts to oppose vasoconstriction, normalize shear stress, and ensure appropriate blood supply to tissues. Bradykinin modulates vascular smooth muscle tone by stimulating endothelial B 2 receptors and releasing NO and other mediators. 5-7 Bradykinin is a product of the cleavage of high and low molecular weight kininogens resulting from activation of proteases such as plasma and tissue kallikreins (TKs), cathepsins, or calpains. 8-12 The presence in the vessel wall of kininogens and kallikrein-like activities, including TK, suggests the existence of an endogenous vascular kinin-generating system, different from the circulating plasma kallikrein-kinin system. 13-16 However, the physiological role of the vascular kallikrein-kinin system itself has not been fully established because of the possible contribution of preadsorbed plasma kallikrein to vascular kinin formation and the lack of specific inhibitors of TK. 17-19 ...