Platelet aggregation responses are critically regulated in vivo by endogenous nitric oxide but not by endothelial nitric oxide synthase

Background and purpose:  Although exogenous nitric oxide (NO) clearly modifies platelet function, the role and the source of endogenous NO in vivo remain undefined. In addition, endothelial NO synthase (NOS‐3) critically regulates vessel tone but its role in modulating platelet function is unclear. In this paper we have investigated the roles of endogenous NO and NOS‐3 in regulating platelet function in vivo and determined the functional contribution made by platelet‐derived NO. Experimental approach:  We used a mouse model for directly assessing platelet functional responses in situ in the presence of an intact vascular endothelium with supporting in vitro and molecular studies. Key results:  Acute NOS inhibition by N ω ‐nitro‐L‐arginine methyl ester hydrochloride (L‐NAME) enhanced platelet aggregatory responses to thrombin and platelets were shown to be regulated primarily by NO sources external to the platelet. Elevation of endogenous NOS inhibitors to mimic effects reported in patients with cardiovascular diseases did not enhance platelet responses. Platelet responsiveness following agonist stimulation was not modified in male or female NOS‐3 −/− mice but responses in NOS‐3 −/− mice were enhanced by L‐NAME. Conclusions and implications:  Platelets are regulated by endogenous NO in vivo , primarily by NO originating from the environment external to the platelet with a negligible or undetectable role of platelet‐derived NO. Raised levels of endogenous NOS inhibitors, as reported in a range of diseases were not, in isolation, sufficient to enhance platelet activity and NOS‐3 is not essential for normal platelet function in vivo due to the presence of bioactive NO following deletion of NOS‐3.