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<article xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" dtd-version="1.1" specific-use="sps-1.9" article-type="research-article" xml:lang="pt">
  <front>
    <journal-meta>
      <journal-id journal-id-type="nlm-ta">Arq Bras Cardiol</journal-id>
      <journal-id journal-id-type="publisher-id">abc</journal-id>
      <journal-title-group>
        <journal-title>Arquivos Brasileiros de Cardiologia</journal-title>
        <abbrev-journal-title abbrev-type="publisher">Arq. Bras. Cardiol.</abbrev-journal-title>
      </journal-title-group>
      <issn pub-type="ppub">0066-782X</issn>
      <issn pub-type="epub">1678-4170</issn>
      <publisher>
        <publisher-name>Sociedade Brasileira de Cardiologia - SBC</publisher-name>
      </publisher>
    </journal-meta>
    <article-meta>
      <article-id specific-use="scielo-v3" pub-id-type="publisher-id">cwPybmDjN58nYzJkcZmhvzd</article-id>
      <article-id specific-use="scielo-v2" pub-id-type="publisher-id">S0066-782X2020001200669</article-id>
      <article-id pub-id-type="publisher-id">abc.20190198</article-id>
      <article-id pub-id-type="doi">10.36660/abc.20190198</article-id>
      <article-categories>
        <subj-group subj-group-type="heading">
          <subject>Artigo Original</subject>
        </subj-group>
      </article-categories>
      <title-group>
        <article-title>Efeito do Diterpeno Manool sobre a Press&#227;o Arterial e Reatividade Vascular em Ratos Normotensos e Hipertensos</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Monteiro</surname>
            <given-names>Ariadne Santana e Neves</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">
            <sup>1</sup>
          </xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Campos</surname>
            <given-names>Debora Ribeiro</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">
            <sup>1</sup>
          </xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Albuquerque</surname>
            <given-names>Agnes Afrodite Sumarelli</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">
            <sup>1</sup>
          </xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0001-9631-946X</contrib-id>
          <name>
            <surname>Evora</surname>
            <given-names>Paulo Roberto Barbosa</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">
            <sup>1</sup>
          </xref>
          <xref ref-type="corresp" rid="c1"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ferreira</surname>
            <given-names>Luciana Garros</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">
            <sup>1</sup>
          </xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Celotto</surname>
            <given-names>Andrea Carla</given-names>
          </name>
          <xref ref-type="aff" rid="aff1">
            <sup>1</sup>
          </xref>
        </contrib>
        <aff id="aff1">
          <label>1</label>
          <institution content-type="orgname">Universidade de S&#227;o Paulo</institution>
          <institution content-type="orgdiv1">Faculdade de Medicina de Ribeir&#227;o Preto</institution>
          <addr-line>
            <named-content content-type="city">Ribeir&#227;o Preto</named-content>
            <named-content content-type="state">SP</named-content>
          </addr-line>
          <country country="BR">Brasil</country>
          <institution content-type="original">Universidade de S&#227;o Paulo Faculdade de Medicina de Ribeir&#227;o Preto, Ribeir&#227;o Preto, SP &#8211; Brasil</institution>
        </aff>
      </contrib-group>
      <author-notes>
        <corresp id="c1"><bold>Correspond&#234;ncia: Paulo Roberto Barbosa Evora</bold> &#8226; Universidade de S&#227;o Paulo Faculdade de Medicina de Ribeir&#227;o Preto - Cirurgia e Anatomia - Campus da USP. CEP <postal-code>14040-900</postal-code>, Ribeir&#227;o Preto, SP &#8211; Brasil. E-mail: <email>prbevora@gmail.com</email></corresp>
        <fn fn-type="con">
          <p>
            <bold>Contribui&#231;&#227;o dos Autores</bold>
          </p>
          <p>Concep&#231;&#227;o e desenho da pesquisa: Monteiro ASN, Albuquerque AAS, Evora PRB, Ferreira LG, Celotto AC; Obten&#231;&#227;o de dados: Monteiro ASN, Campos DR, Albuquerque AAS, Ferreira LG; An&#225;lise e interpreta&#231;&#227;o dos dados: Monteiro ASN, Campos DR, Albuquerque AAS, Ferreira LG, Celotto AC; An&#225;lise estat&#237;stica: Monteiro ASN, Campos DR, Albuquerque AAS, Celotto AC; Obten&#231;&#227;o de financiamento: Evora PRB, Celotto AC; Reda&#231;&#227;o do manuscrito: Monteiro ASN, Campos DR, Albuquerque AAS, Evora PRB, Ferreira LG, Celotto AC; Revis&#227;o cr&#237;tica do manuscrito quanto ao conte&#250;do intelectual importante: Albuquerque AAS, Evora PRB, Celotto AC.</p>
        </fn>
        <fn fn-type="conflict">
          <p>
            <bold>Potencial Conflito de Interesses</bold>
          </p>
          <p>Declaro n&#227;o haver conflito de interesses pertinentes.</p>
        </fn>
      </author-notes>
      <pub-date publication-format="electronic" date-type="pub">
        <day>23</day>
        <month>10</month>
        <year>2020</year>
      </pub-date>
      <pub-date publication-format="electronic" date-type="collection">
        <month>10</month>
        <year>2020</year>
      </pub-date>
      <volume>115</volume>
      <issue>4</issue>
      <fpage>669</fpage>
      <lpage>677</lpage>
      <history>
        <date date-type="received">
          <day>27</day>
          <month>03</month>
          <year>2019</year>
        </date>
        <date date-type="rev-recd">
          <day>27</day>
          <month>08</month>
          <year>2019</year>
        </date>
        <date date-type="accepted">
          <day>23</day>
          <month>10</month>
          <year>2019</year>
        </date>
      </history>
      <permissions>
        <license license-type="open-access" xml:lang="en" xlink:href="https://creativecommons.org/licenses/by/4.0/">
          <license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License</license-p>
        </license>
      </permissions>
      <abstract>
        <title>Resumo</title>
        <sec>
          <title>Fundamento:</title>
          <p>Diversos estudos t&#234;m mostrado que as classes de diterpenos exercem efeito significativo no sistema cardiovascular. Os diterpenos, em particular, est&#227;o entre os principais compostos associados &#224;s propriedades cardiovasculares, como a propriedade vasorrelaxante, inotr&#243;pica, diur&#233;tica e a atividade hipotensora. Embora o mecanismo de vasorrelaxamento do manool seja vis&#237;vel, seu efeito sobre a press&#227;o arterial (PA) ainda &#233; desconhecido.</p>
        </sec>
        <sec>
          <title>Objetivo:</title>
          <p>Avaliar o efeito hipotensor in vivo do manool e verificar o efeito de vasorrelaxamento ex vivo em an&#233;is a&#243;rticos de ratos.</p>
        </sec>
        <sec>
          <title>M&#233;todos:</title>
          <p>Os animais foram divididos aleatoriamente em dois grupos: normotensos e hipertensos. O grupo normotenso foi submetido &#224; cirurgia sham e adotou-se o modelo 2R1C para o grupo hipertenso. Realizou-se monitoramento invasivo da PA para testes com manool em diferentes doses (10, 20 e 40 mg/kg). Foram obtidas curvas de concentra&#231;&#227;o-resposta para o manool nos an&#233;is a&#243;rticos, com endot&#233;lio pr&#233;-contra&#237;do com fenilefrina (Phe) ap&#243;s incuba&#231;&#227;o com N&#969;-nitro-L-arginina metil &#233;ster (L-NAME) ou oxadiazolo[4,3-a]quinoxalina-1-ona (ODQ). Os n&#237;veis plasm&#225;ticos de &#243;xido n&#237;trico (NOx) foram medidos por ensaio de quimioluminesc&#234;ncia.</p>
        </sec>
        <sec>
          <title>Resultados:</title>
          <p>Ap&#243;s a administra&#231;&#227;o de manool, a PA se reduziu nos grupos normotenso e hipertenso, e esse efeito foi inibido pelo L-NAME em animais hipertensos apenas na dose de 10 mg/kg. O manool ex vivo promoveu vasorrelaxamento, inibido pela incuba&#231;&#227;o de L-NAME e ODQ ou remo&#231;&#227;o do endot&#233;lio. Os n&#237;veis plasm&#225;ticos de NOx aumentaram no grupo hipertenso ap&#243;s a administra&#231;&#227;o de manool. O manool induz o relaxamento vascular dependente do endot&#233;lio na aorta de ratos, mediado pela via de sinaliza&#231;&#227;o NO/cGMP e redu&#231;&#227;o da PA, e tamb&#233;m pelo aumento plasm&#225;tico de NOx. Esses efeitos combinados podem estar envolvidos na modula&#231;&#227;o da resist&#234;ncia perif&#233;rica, contribuindo para o efeito anti-hipertensivo do diterpeno.</p>
        </sec>
        <sec>
          <title>Conclus&#227;o:</title>
          <p>Esses efeitos em conjunto podem estar envolvidos na modula&#231;&#227;o da resist&#234;ncia perif&#233;rica, contribuindo para o efeito anti-hipertensivo do diterpeno.</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="pt">
        <title>Palavras-chave:</title>
        <kwd>Doen&#231;as Cardiovasculares</kwd>
        <kwd>Hipertens&#227;o</kwd>
        <kwd>Diterpeno</kwd>
        <kwd>Manool</kwd>
        <kwd>Reatividade</kwd>
        <kwd>Plantas Medicinais</kwd>
        <kwd>&#211;xido N&#237;trico</kwd>
        <kwd>Ratos</kwd>
      </kwd-group>
      <counts>
        <fig-count count="12"/>
        <table-count count="2"/>
        <equation-count count="0"/>
        <ref-count count="39"/>
        <page-count count="9"/>
      </counts>
    </article-meta>
  </front>
  <body>
    <sec sec-type="intro">
      <title>Introdu&#231;&#227;o</title>
      <p>Os diterpenos s&#227;o uma ampla classe de metab&#243;litos qu&#237;micos, amplamente distribu&#237;dos no reino vegetal, com mais de 12.000 compostos conhecidos.<xref ref-type="bibr" rid="B1"><sup>1</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B2"><sup>2</sup></xref> Eles podem ser divididos em dois tipos: diterpenos de metabolismo especializado (secund&#225;rio) e diterpenos de metabolismo geral (prim&#225;rio). Os diterpenos secund&#225;rios podem ter fun&#231;&#245;es nas intera&#231;&#245;es ecol&#243;gicas das plantas com outros organismos e benef&#237;cios em f&#225;rmacos, perfumes, resinas e outros bioprodutos industriais com grande relev&#226;ncia econ&#244;mica.<xref ref-type="bibr" rid="B1"><sup>1</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B2"><sup>2</sup></xref> Diversos metab&#243;litos secund&#225;rios, como terpenos, &#225;cidos fen&#243;licos, polifen&#243;is, flavonoides e antocianinas, foram relatados em esp&#233;cies de s&#225;lvia. Essas esp&#233;cies s&#227;o vistas como excelentes fontes de diterpenos.<xref ref-type="bibr" rid="B3"><sup>3</sup></xref> De acordo com os achados quimiotaxon&#244;micos, o manool foi relatado anteriormente nas seguintes esp&#233;cies de s&#225;lvia: <italic>S. sclarea, S. pubescens, S. lavandulifolia, S. hypoleuca</italic>, <italic>S. miltiorrhizae</italic>. Tamb&#233;m est&#225; presente em outras esp&#233;cies, como na <italic>Pinuscaribaea (Pinaceae), Lourteigiastoechadifolia (Asteraceae)</italic> e <italic>Halocarpusbiformis (Podocarpaceae)</italic>. No entanto, o manool &#233; o principal diterpeno das v&#225;rias esp&#233;cies de s&#225;lvia, sendo encontrado em maior concentra&#231;&#227;o na <italic>Salvia officinalis.</italic><xref ref-type="bibr" rid="B4"><sup>4</sup></xref></p>
      <p>A bioss&#237;ntese das unidades estruturais de isopreno de uma ampla variedade de terpenos, incluindo os diterpenos, ocorre pela via da desoxilulose. Essa via aumenta e evolui para dois produtos distintos: isopentenildifosfato (IPP) e dimetilalildifosfato (DMAPP). Mais especificamente, o manool, cuja composi&#231;&#227;o qu&#237;mica &#233; C<sub>20</sub>H<sub>34</sub>O, &#233; um diperteno do tipo labdano bic&#237;clico. Sua estrutura se baseia em um esqueleto carbonado do tipo 2E, 6E, 10E-geranilgeranilpirofosfato (GGPP).<xref ref-type="bibr" rid="B5"><sup>5</sup></xref><sup>&#8211;</sup><xref ref-type="bibr" rid="B7"><sup>7</sup></xref></p>
      <p>A descoberta de novas subst&#226;ncias com atividade anti-hipertensiva, baixo custo e poucos efeitos adversos &#233; ainda um aspecto desej&#225;vel e de import&#226;ncia para a utiliza&#231;&#227;o cl&#237;nica.<xref ref-type="bibr" rid="B8"><sup>8</sup></xref> Por&#233;m, v&#225;rias dificuldades s&#227;o encontradas para esse fim, como a escolha do modelo experimental, obten&#231;&#227;o de extratos padronizados e a dificuldade de obten&#231;&#227;o, isolamento e identifica&#231;&#227;o das subst&#226;ncias ativas.<xref ref-type="bibr" rid="B9"><sup>9</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B10"><sup>10</sup></xref> A op&#231;&#227;o de conduzir pesquisas, a partir da indica&#231;&#227;o de plantas utilizadas pelas comunidades, encurta o percurso de desenvolvimento de um novo f&#225;rmaco, pois os pesquisadores disp&#245;em, antes mesmo de se iniciarem estudos cient&#237;ficos, de uma indica&#231;&#227;o de qual atividade biol&#243;gica esta droga poderia apresentar.<xref ref-type="bibr" rid="B11"><sup>11</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B12"><sup>12</sup></xref></p>
      <p>Os diterpenos, em particular, est&#227;o entre os principais compostos com liga&#231;&#227;o &#224;s propriedades cardiovasculares, tais como vasorrelaxante, inotr&#243;pica, diur&#233;tica e hipotensiva. A a&#231;&#227;o vascular exercida por esses compostos parece envolver m&#250;ltiplos mecanismos, como endot&#233;lio dependente e endot&#233;lio independente, aumento de prostaciclina e bloqueio de canais de c&#225;lcio dependentes de voltagem.<xref ref-type="bibr" rid="B13"><sup>13</sup></xref><sup>&#8211;</sup><xref ref-type="bibr" rid="B17"><sup>17</sup></xref></p>
      <p>Conforme descrito anteriormente na revis&#227;o da literatura, o manool &#8212; C<sub>20</sub>H<sub>34</sub>O &#8212; &#233; um diterpeno do tipo labdano, comumente encontrado em diversas fam&#237;lias de plantas, &#233; o principal diterpeno de v&#225;rias esp&#233;cies de s&#225;lvia, e est&#225; presente em concentra&#231;&#245;es mais elevadas na <italic>Salvia officinalis</italic> (<xref ref-type="fig" rid="f1">Figura 1</xref>).<xref ref-type="bibr" rid="B1"><sup>1</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B3"><sup>3</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B18"><sup>18</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B19"><sup>19</sup></xref> &#201; uma esp&#233;cie da fam&#237;lia <italic>Lamiaceae (Labiateae)</italic>, origin&#225;ria do sul da Europa. Apresenta h&#225;bito de crescimento herb&#225;ceo ou arbustivo de pequeno porte, &#233; planta perene que floresce no Hemisf&#233;rio Sul entre os meses de agosto e dezembro.<xref ref-type="bibr" rid="B20"><sup>20</sup></xref></p>
      <fig id="f1">
        <label>Figura 1</label>
        <caption>
          <title>Estrutura qu&#237;mica do Manool.<xref ref-type="bibr" rid="B10"><sup>10</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B11"><sup>11</sup></xref></title>
        </caption>
        <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf01.tif"/></fig>
      <p>Li et al.,<xref ref-type="bibr" rid="B21"><sup>21</sup></xref> constaram que embora o manool possua atividades desconhecidas do ponto de vista cardiovascular, ele deve ser considerado como fator crucial nos estudos a serem realizados. Al&#233;m disso, pode ser visto como um novo condutor para o tratamento de doen&#231;as card&#237;acas, merecendo mais investiga&#231;&#227;o.<xref ref-type="bibr" rid="B4"><sup>4</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B21"><sup>21</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B22"><sup>22</sup></xref> O protocolo experimental incluiu observa&#231;&#245;es sobre os n&#237;veis plasm&#225;ticos de &#243;xido n&#237;trico (NOx) em animais hipertensos e o impacto da manool na BP de animais ap&#243;s a administra&#231;&#227;o de diferentes doses do composto.</p>
      <p>Sabendo que o manool pertence &#224; classe dos compostos diterp&#234;nicos, com potencial uso no tratamento da hipertens&#227;o, o presente trabalho teve como objetivo avaliar o poss&#237;vel efeito vasodilatador e os mecanismos celulares envolvidos na resposta de relaxamento de an&#233;is a&#243;rticos de ratos. Portanto, o objetivo foi avaliar o efeito hipotensor in vivo do manool e verificar o efeito vasorrelaxamento ex vivo em an&#233;is a&#243;rticos de ratos.</p>
    </sec>
    <sec sec-type="materials|methods">
      <title>Materiais e M&#233;todos</title>
      <sec>
        <title>Declara&#231;&#227;o de &#201;tica e Animais</title>
        <p>As pol&#237;ticas de manejo de animais e procedimentos experimentais foram analisadas e aprovadas pela Comiss&#227;o de &#201;tica em Experimenta&#231;&#227;o Animal da Faculdade de Medicina de Ribeir&#227;o Preto da Universidade de S&#227;o Paulo (n. 060/210), seguindo as orienta&#231;&#245;es da Diretiva 2010/63 UE da Comiss&#227;o Europeia. Trinta e quatro ratos Wistar machos (180&#8211;220 g) foram acondicionados em condi&#231;&#245;es laboratoriais padr&#227;o (ciclo claro/escuro de 12 horas a 21 &#176;C) com livre acesso &#224; &#225;gua e ra&#231;&#227;o. Os animais foram divididos aleatoriamente em cinco grupos de 7 animais para protocolos de press&#227;o arterial normotensa e hipertensa (ve&#237;culo normotenso, manool normotenso; ve&#237;culo hipertenso, manool hipertenso e manool hipertenso + L-NAME). Os animais alocados nos grupos normotensos foram sham-operados, enquanto os animais alocados nos grupos hipertensos foram submetidos ao procedimento cir&#250;rgico 2R1C (dois rins-um-clipe hipertensos) para indu&#231;&#227;o da hipertens&#227;o. Utilizou-se um outro grupo de 6 animais que n&#227;o realizaram nenhum procedimento (intactos) para estudos de reatividade vascular ex vivo.</p>
      </sec>
      <sec>
        <title>F&#225;rmacos</title>
        <p>Manool, acetilcolina (ACh), 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalina-1-ona (ODQ) e fenilefrina (Phe), da Sigma Chemical Company (St. Louis, MO, EUA); &#233;ster met&#237;lico de N&#969;-nitro-L-arginina (L-NAME), obtido na Calbiochem (San Diego, CA, EUA); Vetec Qu&#237;mica Fina Ltda forneceu isoflurano da Abbott e todos os sais usados para a prepara&#231;&#227;o da solu&#231;&#227;o de Krebs. Quase todos os f&#225;rmacos foram preparados com &#225;gua destilada, sendo o manool solubilizada em dimetilsulf&#243;xido (50 uL) e dilu&#237;do em etanol/&#225;gua (2:10, volume total 200 uL). Para os experimentos de reatividade vascular, 100 uL foram dilu&#237;dos em 900 uL de &#225;gua, formando o estoque (10<sup>&#8722;3</sup>). A partir desse estoque, preparou-se a curva. O volume usado a partir dessa curva foi de 10 uL em uma cuba de 10 ml. Portanto, ap&#243;s tantas dilui&#231;&#245;es, o ve&#237;culo n&#227;o promove nenhum efeito na reatividade vascular.</p>
      </sec>
      <sec>
        <title>Indu&#231;&#227;o da Hipertens&#227;o</title>
        <p>Ap&#243;s anestesia intraperitoneal com cetamina (50 mg/kg) e xilazina (10 mg/kg), a art&#233;ria renal foi exposta. Os grupos hipertensos apresentaram constri&#231;&#227;o parcial da art&#233;ria renal esquerda principal com clipe de prata com abertura de 0,10 mm (2R1C), enquanto os grupos normotensos tiveram a art&#233;ria renal esquerda principal isolada, mas n&#227;o receberam o clipe (sham). Para monitorar o desenvolvimento da hipertens&#227;o, a press&#227;o arterial sist&#243;lica (PAS) foi medida de forma n&#227;o invasiva por meio da pletismografia de cauda, uma vez por semana. (Kent Scientific Corporation, Connecticut, EUA). Os ratos 2R1C foram considerados hipertensos com PAS de cauda &#8805; 160 mmHg na 3&#170; semana ap&#243;s os procedimentos cir&#250;rgicos. Os ratos 2R1C com PAS &lt;160 mmHg na 3&#170; semana foram eutanasiados. Menos de 10% dos animais apresentaram PAS &lt;160 mmHg. Os ratos que foram sham-operados foram inclu&#237;dos no grupo normotenso.</p>
      </sec>
      <sec>
        <title>Efeito do Manool na Press&#227;o Arterial</title>
        <p>Tr&#234;s semanas ap&#243;s a indu&#231;&#227;o da hipertens&#227;o, os animais foram anestesiados, e a art&#233;ria e veia femoral foram canuladas, respectivamente, para medi&#231;&#227;o cont&#237;nua da press&#227;o arterial sist&#243;lica (PAS) e administra&#231;&#227;o de medicamentos. Ap&#243;s anestesia (uretano, 2 mg/kg, intraperitoneal), canula&#231;&#227;o vascular e per&#237;odo de estabiliza&#231;&#227;o (20 minutos) com registro cont&#237;nuo da press&#227;o arterial sist&#243;lica (PAS) em tempo real, tr&#234;s doses de manool (10, 20 e 40 mg/kg) ou ve&#237;culo (dimetilsulf&#243;xido &#8212; DMSO &#8212; e &#225;gua+etanol) foram administrados aos ratos normotensos e hipertensos. Cada dose foi administrada em bolus intravenoso de 200 &#181;L e o intervalo entre cada dose consecutiva foi de 6 minutos. Os animais que receberam ve&#237;culo n&#227;o receberam manool. Para cada animal, a varia&#231;&#227;o na press&#227;o arterial sist&#243;lica (&#916;PAS) foi calculada subtraindo a m&#233;dia dos valores mais baixos de PAS imediatamente ap&#243;s a administra&#231;&#227;o de manool da m&#233;dia dos valores basais de PAS antes do manool ou bolus do ve&#237;culo. A press&#227;o arterial m&#233;dia foi medida por meio do MP System 100 A (BioPac System, Inc., Santa B&#225;rbara, CA, EUA).</p>
      </sec>
      <sec>
        <title>Reatividade Vascular</title>
        <p>Os experimentos foram realizados em an&#233;is a&#243;rticos de ratos normotensos. Seis ratos Wistar machos (280&#8211;300 g) foram anestesiados com isoflurano inalat&#243;rio, seguido de exsanguina&#231;&#227;o da aorta abdominal e toracotomia para retirada da aorta tor&#225;cica. A aorta tor&#225;cica foi cuidadosamente dissecada, confirmada como livre de tecido conjuntivo e imediatamente imersa em solu&#231;&#227;o de Krebs. A solu&#231;&#227;o de Krebs era composta por NaCl (118,0 mM), KCl (4,7 mM), CaCl2 (2,5 mM), KH2PO4 (1,2 mM), MgSO4 (1,66 mM), glicose (11,1 mM) e NaHCO3 (25,0 mM); a solu&#231;&#227;o tinha pH 7,4. A aorta tor&#225;cica imersa em solu&#231;&#227;o de Krebs foi cortada em an&#233;is de 4 a 5 mm de comprimento. Para os testes, o anel com endot&#233;lio desnudado foi removido esfregando-se suavemente o vaso da superf&#237;cie interna com uma haste de a&#231;o fina. Esse procedimento remove efetivamente o endot&#233;lio, mas n&#227;o afeta a capacidade do m&#250;sculo liso vascular de se contrair ou relaxar. Os an&#233;is a&#243;rticos foram colocados em 10 mL de banho org&#226;nico para tecido isolado contendo solu&#231;&#227;o de Krebs, a 37 &#176;C, e 95% O<sub>2</sub>/5% CO<sub>2</sub> (pH 7,4) para medir a for&#231;a isom&#233;trica por meio do equipamento Grass FT03 (Grass Instrument Company, Quincy, MA, EUA). Cada anel foi alongado at&#233; o ponto &#243;timo de estiramento-tens&#227;o de 2,0 g, determinado em um estudo piloto, e permaneceram sob esta tens&#227;o por 60 min. Durante esse tempo, os tecidos foram lavados a cada 15 minutos. O endot&#233;lio foi considerado presente (E+) registrando-se o relaxamento de 80% induzido por Ach (10<sup>&#8722;6</sup> M) ap&#243;s a pr&#233;-contra&#231;&#227;o com Phe (10<sup>&#8722;7</sup> M). O endot&#233;lio foi considerado ausente (E&#8722;) quando a resposta de relaxamento n&#227;o ocorreu. Em seguida, cada anel foi lavado e reestabilizado por 30 min. Os an&#233;is a&#243;rticos foram contra&#237;dos com Phe (10<sup>&#8722;7</sup> M) depois que um plat&#244; est&#225;vel foi atingido e as curvas de dose-resposta de manool foram obtidas. Os ensaios de concentra&#231;&#227;o-resposta nos banhos org&#226;nicos foram realizados na presen&#231;a ou aus&#234;ncia de: L-NAME (2x10<sup>&#8722;4</sup> M), um inibidor n&#227;o espec&#237;fico da &#243;xido n&#237;trico sintase e ODQ (10<sup>&#8722;4</sup> M), um inibidor da guanililciclase.<xref ref-type="bibr" rid="B20"><sup>20</sup></xref> As prepara&#231;&#245;es foram incubadas com os inibidores por 30 min. N&#227;o realizamos curvas de dose-resposta com um ve&#237;culo porque a dilui&#231;&#227;o foi realizada em &#225;gua. A solu&#231;&#227;o inicial 1 M (50 uL de DMSO + 30 uL de etanol + 120 uL de &#225;gua) sofreu dilui&#231;&#227;o em s&#233;rie para 10<sup>&#8722;1</sup> M em &#225;gua.</p>
      </sec>
      <sec>
        <title>Medi&#231;&#245;es Plasm&#225;ticas Indiretas de NO</title>
        <p>Coletou-se amostras de sangue (1 ml) da art&#233;ria femoral ap&#243;s a &#250;ltima curva dose-resposta em ve&#237;culo normotenso e manool hipertenso, sendo colocadas em tubos heparinizados. Ap&#243;s centrifuga&#231;&#227;o do sangue (3000&#215;g, 10 minutos, 4 &#176;C), o plasma foi imediatamente imerso em nitrog&#234;nio l&#237;quido e mantido a &#8722;70 &#176;C at&#233; a dosagem de nitrito e nitrato (NOx). As amostras foram analisadas em duplicata para NOx por ensaio de quimioluminesc&#234;ncia &#224; base de oz&#244;nio. As amostras plasm&#225;ticas foram brevemente tratadas com etanol frio (1 volume de plasma: 2 volumes de etanol por 30 minutos a &#8722;20 &#176;C) e centrifugadas (4000&#215;g, 10 minutos). Os n&#237;veis de NOx foram medidos pela inje&#231;&#227;o de 25 <italic>&#956;</italic>L de sobrenadante em recipiente de purga de vidro contendo 0,8% de van&#225;dio (III) em HCl (1 N) a 90 &#176;C, que reduz o NOx a &#243;xido nitroso. Uma corrente de nitrog&#234;nio foi borbulhada atrav&#233;s do recipiente de purga contendo van&#225;dio (III), em seguida atrav&#233;s de NaOH (1 N), e ent&#227;o em um analisador de NO (Sievers&#174; Nitric Oxide Analyzer 280, GE Analytical Instruments, Boulder, CO, EUA).</p>
      </sec>
      <sec>
        <title>An&#225;lise Estat&#237;stica</title>
        <p>Os dados s&#227;o apresentados como m&#233;dia &#177; erro-padr&#227;o da m&#233;dia. Realizamos an&#225;lises estat&#237;sticas com o teste T de Student, an&#225;lise de vari&#226;ncia simples (ANOVA), p&#243;s-teste de Bonferroni, e ANOVA de duas vias com medidas repetidas, com o p&#243;s-teste de Bonferroni para detectar poss&#237;veis diferen&#231;as entre os valores do estudo. Para cada figura, a legenda descreve qual teste foi realizado para an&#225;lise. Considerou-se significativo um p&lt;0,05 (Prism 5.0, GraphPad Software, San Diego, CA, EUA). Um tamanho de amostra de (N = 5&#8211;7) por grupo forneceu 95% de poder com um n&#237;vel de signific&#226;ncia de 0,05% em protocolos de medi&#231;&#227;o da press&#227;o arterial in vivo. Al&#233;m disso, um tamanho de amostra de (N = 6&#8211;8) animais por grupo forneceu 95% de poder com um n&#237;vel de signific&#226;ncia de 0,05 para detectar uma redu&#231;&#227;o relativa de 10% na contra&#231;&#227;o m&#225;xima em vasos pr&#233;-contra&#237;dos. O n&#250;mero de animais foi escolhido com base na literatura.<xref ref-type="bibr" rid="B20"><sup>20</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B23"><sup>23</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B24"><sup>24</sup></xref></p>
      </sec>
    </sec>
    <sec sec-type="results">
      <title>Resultados</title>
      <p>Antes dos procedimentos cir&#250;rgicos, n&#227;o havia diferen&#231;as na PA entre os grupos normotenso e hipertenso. Por&#233;m, ap&#243;s a indu&#231;&#227;o da hipertens&#227;o, da 1&#170; &#224; 3&#170; semana, a PA mostrou-se significativamente mais elevada nos ratos hipertensos (130,6 mmHg versus 193,0 mmHg) (<xref ref-type="fig" rid="f2">Figura 2</xref>).</p>
      <fig id="f2">
        <label>Figura 2</label>
        <caption>
          <title>Evolu&#231;&#227;o temporal da press&#227;o arterial sist&#243;lica (PAS) de forma n&#227;o invasiva em animais normotensos e hipertensos. Os valores representam a m&#233;dia &#177; erro padr&#227;o da press&#227;o arterial m&#233;dia antes da cirurgia de coloca&#231;&#227;o de clipe (pr&#233;-operat&#243;rio) e tr&#234;s semanas ap&#243;s a cirurgia. *p&lt;0,05 e # p&lt;0,01 indicam diferen&#231;a significativa entre o grupo de hipertensos e normotensos. ANOVA de duas vias, p&#243;s-teste de Bonferroni. n=14 normotenso e n=14 hipertenso.</title>
        </caption>
        <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf02.tif"/></fig>
      <p>A avalia&#231;&#227;o do peso corporal mostrou que, na primeira semana, os grupos apresentavam cargas semelhantes. Por&#233;m, ao final de tr&#234;s semanas, o grupo de hipertensos apresentou valores significativamente menores em rela&#231;&#227;o ao grupo de normotensos (<xref ref-type="table" rid="t1">Tabela 1</xref>).</p>
      <table-wrap id="t1">
        <label>Tabela 1</label>
        <caption>
          <title>Evolu&#231;&#227;o temporal do peso corporal de animais normotensos e hipertensos</title>
        </caption>
        <table frame="hsides" rules="rows">
          <colgroup width="33%">
            <col/>
            <col/>
            <col/>
          </colgroup>
          <thead style="border-top: thin solid; border-bottom: thin solid; border-color: #000000">
            <tr>
              <th align="center" valign="middle" colspan="3">Evolu&#231;&#227;o do peso corporal (g)</th>
            </tr>
            <tr>
              <th align="left" valign="middle">Grupos</th>
              <th align="center" valign="middle">Inicial</th>
              <th align="center" valign="middle">Final</th>
            </tr>
          </thead>
          <tbody style="border-bottom: thin solid; border-color: #000000">
            <tr>
              <td align="left" valign="middle">Normotenso</td>
              <td align="center" valign="middle">233,4&#177;7,1</td>
              <td align="center" valign="middle">480,2&#177;10,2</td>
            </tr>
            <tr>
              <td align="left" valign="middle">Hipertenso</td>
              <td align="center" valign="middle">239,4&#177;7,7</td>
              <td align="center" valign="middle">404,8&#177;18,2<xref ref-type="table-fn" rid="TFN2">*</xref></td>
            </tr>
          </tbody>
        </table>
        <table-wrap-foot>
          <fn id="TFN1">
            <p>Cada valor representa a m&#233;dia &#177; erro-padr&#227;o da m&#233;dia.</p>
          </fn>
          <fn id="TFN2">
            <label>*</label>
            <p>p&lt;0,05 indica diferen&#231;a significativa entre o grupo hipertenso e o grupo normotenso. Teste t de Student.</p>
          </fn>
        </table-wrap-foot>
      </table-wrap>
      <p>Na an&#225;lise da PAS in vivo, apenas a cirurgia (2R1C) foi capaz de alterar o sangue (ve&#237;culo normotenso versus ve&#237;culo hipertenso). O manool promoveu resposta dose-dependente na PAS, reduzindo significativamente a press&#227;o a partir da dose de 20 mg/kg no grupo normotenso, n&#227;o havendo diferen&#231;a entre 20 e 40 mg/kg neste grupo para o manool. No grupo hipertenso, apenas uma dose menor de manool (10 mg/kg) reduziu a PAS em compara&#231;&#227;o ao grupo controle (ve&#237;culo hipertenso), e a administra&#231;&#227;o pr&#233;via de L-NAME preveniu o efeito manool. No grupo hipertenso, o efeito manool n&#227;o foi dose-dependente (<xref ref-type="fig" rid="f3">Figura 3</xref>).</p>
      <fig id="f3">
        <label>Figura 3</label>
        <caption>
          <title>Altera&#231;&#227;o da press&#227;o arterial sist&#243;lica (&#916;PAS) ap&#243;s administra&#231;&#227;o de manool ou ve&#237;culo em ratos normotensos e hipertensos. Os dados s&#227;o apresentados como m&#233;dia &#177; erro-padr&#227;o da m&#233;dia. Ve&#237;culo normotenso (n=7), manool normotenso (n=7), ve&#237;culo hipertenso (n=7), manool hipertenso (n=7) e manool hipertenso + L-NAME (n=7), *p&lt;0,05, ** p&lt;0,01 indica diferen&#231;a significativa. ANOVA de duas vias, p&#243;s-teste de Bonferroni.</title>
        </caption>
        <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf03.tif"/></fig>
      <p>O NOx plasm&#225;tico fica um pouco alto no grupo normotenso ap&#243;s a administra&#231;&#227;o de manool, mas n&#227;o &#233; significativo. Por&#233;m, no grupo hipertenso, o manool promoveu aumento nos n&#237;veis plasm&#225;ticos de NOx (<xref ref-type="fig" rid="f4">Figura 4</xref>).</p>
      <fig id="f4">
        <label>Figura 4</label>
        <caption>
          <title>N&#237;veis plasm&#225;ticos de nitrito e nitrato (NOx) em ve&#237;culos normotensos e manool e ve&#237;culos hipertensos e animais com manool. ANOVA de uma via, p&#243;s-teste de Bonferroni (n=7). *p&lt;0,01 indica diferen&#231;a significativa entre ve&#237;culo hipertenso e manool hipertenso.</title>
        </caption>
        <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf04.tif"/></fig>
      <p>Sobre os experimentos de reatividade vascular, o manool promoveu um relaxamento dose-dependente em an&#233;is intactos (<xref ref-type="fig" rid="f5">Figura 5</xref>), pr&#233;-contra&#237;dos com Phe. A incuba&#231;&#227;o com L-NAME ou ODQ bloqueou o relaxamento induzido por manool em an&#233;is com endot&#233;lio intacto da mesma forma que a remo&#231;&#227;o do endot&#233;lio (<xref ref-type="fig" rid="f6">Figuras 6A</xref> e <xref ref-type="fig" rid="f6">6B</xref>).</p>
      <fig id="f5">
        <label>Figura 5</label>
        <caption>
          <title>Curva de relaxamento em an&#233;is de aorta tor&#225;cica de ratos com endot&#233;lio intacto e endot&#233;lio desnudado expostos a manool. Os an&#233;is foram pr&#233;-contra&#237;dos com fenilefrina (Phe) (10-7.M). Todos os valores correspondem &#224; m&#233;dia &#177; erro-padr&#227;o da m&#233;dia (n=6). *p&lt;0,05 e # p&lt;0,001. ANOVA de duas vias com medidas repetidas e p&#243;s-teste de Bonferroni.</title>
        </caption>
        <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf05.tif"/></fig>
      <fig id="f6">
        <label>Figura 6</label>
        <caption>
          <title>Curva de relaxamento em an&#233;is de aorta tor&#225;cica de ratos com endot&#233;lio intacto expostos a manool na presen&#231;a e aus&#234;ncia de L-NAME (2x10-4 M) ou oxadiazolo[4,3-a]quinoxalina-1-ona (ODQ) (10-4 M). (A) curva dose-resposta e (B) Gr&#225;fico de barras Emax. Os an&#233;is foram pr&#233;-contra&#237;dos com fenilefrina (Phe) (10-7.M). Todos os valores correspondem &#224; m&#233;dia &#177; erro-padr&#227;o da m&#233;dia (n=6). * p&lt;0,05 e #p&lt;0,001 indicam diferen&#231;as significativas entre cada grupo e o grupo controle (vasos com endot&#233;lio); ANOVA de duas vias com medidas repetidas e p&#243;s-teste de Bonferroni.</title>
        </caption>
        <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf06.tif"/></fig>
    </sec>
    <sec sec-type="discussion">
      <title>Discuss&#227;o</title>
      <p>Pesquisas anteriores mostraram que diterpenos labdanos t&#234;m uma ampla gama de efeitos farmacol&#243;gicos, como a capacidade de inibir a replica&#231;&#227;o do v&#237;rus HIV, prevenir resfriados comuns, a&#231;&#227;o antimal&#225;rica, antibacteriana, anti-inflamat&#243;ria, anti-hiperglic&#234;mica, evitar a disenteria, al&#233;m de suprimir diversas c&#233;lulas cancerosas.<xref ref-type="bibr" rid="B6"><sup>6</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B13"><sup>13</sup></xref> J&#225; em aspecto cardiovascular, evidenciaram: significativa redu&#231;&#227;o de estenose em art&#233;rias ateroscler&#243;ticas, associada &#224; redu&#231;&#227;o das taxas de reestenose ap&#243;s angioplastia em coelhos; redu&#231;&#227;o da agrega&#231;&#227;o plaquet&#225;ria in vitro e a&#231;&#227;o anti-hipertensiva em ratos.<xref ref-type="bibr" rid="B13"><sup>13</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B15"><sup>15</sup></xref><sup>&#8211;</sup><xref ref-type="bibr" rid="B17"><sup>17</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B25"><sup>25</sup></xref> S&#227;o, portanto, vistos como fonte promissora de novos prot&#243;tipos para a descoberta e desenvolvimento de novos agentes terap&#234;uticos cardiovasculares.</p>
      <p>Os diterpenos, em particular, est&#227;o entre os principais compostos com liga&#231;&#227;o &#224;s propriedades cardiovasculares, como a propriedade vasorrelaxante, inotr&#243;pica, diur&#233;tica e atividade hipotensora.<xref ref-type="bibr" rid="B26"><sup>26</sup></xref> A a&#231;&#227;o vascular exercida por esses compostos parece envolver m&#250;ltiplos mecanismos, como endot&#233;lio dependente e endot&#233;lio independente, aumento de prostaciclinas e bloqueio de canais de c&#225;lcio dependentes de voltagem.</p>
      <p>No presente estudo, utilizamos o modelo 2R1C para investigar o poss&#237;vel efeito anti-hipertensivo do manool. Esse modelo produziu resultados satisfat&#243;rios para a indu&#231;&#227;o de hipertens&#227;o, com aumento significativo da press&#227;o arterial em animais, ap&#243;s tr&#234;s semanas da cirurgia. Mesmo na primeira semana ap&#243;s a cirurgia, a PAS de 2R1C foi maior que em um animal normotenso. A PAS encontrada em animais hipertensos est&#225; de acordo com outros autores que avaliaram um modelo semelhante.<xref ref-type="bibr" rid="B23"><sup>23</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B27"><sup>27</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B28"><sup>28</sup></xref></p>
      <p>Os resultados obtidos ap&#243;s a administra&#231;&#227;o de 3 doses crescentes de manool mostraram que este composto foi capaz de reduzir a PA em ratos normotensos e hipertensos. Em animais normotensos, o manool apresenta efeito dose-resposta positivo. Esse achado difere de outros compostos naturais, incluindo o &#225;cido rosmar&#237;nico, que reduziu a PA apenas em animais hipertensos.<xref ref-type="bibr" rid="B23"><sup>23</sup></xref> Esse perfil de resposta n&#227;o &#233; observado em animais hipertensos, onde o aumento da dose n&#227;o representa um efeito mais significativo. A &#916;PAS &#233; a mesma ap&#243;s 10, 20 e 40 mg/kg de manool em animais hipertensos; em outras palavras, independentemente das doses, a press&#227;o arterial m&#225;xima era de cerca de 40&#8211;50 mmHg. Por&#233;m, como no grupo com ve&#237;culo hipertenso houve redu&#231;&#227;o da PAS, apenas 10 mg/kg foi capaz de reduzir efetivamente a press&#227;o.</p>
      <p>Nossa hip&#243;tese para esse efeito anti-hipertensivo da manool baseou-se em estudos recentes sobre a atividade vasodilatadora de diterpenos mediada por NO.<xref ref-type="bibr" rid="B13"><sup>13</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B15"><sup>15</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B16"><sup>16</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B26"><sup>26</sup></xref> Demonstrou-se que a hipertens&#227;o tem forte associa&#231;&#227;o com a forma&#231;&#227;o de esp&#233;cies reativas de oxig&#234;nio (EROs).<xref ref-type="bibr" rid="B29"><sup>29</sup></xref> Consequentemente, a inativa&#231;&#227;o do NO pelo super&#243;xido induz o desenvolvimento de disfun&#231;&#227;o endotelial em doen&#231;as cardiovasculares.<xref ref-type="bibr" rid="B30"><sup>30</sup></xref> A propriedade de alguns compostos de aumentar o NO pode ser atraente para reduzir a disfun&#231;&#227;o endotelial da hipertens&#227;o. Nossos achados indicam que o efeito anti-hipertensivo do manool pode ser parcialmente mediado pelo NO, uma vez que a administra&#231;&#227;o de L-NAME antes da inje&#231;&#227;o de manool bloqueia a redu&#231;&#227;o da PAS em animais hipertensos apenas na dose de 10 mg/kg. Corroborando esses achados, a concentra&#231;&#227;o plasm&#225;tica de NOx aumentou significativamente apenas nos animais hipertensos que receberam manool. Alguns estudos de NOx no modelo 2R1C mostram que a hipertens&#227;o pode reduzir esses n&#237;veis, mas nosso achado est&#225; em desacordo com esses dados, talvez por causa do tempo da cirurgia 2R1C.<xref ref-type="bibr" rid="B31"><sup>31</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B32"><sup>32</sup></xref> Embora o efeito anti-hipertensivo total do manool permane&#231;a desconhecido, outras hip&#243;teses podem ser levantadas, como inibi&#231;&#227;o e modula&#231;&#227;o da ECA (enzima de convers&#227;o da angiotensina).<xref ref-type="bibr" rid="B33"><sup>33</sup></xref> Demonstrou-se que, no modelo 2R1C, h&#225; aumento na atividade da ECA plasm&#225;tica e alguns pept&#237;deos naturais de arroz, terpenos, fitoestrog&#234;nio e compostos polifen&#243;licos podem reduzir a atividade da ECA,<xref ref-type="bibr" rid="B20"><sup>20</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B34"><sup>34</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B35"><sup>35</sup></xref> o que poderia caracterizar esse mecanismo como complementar ao NO na manuten&#231;&#227;o da PA.</p>
      <p>Seria poss&#237;vel atribuir o efeito anti-hipertensivo do manool a um efeito direto na reatividade vascular que n&#227;o inclui o aumento do NO sist&#234;mico. O presente estudo mostrou que o manool induz o relaxamento a&#243;rtico em ratos apenas na presen&#231;a de endot&#233;lio e pr&#233;-incuba&#231;&#227;o dos an&#233;is a&#243;rticos com inibidores da sintase de &#243;xido n&#237;trico (NOS) ou guanilato ciclase (GC). As propriedades cardiovasculares do diterpeno est&#227;o relacionadas ao bloqueio dos canais de Ca<sup>2+</sup> e ativa&#231;&#227;o de NO/GMPc (guanosina monofosfato c&#237;clica).<xref ref-type="bibr" rid="B13"><sup>13</sup></xref> O endot&#233;lio produz vasodilatadores potentes, como o fator relaxante derivado do endot&#233;lio (EDRF, NO), prostaciclina e fator de hiperpolariza&#231;&#227;o derivado do endot&#233;lio (EDHF). O NO &#233; o mediador predominante na condut&#226;ncia e nas grandes art&#233;rias, enquanto o EDHF e a prostaciclina s&#227;o mais prevalentes nas art&#233;rias menores, como os vasos mesent&#233;ricos, art&#233;rias coron&#225;rias e vasos de resist&#234;ncia perif&#233;rica.<xref ref-type="bibr" rid="B36"><sup>36</sup></xref> Corroborando nossos achados, alguns t&#234;m-se relatos de que alguns diterpenos, como o 14-desoxi-11,12-dihydroandrographolide e 14-desoxyandrographolide dilatam an&#233;is a&#243;rticos. O composto 14-desoxi-11,12-dihydroandrographolide teve um efeito hipotensor em ratos anestesiados. Ambos os compostos exercem sua atividade vasorrelaxante pela libera&#231;&#227;o de NO e ativa&#231;&#227;o da via da guanilateciclase, bem como pelo bloqueio do influxo de Ca<sup>2+</sup> por meio de canais de Ca<sup>2+</sup> operados por voltagem e por receptor.<xref ref-type="bibr" rid="B13"><sup>13</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B37"><sup>37</sup></xref><sup>&#8211;</sup><xref ref-type="bibr" rid="B39"><sup>39</sup></xref> No presente estudo, tamb&#233;m sugerimos que o manool tem um efeito vasorrelaxante dependente do endot&#233;lio operando atrav&#233;s da via NO/GMPc.</p>
    </sec>
    <sec sec-type="conclusions">
      <title>Conclus&#227;o</title>
      <p>Em resumo, o manool induz relaxamento vascular dependente do endot&#233;lio na aorta de ratos mediado pela via de sinaliza&#231;&#227;o NO/GMPc e redu&#231;&#227;o da PA tamb&#233;m pelo aumento plasm&#225;tico de NOx. Esses efeitos em conjunto podem estar envolvidos na modula&#231;&#227;o da resist&#234;ncia perif&#233;rica, contribuindo para o efeito anti-hipertensivo desse diterpeno.</p>
    </sec>
  </body>
  <back>
    <fn-group>
      <fn fn-type="supported-by" id="fn1">
        <p>
          <bold>Fontes de Financiamento</bold>
        </p>
        <p>O presente estudo foi financiado pelo FAEPA e CNPq.</p>
      </fn>
      <fn fn-type="other" id="fn2">
        <p>
          <bold>Vincula&#231;&#227;o Acad&#234;mica</bold>
        </p>
        <p>Este artigo &#233; parte de disserta&#231;&#227;o de Mestrado de Ariadne Santana e Neves Monteiro pela Universidade de S&#227;o Paulo Faculdade de Medicina de Ribeir&#227;o Preto.</p>
      </fn>
    </fn-group>
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      </article-categories>
      <title-group>
        <article-title>Effect of Diterpene Manool on the Arterial Blood Pressure and Vascular Reactivity in Normotensive and Hypertensive Rats</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <name>
            <surname>Monteiro</surname>
            <given-names>Ariadne Santana e Neves</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">
            <sup>1</sup>
          </xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Campos</surname>
            <given-names>Debora Ribeiro</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">
            <sup>1</sup>
          </xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Albuquerque</surname>
            <given-names>Agnes Afrodite Sumarelli</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">
            <sup>1</sup>
          </xref>
        </contrib>
        <contrib contrib-type="author">
          <contrib-id contrib-id-type="orcid">0000-0001-9631-946X</contrib-id>
          <name>
            <surname>Evora</surname>
            <given-names>Paulo Roberto Barbosa</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">
            <sup>1</sup>
          </xref>
          <xref ref-type="corresp" rid="c2"/>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Ferreira</surname>
            <given-names>Luciana Garros</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">
            <sup>1</sup>
          </xref>
        </contrib>
        <contrib contrib-type="author">
          <name>
            <surname>Celotto</surname>
            <given-names>Andrea Carla</given-names>
          </name>
          <xref ref-type="aff" rid="aff2">
            <sup>1</sup>
          </xref>
        </contrib>
        <aff id="aff2">
          <label>1</label>
          <addr-line>
            <named-content content-type="city">Ribeir&#227;o Preto</named-content>
            <named-content content-type="state">SP</named-content>
          </addr-line>
          <country country="BR">Brazil</country>
          <institution content-type="original">Universidade de S&#227;o Paulo Faculdade de Medicina de Ribeir&#227;o Preto, Ribeir&#227;o Preto, SP &#8211; Brazil</institution>
        </aff>
      </contrib-group>
      <author-notes>
        <corresp id="c2"><bold>Mailing Address: Paulo Roberto Barbosa Evora</bold> &#8226; Universidade de S&#227;o Paulo Faculdade de Medicina de Ribeir&#227;o Preto - Cirurgia e Anatomia - Campus da USP. Postal Code <postal-code>14040-900</postal-code>, Ribeir&#227;o Preto, SP &#8211; Brazil. E-mail: <email>prbevora@gmail.com</email></corresp>
        <fn fn-type="con">
          <p>
            <bold>Author Contributions</bold>
          </p>
          <p>Conception and design of the research: Monteiro ASN, Albuquerque AAS, Evora PRB, Ferreira LG, Celotto AC; Acquisition of data: Monteiro ASN, Campos DR, Albuquerque AAS, Ferreira LG; Analysis and interpretation of the data: Monteiro ASN, Campos DR, Albuquerque AAS, Ferreira LG, Celotto AC; Statistical analysis: Monteiro ASN, Campos DR, Albuquerque AAS, Celotto AC; Obtaining financing: Evora PRB, Celotto AC; Writing of the manuscript: Monteiro ASN, Campos DR, Albuquerque AAS, Evora PRB, Ferreira LG, Celotto AC; Critical revision of the manuscript for intellectual content: Albuquerque AAS, Evora PRB, Celotto AC.</p>
        </fn>
        <fn fn-type="conflict">
          <p>
            <bold>Potential Conflict of Interest</bold>
          </p>
          <p>No potential conflict of interest relevant to this article was reported.</p>
        </fn>
      </author-notes>
      <abstract>
        <title>Abstract</title>
        <sec>
          <title>Background:</title>
          <p>Many studies have shown that the diterpenoid classes exert a significant effect on the cardiovascular system. Diterpenes, in particular, are among the main compound links to cardiovascular properties such as vasorelaxant, inotropic, diuretic and hypotensive activity. While the manool vasorelaxation mechanism is visible, its effect on blood pressure (BP) is still unknown.</p>
        </sec>
        <sec>
          <title>Objective:</title>
          <p>To evaluate the in vivo hypotensive effect of manool and check the ex vivo vasorelaxation effect in rat aortic rings.</p>
        </sec>
        <sec>
          <title>Methods:</title>
          <p>The animals were divided randomly into two groups: normotensive and hypertensive. The normotensive group was sham-operated, and the 2K1C model was adopted for the hypertensive group. Invasive BP monitoring was performed for manool tests at different doses (10, 20 and 40 mg/kg). Concentration-response curves for manool were obtained in the aorta rings, with endothelium, pre-contracted with phenylephrine (Phe) after incubation with N&#969;-nitro-L-arginine methyl ester(L-NAME) or oxadiazole [4,3-a]quinoxalin-1-one (ODQ). Nitric oxide (NOx) plasma levels were measured by chemiluminescence assay.</p>
        </sec>
        <sec>
          <title>Results:</title>
          <p>After manool administration, BP was reduced in normotensive and hypertensive groups, and this effect was inhibited by L-NAME in hypertensive animals only in 10 mg/kg dose. Ex vivo manool promoted vasorelaxation, which was inhibited by L-NAME and ODQ incubation or endothelium removal. NOx plasma levels increased in the hypertensive group after manool administration. Manool elicits endothelium-dependent vascular relaxation in rat aorta mediated by the NO/cGMP signaling pathway and BP reduction, also by NOx plasma increase. These combined effects could be involved in modulating peripheral resistance, contributing to the antihypertensive effect of diterpene.</p>
        </sec>
        <sec>
          <title>Conclusion:</title>
          <p>These effects together could be involved in modulating peripheral resistance, contributing to the antihypertensive effect of diterpene.</p>
        </sec>
      </abstract>
      <kwd-group xml:lang="en">
        <title>Keywords:</title>
        <kwd>Cardiovascular Diseases</kwd>
        <kwd>Hypertension</kwd>
        <kwd>Diterpenes</kwd>
        <kwd>Manool</kwd>
        <kwd>Reactivity</kwd>
        <kwd>Nitric Oxide</kwd>
        <kwd>Rats</kwd>
      </kwd-group>
    </front-stub>
    <body>
      <sec sec-type="intro">
        <title>Introduction</title>
        <p>Diterpenes is a broad class of chemical metabolites, which are widely distributed in the flora, with more than 12,000 known compounds.<xref ref-type="bibr" rid="B1"><sup>1</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B2"><sup>2</sup></xref> They can be divided into two types: specialized (secondary) metabolism diterpenes and general (primary) metabolism diterpenes. Secondary diterpenes can have functions in the ecological interactions of plants with other organisms and benefits in pharmaceuticals, perfumes, resins and other industrial bioproducts with great economic relevance.<xref ref-type="bibr" rid="B1"><sup>1</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B2"><sup>2</sup></xref> Several secondary metabolites, such as terpenes, phenolic acids, polyphenols, flavonoids and anthocyanins, have been reported from Salvia species. These species are seen as excellent sources of diterpenes.<xref ref-type="bibr" rid="B3"><sup>3</sup></xref> According to chemotaxonomic findings, manool was previously reported in the following Salvia species: <italic>S. sclarea, S. pubescens, S. lavandulifolia, S. hypoleuca</italic>, <italic>S. miltiorrhizae</italic>. It is also present in other species, such as <italic>Pinuscaribaea (Pinaceae), Lourteigiastoechadifolia (Asteraceae)</italic> and <italic>Halocarpusbiformis (Podocarpaceae)</italic>. However, manool is the main diterpene of the various species of Salvia, and it is found in higher concentration in <italic>Salvia officinalis</italic>.<xref ref-type="bibr" rid="B4"><sup>4</sup></xref></p>
        <p>The biosynthesis of the isoprene structural units of a wide variety of terpenes, including diterpenes, occurs by the deoxyxylulose pathway. This pathway rises to two distinct products: isopentenyl diphosphate (IPP) and dimethylallyl diphosphate (DMAPP). More specifically, manool, whose chemical composition is C<sub>20</sub>H<sub>34</sub>O, is a bicyclic labdane diterpene. Its structure is based on a 2E, 6E, 10E-geranylgeranyl pyrophosphate (GGPP) carbon skeleton.<xref ref-type="bibr" rid="B5"><sup>5</sup></xref><sup>&#8211;</sup><xref ref-type="bibr" rid="B7"><sup>7</sup></xref></p>
        <p>The discovery of new substances with antihypertensive activity, with low cost and few adverse effects, is still desirable and important to clinical use.<xref ref-type="bibr" rid="B8"><sup>8</sup></xref> However, several difficulties are encountered for this purpose, such as the choice of experimental model, obtaining standardized extracts and the difficulty of obtaining, isolating and identifying the active substances.<xref ref-type="bibr" rid="B9"><sup>9</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B10"><sup>10</sup></xref> The option to conduct research, from the indication of plants used by communities, shortens the route of developing a new drug, as researchers have, before starting scientific studies, a hint of which biological activity this medication might present.<xref ref-type="bibr" rid="B11"><sup>11</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B12"><sup>12</sup></xref></p>
        <p>Diterpenes, in particular, are among the primary compound links to cardiovascular properties, such as vasorelaxant, inotropic, diuretic and hypotensive activity. The vascular action exerted by these compounds appears to involve multiple mechanisms. Such mechanisms are either independent or endothelium-dependents, prostacyclin, and increased blocking of voltage-dependent calcium channels.<xref ref-type="bibr" rid="B13"><sup>13</sup></xref><sup>&#8211;</sup><xref ref-type="bibr" rid="B17"><sup>17</sup></xref></p>
        <p>As previously described in the literature review, manool &#8212; C<sub>20</sub>H<sub>34</sub>O &#8212; is a labdane-type diterpene, commonly found in various plant families, it is the main diterpene of several species of Salvia, and is present in higher concentrations in <italic>Salvia officinalis</italic> (<xref ref-type="fig" rid="f7">Figure 1</xref>).<xref ref-type="bibr" rid="B1"><sup>1</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B3"><sup>3</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B18"><sup>18</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B19"><sup>19</sup></xref> It is a species of the family <italic>Lamiaceae (Labiateae)</italic>, originating in southern Europe. It presents a habit of herbaceous growth or small shrub; it is a perennial plant that flourishes in the Southern Hemisphere between August and December.<xref ref-type="bibr" rid="B20"><sup>20</sup></xref></p>
        <fig id="f7">
          <label>Figure 1</label>
          <caption>
            <title>Manool chemical structure.<xref ref-type="bibr" rid="B10"><sup>10</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B11"><sup>11</sup></xref></title>
          </caption>
          <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf01-en.tif"/></fig>
        <p>Li et al.<xref ref-type="bibr" rid="B21"><sup>21</sup></xref> found that although manool possesses cardiovascular activity that is still unknown, it must be considered a crucial factor to be investigated. Moreover, it can be seen as a new driver for the treatment of heart disease and deserves further research.<xref ref-type="bibr" rid="B4"><sup>4</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B21"><sup>21</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B22"><sup>22</sup></xref> The experimental protocol included observations on plasma levels of nitric oxide (NO) in hypertensive animals and the impact of manool on the BP of animals following the administration of different doses of the compound.</p>
        <p>Knowing that manool belongs to the class of diterpene compounds, with potential use in the treatment of hypertension, the present investigation was designed to assess the possible vasodilator effect and the cellular mechanisms involved in the relaxation response of aortic rings of rats. Therefore, the aim was to evaluate the in vivo hypotensive effect of manool and check the <italic>ex vivo</italic> vasorelaxation effect in aortic rings of rats.</p>
      </sec>
      <sec sec-type="materials|methods">
        <title>Material and Methods</title>
        <sec>
          <title>Ethics Statement and Animals</title>
          <p>Animal handling policies and experimental procedures were reviewed and approved by the Institutional Committee for Animal Care from Faculdade de Medicina de Ribeir&#227;o Preto, Universidade de S&#227;o Paulo (n. 060/210), following the directions of the European Commission's Directive 2010/63/EU. Thirty-four male Wistar rats (180&#8211;220 g) were housed under standard laboratory conditions (12 h light/dark cycle at 21 &#176;C) with water and food ad libitum. The animals were allocated randomly into five groups of 7 animals for normotensive and hypertensive blood pressure protocols (normotensive vehicle, normotensive manool; hypertensive vehicle, hypertensive manool and hypertensive manool + L-NAME). The animals allocated to the normotensive groups were sham-operated, while animals allocated to the hypertensive groups underwent the surgical procedure 2K1C (two-kidney-one-clip hypertensive rats) for hypertensive induction. Another group of 6 animals that did not undergo any procedure (intact) was used for <italic>ex vivo</italic> vascular reactivity studies.</p>
        </sec>
        <sec>
          <title>Drugs</title>
          <p>Manool, acetylcholine (ACh), 1H-[1,2,4]oxadiazole[4,3-a]quinoxalin-1-one (ODQ), and phenylephrine (Phe) were from Sigma Chemical Company (St. Louis, MO, USA); N&#969;-nitro-L-arginine methyl ester (L-NAME) was obtained from Calbiochem (San Diego, CA, USA); Vetec Qu&#237;mica Fina Ltda furnished isoflurane from Abbott and all the salts used for Krebs solution preparation. Almost all the drugs were prepared with distilled water, and manool was solubilized in dimethyl sulfoxide (50 uL) and diluted in ethanol/water (2:10, total volume 200 uL). For vascular reactivity experiments, 100 uL was diluted in 900 uL of water, making the stock (10<sup>&#8722;3</sup>). From this stock, the curve was prepared. The volume used from this curve was 10 uL in a 10 ml cube. Therefore, after so many dilutions, the vehicle does not promote any effect on vascular reactivity.</p>
        </sec>
        <sec>
          <title>Induction of Hypertension</title>
          <p>After i.p. anesthesia with ketamine (50 mg/kg) and xylazine (10 mg/kg), the renal artery was exposed. The hypertensive groups had partial constriction of the main left renal artery with a silver clip of 0.10 mm gap (2K1C), while the normotensive groups had the main left renal artery isolated but did not receive the clip (sham). To monitor hypertension development, systolic blood pressure (SBP) was noninvasively measured using a tail-cuff, once a week. (Kent Scientific Corporation, Connecticut, USA). The 2K1C rats were considered hypertensive with tail SBP &#8805; 160 mmHg at the 3<sup>rd</sup> week after the surgical procedures. The 2K1C rats with SBP &lt; 160 mmHg at the 3<sup>rd</sup> week were euthanatized. Less than 10% of animals had SBP &lt; 160 mmHg. The sham-operated rats were included in the normotensive group.</p>
        </sec>
        <sec>
          <title>Manool Effect on Systolic Blood Pressure</title>
          <p>Three weeks after hypertension induction, the animals were anaesthetized, and the femoral artery and vein were respectively cannulated for continuous measurement of systolic blood pressure (SBP) and drugs administration. After anesthesia (urethane, 2 mg/kg, intraperitoneal), vascular cannulation and stabilization period (20 minutes) with continuous real-time SBP recording, three doses of manool (10, 20 and 40 mg/kg) or vehicle (Dimethyl sulfoxide &#8212; DMSO &#8212; and water+ethanol) were administered to the normotensive and hypertensive rats. Each dose was given in a 200 <italic>&#181;</italic>L intravenous bolus, and the interval between each consecutive dose was 6 minutes. The animals that received vehicle did not receive manool. For each animal, the variation in systolic blood pressure (&#916;SBP) was calculated subtracting the mean of the lowest SBP values immediately after manool administration from the average of the baseline SBP values before manool or vehicle bolus. Mean blood pressure was measured using MP System 100 A (BioPac System, Inc., Santa Barbara, CA, USA).</p>
        </sec>
        <sec>
          <title>Vascular Reactivity</title>
          <p>Experiments were conducted in aortic rings from normotensive rats. Six male Wistar rats (280&#8211;300 g) were anaesthetized with inhalational isoflurane, followed by abdominal aorta exsanguinations and thoracotomy for thoracic aorta harvesting. The thoracic aorta was carefully dissected, confirmed to be free of connective tissue, and immediately immersed in Krebs solution. The Krebs solution was composed of NaCl (118.0 mM), KCl (4.7 mM), CaCl2 (2.5 mM), KH2PO4 (1.2 mM), MgSO4 (1.66 mM), glucose (11.1 mM), and NaHCO3 (25.0 mM); the solution had pH 7.4. The thoracic aorta immersed in Krebs solution was cut into rings that were 4&#8211;5 mm in length. For tests, the endothelium-denuded ring was removed by gently rubbing the internal surface vessel with a thin steel rod. This procedure effectively removes the endothelium, but it does not affect the ability of the vascular smooth muscle to contract or relax. The aortic rings were placed in 10 mL isolated organ bath containing Krebs solution, at 37 &#176;C, and 95% O<sub>2</sub>/5% CO<sub>2</sub> (pH 7.4) to measure the isometric force with Grass FT03 equipment (Grass Instrument Company, Quincy, MA, USA). Each ring was stretched to the optimal 2.0 g length-tension, determined in a pilot study, and was allowed to equilibrate for 60 min. During this time, tissues were washed every 15 min. The endothelium was considered to be present (E+) recording the Ach-induced 80% relaxation (10<sup>&#8722;6</sup> M) after pre-contraction with Phe (10<sup>&#8722;7</sup> M). Endothelium was considered absent (E&#8722;) when the relaxation response did not occur. Next, each ring was washed and re-equilibrated for 30 min. The aortic rings were precontracted with Phe (10<sup>&#8722;7</sup> M) after a stable plateau was reached, and dose-response curves of manool were obtained. The concentration-response assays in the organ baths were carried out in the presence or absence of: L-NAME (2x10<sup>&#8722;4</sup> M), a nonspecific nitric oxide synthase inhibitor and ODQ (10<sup>&#8722;4</sup> M), a guanylyl cyclase inhibitor.<xref ref-type="bibr" rid="B20"><sup>20</sup></xref> The preparations were incubated with the inhibitors for 30 min. We did not perform dose-response curves with a vehicle because the dilution was performed in water. The initial solution 1 M (50 uL DMSO + 30 uL ethanol + 120 uL water) suffered serial dilution for 10<sup>&#8722;1</sup> M in water.</p>
        </sec>
        <sec>
          <title>Indirect Plasma Measurements of NO</title>
          <p>Blood samples (1 ml) were collected from the femoral artery, after the last dose-response curve from a normotensive vehicle and hypertensive manool, and placed in heparinized tubes. After blood centrifugation (3000&#215;g, 10 minutes, 4 &#176;C), the plasma was immediately immersed in liquid nitrogen and kept at &#8722;70 &#176;C until nitrite and nitrate (NOx) measurements. Samples were analyzed in duplicates for NOx by ozone-based chemiluminescence assay. The plasma samples were briefly treated with cold ethanol (1 volume of plasma: 2 volumes of ethanol for 30 minutes at &#8722;20 &#176;C) and centrifuged (4000&#215;g, 10 minutes). The NOx levels were measured by injecting 25 &#956;L of the supernatant in a glass purge vessel containing 0.8% of vanadium (III) in HCl (1 N) at 90 &#176;C, which reduces NOx to NO gas. A nitrogen stream was bubbled through the purge vessel containing vanadium (III), then through NaOH (1 N), and then into a NO analyzer (Sievers&#174; Nitric Oxide Analyzer 280, GE Analytical Instruments, Boulder, CO, USA).</p>
        </sec>
        <sec>
          <title>Statistical Analysis</title>
          <p>The data are presented as mean &#177; standard error of the mean (SEM). We performed statistical analyses with Student's T-test, one-way (ANOVA), Bonferroni post-test and two-way repeated-measures of variance (ANOVA) with the Bonferroni post-test to detect potential differences between the values in the study. For each figure, the legend describes which test was performed for analysis. P&lt;0.05 was considered significant (Prism 5.0, GraphPad Software, San Diego, CA, USA). A sample size of (N = 5&#8211;7) per group provided 95% power with a 0.05% significance level in protocols of in vivo blood pressure measurement. Moreover, a sample size of (N = 6&#8211;8) animals per group provided 95% power with a 0.05 significance level to detect a relative 10% reduction in the maximal contraction in precontracted vessels. The number of animals was based on the literature.<xref ref-type="bibr" rid="B20"><sup>20</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B23"><sup>23</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B24"><sup>24</sup></xref></p>
        </sec>
      </sec>
      <sec sec-type="results">
        <title>Results</title>
        <p>Before surgical procedures, there were no differences in the BP between normotensive and hypertensive groups. However, after hypertension induction, from the 1<sup>st</sup> to the 3<sup>rd</sup> week, the BP was significantly higher in the hypertensive rats (130,6 mmHg versus 193,0 mmHg) (<xref ref-type="fig" rid="f8">Figure 2</xref>).</p>
        <fig id="f8">
          <label>Figure 2</label>
          <caption>
            <title>Temporal evolution of systolic blood pressure (SBP) non-invasively in normotensive and hypertensive animals. The values represent mean &#177; standard error of mean arterial pressure before the clip placement surgery (pre-operative) and at three weeks following the surgery. * p&lt;0.05 and # p &lt;0.01 indicate a significant difference between the hypertensive group and the normotensive group. Two-Way ANOVA, Bonferroni post-test. n=14 normotensive and n=14 hypertensive.</title>
          </caption>
          <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf02-en.tif"/></fig>
        <p>The evaluation of body weight showed that, in the first week, the groups had similar loads. However, at the end of three weeks, the hypertensive group showed significantly lower values compared to the normotensive group (<xref ref-type="table" rid="t2">Table 1</xref>).</p>
        <table-wrap id="t2">
          <label>Table 1</label>
          <caption>
            <title>Time evolution of body weight normotensive and hypertensive animals</title>
          </caption>
          <table frame="hsides" rules="rows">
            <colgroup width="33%">
              <col/>
              <col/>
              <col/>
            </colgroup>
            <thead style="border-top: thin solid; border-bottom: thin solid; border-color: #000000">
              <tr>
                <th align="left" valign="middle" colspan="3">Evolution of body weight (g)</th>
              </tr>
              <tr>
                <th align="left" valign="middle">Groups</th>
                <th align="center" valign="middle">Initial</th>
                <th align="center" valign="middle">Final</th>
              </tr>
            </thead>
            <tbody style="border-bottom: thin solid; border-color: #000000">
              <tr>
                <td align="left" valign="middle">Normotensive</td>
                <td align="center" valign="middle">233.4&#177;7.1</td>
                <td align="center" valign="middle">480.2&#177;10.2</td>
              </tr>
              <tr>
                <td align="left" valign="middle">Hypertensive</td>
                <td align="center" valign="middle">239.4&#177;7.7</td>
                <td align="center" valign="middle">404.8&#177;18.2<xref ref-type="table-fn" rid="TFN4">*</xref></td>
              </tr>
            </tbody>
          </table>
          <table-wrap-foot>
            <fn id="TFN3">
              <p>Each value represents mean &#177; SEM.</p>
            </fn>
            <fn id="TFN4">
              <label>*</label>
              <p>p&lt;0.05 indicates significant difference between the hypertensive group and the normotensive group. Student's T-test.</p>
            </fn>
          </table-wrap-foot>
        </table-wrap>
        <p>In the <italic>in vivo</italic> SBP analysis, only the surgery (2K1C) was able to change the blood (normotensive vehicle versus hypertensive vehicle). Manool promoted a dose-dependent response on SBP, reducing the pressure significantly from the dose of 20 mg/kg in the normotensive group, and there is not any difference between 20 and 40 mg/kg in this group for manool. In the hypertensive group, only a lower dose of manool (10 mg/kg) reduced the SBP compared to the control (hypertensive vehicle) group, and the previous administration of L-NAME prevented the manool effect. In the hypertensive group, the manool effect was not dose-dependent (<xref ref-type="fig" rid="f9">Figure 3</xref>).</p>
        <fig id="f9">
          <label>Figure 3</label>
          <caption>
            <title>Change in systolic blood pressure (&#916;SBP) after administration of manool or vehicle in normotensive and hypertensive rats. Data are presented as mean &#177; standard error of the mean. Normotensive vehicle (n=7), normotensive manool (n=7), hypertensive vehicle (n=7), hypertensive manool (n=7) and hypertensive manool + L-NAME (n=7), * p&lt; 0.05, ** p &lt;0.01 indicates significant difference. Two-way ANOVA, Bonferroni post-test.</title>
          </caption>
          <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf03-en.tif"/></fig>
        <p>The plasma NOx is a little high in the normotensive group after manool administration, but it is not significant. However, in the hypertensive group, manool promoted an increase in plasma NOx levels (<xref ref-type="fig" rid="f10">Figure 4</xref>).</p>
        <fig id="f10">
          <label>Figure 4</label>
          <caption>
            <title>Nitrite and nitrate levels (NOx) plasma in normotensive vehicle and manool and hypertensive vehicle and manool animals. One-way ANOVA, Bonferroni post-test (n=7). *p&lt;0.01 indicates significant difference between hypertensive vehicle and hypertensive manool.</title>
          </caption>
          <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf04-en.tif"/></fig>
        <p>About vascular reactivity experiments, manool promoted a dose-dependent relaxation only in intact rings (<xref ref-type="fig" rid="f11">Figure 5</xref>), precontracted with Phe. Incubation with either L-NAME or ODQ blocked the relaxation induced by manool in endothelium-intact rings in the same way of endothelium removal (<xref ref-type="fig" rid="f12">Figures 6A</xref> and <xref ref-type="fig" rid="f12">6B</xref>).</p>
        <fig id="f11">
          <label>Figure 5</label>
          <caption>
            <title>Relaxation curve in endothelium-intact and endothelium-denuded rat thoracic aortic rings exposed to manool. The rings were pre-contracted with phenylephrine (Phe) (10-7.M). All values correspond to the mean &#177; SEM (n = 6). * p&lt;0.05 and # p &lt;0.001. Two-way repeated-measures ANOVA and Bonferroni post-test.</title>
          </caption>
          <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf05-en.tif"/></fig>
        <fig id="f12">
          <label>Figure 6</label>
          <caption>
            <title>Relaxation curve in endothelium-intact rat thoracic aortic rings exposed to manool in the presence and absence of L-NAME (2x10-4 M) or oxadiazole [4,3-a]quinoxalin-1-one (ODQ) (10-4 M). (A) dose-response curve and (B) Bar graph Emax. The rings were pre-contracted with phenylephrine (Phe) (10-7.M). All values correspond to the mean &#177; SEM (n = 6). *p&lt; 0.05 and # p&lt; 0.001 indicate significant differences between each group and the control group (vessels with endothelium); Two-way repeated-measures ANOVA and Bonferroni post-test.</title>
          </caption>
          <graphic xlink:href="1678-4170-abc-115-04-0669-90198-gf06-en.tif"/></fig>
      </sec>
      <sec sec-type="discussion">
        <title>Discussion</title>
        <p>Previous research has shown that labdane diterpenes have a wide range of pharmacological effects, such as the ability to inhibit HIV replication, prevent common colds, it is antimalarial, antibacterial, anti-inflammatory, antihyperglycemic, prevents dysentery, besides suppressing various cancerous cells.<xref ref-type="bibr" rid="B6"><sup>6</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B13"><sup>13</sup></xref> On the cardiovascular side, they showed: significant reduction of stenosis in atherosclerotic arteries, associated with the fewer restenosis rates after angioplasty in rabbits; reduction of <italic>ex vivo</italic> platelet aggregation, and antihypertensive action in rats.<xref ref-type="bibr" rid="B13"><sup>13</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B15"><sup>15</sup></xref><sup>&#8211;</sup><xref ref-type="bibr" rid="B17"><sup>17</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B25"><sup>25</sup></xref> They are thus seen as a promising source of new prototypes for the discovery and development of new agents of cardiovascular therapeutics.</p>
        <p>Diterpenes, in particular, are among the significant compounds with binding to cardiovascular properties, such as vasorelaxant, inotropic, diuretic and hypotensive activity.<xref ref-type="bibr" rid="B26"><sup>26</sup></xref> The vascular action exerted by these compounds seems to involve multiple mechanisms, such as dependent and independent endothelium, increase of prostacyclin and blockade of voltage-dependent calcium channels.</p>
        <p>In the present study, we used the 2K1C model for investigating the possible antihypertensive effect of manool. This model produced satisfactory results, for hypertension induction, with a significant increase in blood pressure in animals, after three weeks of surgery. Even the first week post-surgery, the 2K1C SBP was higher than in a normotensive animal. SBP found in hypertensive animals agree with other authors who evaluated a similar model.<xref ref-type="bibr" rid="B23"><sup>23</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B27"><sup>27</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B28"><sup>28</sup></xref></p>
        <p>The results obtained after administration of 3 increasing doses of manool showed that this compound was able to reduce BP in both normotensive and hypertensive rats. In normotensive animals, manool presents a positive dose-response effect. This finding is different from other natural compounds, including Rosmarinic acid, which reduced BP only in hypertensive animals.<xref ref-type="bibr" rid="B23"><sup>23</sup></xref> This response profile is not observed in hypertensive animals, where the dose increase does not represent a more significant effect. &#916;SBP is the same after 10, 20 and 40 mg/kg of manool in hypertensive animals; in other words, regardless of the doses, maximum blood pressure was about 40&#8211;50 mmHg. However, as in the hypertensive vehicle group there was a reduced SBP, only the 10 mg/kg was able to effectively reduce the pressure.</p>
        <p>Our hypothesis to this antihypertensive effect of manool was based on recent studies about the vasodilator activity of diterpenes mediated by NO.<xref ref-type="bibr" rid="B13"><sup>13</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B15"><sup>15</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B16"><sup>16</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B26"><sup>26</sup></xref> It has been demonstrated that hypertension has a strong association with the formation of reactive oxygen species (ROS).<xref ref-type="bibr" rid="B29"><sup>29</sup></xref> Consequently, inactivation of NO by superoxide induces the development of endothelial dysfunction in cardiovascular diseases.<xref ref-type="bibr" rid="B30"><sup>30</sup></xref> The property of some compounds to increase NO can be attractive to reducing the endothelial dysfunction of hypertension. Our findings indicate that the antihypertensive effect of manool can be partially mediated by NO once L-NAME administration before manool injection blocks SBP reduction in hypertensive animals only at a dose of 10 mg/kg. Corroborating these findings, the plasma NOx concentration was increased significantly only in the hypertensive animals that received manool. Some NOx studies in the 2K1C model show that hypertension can reduce these levels, but our finding is in disagreement with this data, perhaps because of the time of 2K1C surgery.<xref ref-type="bibr" rid="B31"><sup>31</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B32"><sup>32</sup></xref> Though the full antihypertensive effect of manool remains unknown, other hypotheses can be raised, such as ACE (angiotensin-converting enzyme) inhibition and modulation.<xref ref-type="bibr" rid="B33"><sup>33</sup></xref> It was demonstrated that, in the 2K1C model, there is an increase in plasma ACE activity and some natural peptides from rice, terpenes, phytoestrogen and polyphenol compounds can reduce this ACE activity,<xref ref-type="bibr" rid="B20"><sup>20</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B34"><sup>34</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B35"><sup>35</sup></xref> which could characterize this mechanism as complementary to NO on BP maintenance.</p>
        <p>It would be possible to attribute the antihypertensive effect of manool to a direct effect on vascular reactivity that does not include an increase of systemic NO. The present study showed that manool induces relaxation in rat aorta only in the presence of endothelium and pre-incubation of the aortic rings with nitric oxide synthase (NOS) or guanylyl cyclase (GC) inhibitors. The cardiovascular properties of diterpene are related to Ca<sup>2+</sup> channels blockade and NO/cGMP (cyclic guanosine monophosphate) activation.<xref ref-type="bibr" rid="B13"><sup>13</sup></xref> The endothelium produces potent vasodilators, such as the endothelium-derived relaxing factor (EDRF, NO), prostacyclin, and endothelium-derived hyperpolarizing factor (EDHF). NO is the predominant mediator in conductance and large arteries, whereas EDHF and prostacyclin are more prevalent in smaller arteries, such as the mesenteric vessels, coronary arteries and peripheral resistance vessels.<xref ref-type="bibr" rid="B36"><sup>36</sup></xref> Corroborating our findings, some diterpenes, such as 14-deoxy-11,12-dihydroandrographolide and 14-deoxyandrographolide have been reported to dilate aortic rings. The compound 14-deoxy-11,12-dihydroandrographolide had a hypotensive effect in anaesthetized rats. Both compounds exert their vasorelaxant activity by the release of NO and activation of the guanylate cyclase pathway, as well as the blockade of Ca<sup>2+</sup> influx through both voltage- and receptor-operated Ca2+ channels.<xref ref-type="bibr" rid="B13"><sup>13</sup></xref><sup>,</sup><xref ref-type="bibr" rid="B37"><sup>37</sup></xref><sup>&#8211;</sup><xref ref-type="bibr" rid="B39"><sup>39</sup></xref> In the present study, we also suggest that manool has an endothelium-dependent vasorelaxant effect operating via the NO/cGMP pathway.</p>
      </sec>
      <sec sec-type="conclusions">
        <title>Conclusion</title>
        <p>In summary, manool elicits endothelium-dependent vascular relaxation in rat aorta mediated by the NO/cGMP signaling pathway and BP reduction also by NOx plasma increase. These effects together could be involved in modulating the peripheral resistance, contributing to the antihypertensive effect of this diterpene.</p>
      </sec>
    </body>
    <back>
      <fn-group>
        <fn fn-type="supported-by" id="fn3">
          <p>
            <bold>Sources of Funding</bold>
          </p>
          <p>This study was funded by Abbot Vascular.</p>
        </fn>
        <fn fn-type="other" id="fn4">
          <p>
            <bold>Study Association</bold>
          </p>
          <p>This article is part of the thesis of master submitted by Ariadne Santana e Neves Monteiro, from Universidade de S&#227;o Paulo Faculdade de Medicina de Ribeir&#227;o Preto.</p>
        </fn>
      </fn-group>
    </back>
  </sub-article>
</article>
