Nitric oxide (NO) activates soluble guanylyl cyclase in smooth muscle cells to induce vasodilation in the vasculature. However, as hemoglobin (Hb) is an effective scavenger of NO and is present in high concentrations inside the red blood cell (RBC), the bioavailability of NO would be too low to elicit soluble guanylyl cyclase activation in the presence of blood. Therefore, NO bioactivity must be preserved. Here we present evidence suggesting that the RBC participates in the preservation of NO bioactivity by reducing NO influx. The NO uptake by RBCs was increased and decreased by altering the degree of band 3 binding to the cytoskeleton. Methemoglobin and denatured hemoglobin binding to the RBC membrane or cytoskeleton also were shown to contribute to reducing the NO uptake rate of the RBC. These alterations in NO uptake by the RBC, hence the NO bioavailability, were determined to correlate with the vasodilation of isolated blood vessels. Our observations suggest that RBC membrane and cytoskeleton associated NO-inert proteins provide a barrier for NO diffusion and thus account for the reduction in the NO uptake rate of RBCs. E xtensive studies have established the bioactivity of nitric oxide (NO) in vasoregulation through activation of soluble guanylyl cyclase (ref. 1 and references therein). On the other hand, NO is rapidly deactivated by oxygenated hemoglobin (HbO 2 ) and myoglobin (MbO 2 ) to form nitrate. As NO reacts rapidly (k ϳ 10 7 M Ϫ1 ⅐s
Ϫ1) with HbO 2 and deoxygenated Hb (deoxyHb), infusion of cell-free normoxic Hb (hereafter, Hb denotes both HbO 2 and deoxyHb) at M levels into animal models, human subjects, or isolated blood vessels (2-5) causes significant vessel constriction due to NO scavenging. However, normal blood containing RBC-encapsulated Hb (rbcHb) at an equivalent concentration of about 10 mM shows insignificant NO reactivity under physiological conditions (4,6,7). This discrepancy is difficult to explain in view of the high permeability of NO through lipid bilayers. Thus, NO bioactivity in blood must be preserved by a yet unclear mechanism under physiological conditions. This problem recently was addressed by a NO bioactivity export theory (8). According to this theory, NO enters the RBC and preferentially binds with the free heme on Hb to form heme-nitrosylHb (HbNO) rather than being oxidized by O 2 -conjugated heme (9). HbNO then transfers the conjugated NO to -93Cys to form S-nitrosoHb (9). NO bioactivity is then exported out of RBCs through the anion exchange protein, band 3 (or AE1). Although detailed mechanisms of SNO (Snitrosothiol species) formation and NO bioactivity export from band 3 are still unclear (10, 11), the theory provides an explanation for the preservation of NO bioactivity and highlights the importance of the RBC in preserving NO bioavailability, which has been suggested previously (12).In parallel to the NO bioactivity export theory, an independent, but not mutually exclusive, explanation that NO bioavailability is preserved by reducing interactions between NO and r...