Sandvik GK, Nilsson GE, Jensen FB. Dramatic increase of nitrite levels in hearts of anoxia-exposed crucian carp supporting a role in cardioprotection. Am J Physiol Regul Integr Comp Physiol 302: R468 -R477, 2012. First published November 30, 2011 doi:10.1152/ajpregu.00538.2011 Ϫ ) functions as an important nitric oxide (NO) donor under hypoxic conditions. Both nitrite and NO have been found to protect the mammalian heart and other tissues against ischemia (anoxia)-reoxygenation injury by interacting with mitochondrial electron transport complexes and limiting the generation of reactive oxygen species upon reoxygenation. The crucian carp naturally survives extended periods without oxygen in an active state, which has made it a model for studying how evolution has solved the problems of anoxic survival. We investigated the role of nitrite and NO in the anoxia tolerance of this fish by measuring NO metabolites in normoxic, anoxic, and reoxygenated crucian carp. We also cloned and sequenced crucian carp NO synthase variants and quantified their mRNA levels in several tissues in normoxia and anoxia. Despite falling levels of blood plasma nitrite, the crucian carp showed massive increases in nitrite, S-nitrosothiols (SNO), and ironnitrosyl (FeNO) compounds in anoxic heart tissue. NO 2 Ϫ levels were maintained in anoxic brain, liver, and gill tissues, whereas SNO and FeNO increased in a tissue-specific manner. Reoxygenation reestablished normoxic values. We conclude that NO 2 Ϫ is shifted into the tissues where it acts as NO donor during anoxia, inducing cytoprotection under anoxia/reoxygenation. This can be especially important in the crucian carp heart, which maintains output in anoxia. NO 2 Ϫ is currently tested as a therapeutic drug against reperfusion damage of ischemic hearts, and the present study provides evolutionary precedent for such an approach. nitric oxide; S-nitrosothiols; anoxia/reoxygenation; cytoprotection; nitric oxide synthase NITRIC OXIDE (NO) is an important regulator of many biological functions in vertebrates. In normoxic conditions, NO is produced from L-arginine and O 2 by NO synthases (NOS). The classical role is in vasodilation, where NO binds to the heme of the guanylyl cyclase in smooth muscle cells, leading to a rise in cGMP and subsequent muscle relaxation (35). NO also binds to heme groups of other proteins and is involved in reactions with thiols and secondary amines of different proteins, leading to formation of iron-nitrosyls (FeNO), S-nitrosothiols (SNO), and N-nitrosamines (NNO), respectively (26). Through formation of FeNO and SNO, NO can activate and inactivate enzymes or modify protein function (17,73). NO is inactivated by oxidation to nitrate (NO 3 Ϫ ) in reaction with oxygenated hemoglobin and myoglobin, and it is metabolized to nitrite (NO 2 Ϫ ) in reaction with O 2 (48). Nitrite was previously considered an inert end product of this oxidation, but nitrite can be reduced back to NO, and it has become clear that nitrite functions as a NO storage pool that is activated by va...