Neutrophil-derived hydrogen peroxide (H202) is believed to play an important role in the pathogenesis of vascular injury and pulmonary edema. H202 time-and dose-dependently increased the hydraulic conductivity and decreased the selectivity of an endothelial cell monolayer derived from porcine pulmonary arteries. Effects of H202 on endothelial permeability were completely inhibited by adenylate cyclase activation with 10-12 M cholera toxin or 0.1 juM forskolin. 10' M Sp-cAMPS, a cAMP-dependent protein kinase A agonist, was similarly effective. The phosphodiesterase (PDE) inhibitors motapizone (10'-M), rolipram (10-' M), and zardaverine (10-8 M), which specifically inhibit PDE-isoenzymes III, IV, and III/IV potently blocked H202-induced endothelial permeability when combined with 10' M prostaglandin El. Overall cellular cAMP content and inhibition of H202 effects on endothelial permeability were poorly correlated. H202 exposure resulted in a rapid and substantial decrease in endothelial cAMP content. The analysis of the PDE isoenzyme spectrum showed high activities of isoenzymes II, III, and IV in porcine pulmonary endothelial cells. The data suggest that adenylate cyclase activation/PDE inhibition is a powerful approach to block H202-induced increase in endothelial permeability. This concept appears especially valuable when endothelial PDE isoenzyme pattern and PDE inhibitor profile are matched optimally. (J.