Hyporeactivity to vasoconstrictors in aortae from portal vein-stenosed rats is associated with an increased activity of endothelial NO synthase (NOS3). In contrast, during sepsis, which is common in cirrhosis, vascular hyporeactivity is associated with an induction of inducible NOS2. The aim of this study was to investigate the in vitro reactivity to phenylephrine and the regulation of NOS2 and NOS3 in aortae from portal vein-stenosed rats after lipopolysaccharide (LPS) administration. Aortic vascular reactivity for phenylephrine, aortic NOS activity, and NOS2 and NOS3 protein expression were determined 5 hours after intravenous LPS or saline administration. Moreover, aortic NOS activity was measured after 5-hour in vitro incubation in LPS. LPS induced a significantly smaller decrease in aortic tension in portal vein-stenosed than in sham-operated rats. Under baseline conditions, aortic NOS activity and NOS3 protein expression were higher in portal vein-stenosed than in sham-operated rats, and NOS2 protein expression was not detected in aortae from either group. After LPS administration, NOS activity and NOS2 protein expression increased significantly less in portal vein-stenosed than in sham-operated rat aortae. Similar results were obtained after in vitro incubation with LPS. Endothelium removal or NOS3 inhibition with the calmodulin inhibitor, W7, increased NOS activity in the aortae of portal vein-stenosed rats after LPS incubation. In conclusion, in aortae of portal vein-stenosed rats exposed to LPS, no further decrease in aortic reactivity to phenylephrine was observed, and the induction of NOS2 was down-regulated. Endothelium removal or calmodulin inhibition inhibits NOS3 overactivity and leads to normalized NOS2 activation after LPS in aortae from portal vein-stenosed rats. (HEPATOLOGY 1999;30:698-704.)In cirrhosis, the occurrence of sepsis and the morbidity and mortality of septic shock are increased in humans and animal models. 1-4 Vasodilation in septic shock or during endotoxemia is caused part by an overproduction of nitric oxide (NO), which in this case is synthesized by the inducible NO synthase isoform (NOS2). [5][6][7][8][9][10] On the other hand, a hyperdynamic syndrome that results in systemic and splanchnic vasodilation, 11-13 a decreased responsiveness to vasoconstrictors, [14][15][16] and an increased cardiac output is also observed in portal hypertension with or without liver disease. In contrast to the hypothesis by Vallance and Moncada, 17 who suggested that circulating bacterial endotoxins induced vascular NOS2 in patients with cirrhosis, there is increasing evidence that the overproduction of NO in aortae of rats with extrahepatic portal hypertension 18-20 and cirrhotic rats without ascites [21][22][23] is caused by increased endothelial, constitutive NO synthase (NOS3) expression and activity without NOS2 induction. [23][24][25] In fact, because bacterial infections and sepsis are frequent in cirrhosis, NO overproduction in relation to both NOS3 overactivity and NOS2 induction may occ...