Matsumoto, Takayuki, Tsuneo Kobayashi, Kentaro Wakabayashi, and Katsuo Kamata. Cilostazol improves endothelium-derived hyperpolarizing factor-type relaxation in mesenteric arteries from diabetic rats. Am J Physiol Heart Circ Physiol 289: H1933-H1940, 2005. First published May 20, 2005; doi:10.1152/ajpheart.00303.2005.-We previously reported that in mesenteric arteries from streptozotocin (STZ)-induced diabetic rats that 1) endothelium-derived hyperpolarizing factor (EDHF)-type relaxation is impaired, possibly due to a reduced action of cAMP via increased phosphodiesterase 3 (PDE3) activity (Matsumoto T, Kobayashi T, and Kamata K. Am J Physiol Heart Circ Physiol 285: H283-H291, 2003) and that 2) PKA activity is decreased (Matsumoto T, Wakabayashi K, Kobayashi T, and Kamata K. Am J Physiol Heart Circ Physiol 287: H1064 -H1071, 2004). Here we investigated whether chronic treatment with cilostazol, a PDE3 inhibitor, improves EDHF-type relaxation in mesenteric arteries isolated from STZ rats. We found that in such arteries 1) cilostazol treatment (2 wk) improved ACh-, A-23187-, and cyclopiazonic acid-induced EDHF-type relaxations; 2) the ACh-induced cAMP accumulation was transient and sustained in arteries from cilostazol-treated STZ rats; 3) the EDHF-type relaxation was significantly decreased by a PKA inhibitor in the cilostazol-treated group, but not in the cilostazol-untreated group; 4) cilostazol treatment improved both the relaxations induced by cAMP analogs and the PKA activity level; and 5) PKA catalytic subunit (Cat-␣) protein was significantly decreased, but the regulatory subunit RII- was increased (and the latter effect was significantly decreased by cilostazol treatment). These results strongly suggest that cilostazol improves EDHF-type relaxations in STZ rats via an increase in cAMP and PKA signaling.adenosine; 3Ј,5Ј-cyclic monophosphate; diabetes; phosphodiesterase; protein kinase A; streptozotocin VASCULAR COMPLICATIONS are the main causes of morbidity and mortality in patients with diabetes. Several lines of evidence suggest that endothelial dysfunction could play a key role in the development of both macro-and microangiopathy in humans and in animal models of the disease (11,42,43,47). Endothelial cells relax the tone of the underlying vascular smooth muscle cells by releasing a number of vasodilator substances, including nitric oxide (NO), prostacyclin, and an as-yet-elusive endothelium-derived hyperpolarizing factor (EDHF) (7). Although NO has generally been considered to be the principal mediator of endothelium-dependent relaxations, it has become increasingly clear that NO-independent endothelium-derived relaxing factors might play an important role in local vasomotor control. The contribution made by EDHF to relaxation is dependent on vessel size, it being more prominent in the smaller, physiologically more important arteries than in larger ones (5,12,14). Impaired endothelium-dependent relaxations have been reported in various types of blood vessels in several animal models of diabetes (11)...