Mortensen SP, Gonzá lez-Alonso J, Bune LT, Saltin B, Pilegaard H, Hellsten Y. ATP-induced vasodilation and purinergic receptors in the human leg: roles of nitric oxide, prostaglandins, and adenosine. Am J Physiol Regul Integr Comp Physiol 296: R1140 -R1148, 2009. First published December 31, 2008 doi:10.1152/ajpregu.90822.2008.-Plasma ATP is thought to contribute to the local regulation of skeletal muscle blood flow. Intravascular ATP infusion can induce profound limb muscle vasodilatation, but the purinergic receptors and downstream signals involved in this response remain unclear. This study investigated: 1) the role of nitric oxide (NO), prostaglandins, and adenosine as mediators of ATP-induced limb vasodilation and 2) the expression and distribution of purinergic P 2 receptors in human skeletal muscle. Systemic and leg hemodynamics were measured before and during 5-7 min of femoral intra-arterial infusion of ATP [0.45-2.45 mol/min] in 19 healthy male subjects with and without coinfusion of N G -monomethyl-L-arginine (L-NMMA; NO formation inhibitor; 12.3 Ϯ 0.3 (SE) mg/min), indomethacin (INDO; prostaglandin formation blocker; 613 Ϯ 12 g/ min), and/or theophylline (adenosine receptor blocker; 400 Ϯ 26 mg). During control conditions, ATP infusion increased leg blood flow (LBF) from baseline conditions by 1.82 Ϯ 0.14 l/min. When ATP was coinfused with either L-NMMA, INDO, or L-NMMA ϩ INDO combined, the increase in LBF was reduced by 14 Ϯ 6, 15 Ϯ 9, and 39 Ϯ 8%, respectively (all P Ͻ 0.05), and was associated with a parallel lowering in leg vascular conductance and cardiac output and a compensatory increase in leg O 2 extraction. Infusion of theophylline did not alter the ATP-induced leg hyperemia or systemic variables. Real-time PCR analysis of the mRNA content from the vastus lateralis muscle of eight subjects showed the highest expression of P2Y2 receptors of the 10 investigated P2 receptor subtypes. Immunohistochemistry showed that P2Y2 receptors were located in the endothelium of microvessels and smooth muscle cells, whereas P2X1 receptors were located in the endothelium and the sacrolemma. Collectively, these results indicate that NO and prostaglandins, but not adenosine, play a role in ATP-induced vasodilation in human skeletal muscle. The expression and localization of the nucleotide selective P2Y2 and P2X1 receptors suggest that these receptors may mediate ATP-induced vasodilation in skeletal muscle. skeletal muscle; adenosine 5Ј-triphosphate; purinergic receptors; nitric oxide; prostaglandins SKELETAL MUSCLE BLOOD FLOW is closely regulated to match O 2 delivery to the metabolic demand of contracting myocytes during a wide array of exercise modalities (2,15,29,42). The precise regulation of muscle blood flow is believed to mainly be the result of the competing influences of locally released vasodilator signals and sympathetic neural vasoconstrictor activity (9). Previous reports employing double blockade of nitric oxide synthase (NOS) and cyclooxygenase (COX) by which nitric oxide (NO) and prostaglindi...