A pro-inflammatory and vasoconstrictor and endothelin-1 (ET-1) are pathogenic molecules related to a series of cardiovascular diseases. Unlike ET-1 signaling for
vasoconstriction of the main
artery, we have proven herein that coronary microvessels exhibit a unique signaling mechanism for
constriction (independent of PKC, CPI-17, and
intracellular calcium storage). The pathophysiological level of ET-1 acts preferentially on the microvessels to exert persistent
vasoconstriction by activating Rho
kinase upon binding to ETAR of the ET-1
receptor. The ETAR
antagonist BQ123 only blocks but cannot reverse
vasoconstriction against ET-1. In contrast, ROCK inhibitors (e.g., H-1152) are effective to reverse arteriolar
systole against ET-1. Thus, ROCK inhibition is a potent and specific choice for the treatment of coronary
ischemic disease (abnormal vasoconstriction) associated with microvascular dysfunction due to excessive production of ET-1. The ROCK inhibitors may also be used to treat microvascular diseases associated with
diabetic retinopathy as well as microvascular dysfunction caused by
cancer therapy or immunosuppressive drugs. Since H-1152 can also reduce the basal tension of microvessels, a ROCK inhibitor is also a good
diagnostic agent when used during
angiography or by a non-invasive method.