Adriamycin (or doxorubicin) is an active andbroad spectrum chemotherapeutic agent.Unfortunately, its clinical use is severely restricted by adose-limiting cardiotoxicity which has been linkedto the formation of superoxide. Enzymatic one-electron reductionof adriamycin forms adriamycinsemiquinone radical, which rapidly reacts with oxygen to formsuperoxide and adriamycin. In this way,adriamycin provides a kinetic mechanism for the one-electron reductionof oxygen by flavoenzymes suchas NADPH-cytochrome P450 reductase and mitochondrial NADHdehydrogenase. We demonstrate herethat the endothelial isoform of nitric oxide synthase (eNOS) reducesadriamycin to the semiquinone radical.As a consequence, superoxide formation is enhanced and nitricoxide production is decreased. Adriamycinbinds to eNOS with a
Km of approximately 5
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M,as calculated from both eNOS-dependent NADPHconsumption and superoxide generation. Adriamycin stimulatedsuperoxide formation is not affected bycalcium/calmodulin and is abolished by the flavoenzyme inhibitor,diphenyleneiodonium. This stronglysuggests that adriamycin undergoes reduction at the reductase domain ofeNOS. A consequence of eNOS-mediated reductive activation of adriamycin is the disruption of thebalance between nitric oxide andsuperoxide. This may lead eNOS to generate peroxynitrite andhydrogen peroxide, potent oxidantsimplicated in several vascular pathologies.