Multiple effects of dipyridamole on neutrophils and mononuclear leukocytes: adenosine-dependent and adenosine-independent mechanisms

Dipyridamole is an antithrombotic drug that has been shown to influence not only platelet function but also some aspects of leukocyte activation. In this study we demonstrate that dipyridamole effectively inhibits superoxide anion generation by neutrophils, mononuclear leukocytes, and whole blood stimulated with N-formyl-methionyl-leucyl phenylalanine and calcium ionophore A23187. In addition, the drug, at concentrations as low as 1 mumol/L, inhibits the expression of procoagulant activity--basal and stimulated--by mononuclear leukocytes. It is shown that, similar to its effect on platelets, dipyridamole influences these leukocyte functions indirectly, that is, through an increase of extracellular adenosine that in turn inhibits both superoxide anion generation by leukocytes and the expression of procoagulant activity by mononuclear leukocytes. In fact, adenosine deaminase, which metabolizes adenosine to inactive product, prevents the effects of dipyridamole on superoxide anion generation and on the expression of procoagulant activity by leukocytes. Experiments carried out with 8-phenyl-theophylline indicate that the adenosine-dependent effects of dipyridamole may involve multiple pathways, only some of which are dependent on the interaction of adenosine with its receptors. Dipyridamole also dose-dependently inhibits the synthesis of leukotrienes B4 and C4 by stimulated neutrophils and mononuclear leukocytes through a mechanism that is not mediated by the presence of adenosine in the extracellular medium. The reported effects of dipyridamole on separate and distinct pathways involved in leukocyte activation are of relevance in the overall evaluation of the antithrombotic activity of this drug.