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This is an experimental combination of three agents—isosorbide, L-NMMA (NG-monomethyl-L-arginine), and bradykinin—used in clinical research to study vascular function and the interplay between nitric oxide pathways, vasodilation, and endothelial function. - **Isosorbide** (typically as dinitrate or mononitrate) is a nitrate vasodilator that acts as a prodrug for nitric oxide (NO), leading to smooth muscle relaxation via activation of soluble guanylyl cyclase and increased cyclic GMP in vascular endothelium[8]. - **L-NMMA** is an inhibitor of nitric oxide synthase (NOS), reducing endogenous NO production. It serves as a tool compound to block NO-mediated effects in vivo[5]. - **Bradykinin** is an endogenous peptide that acts primarily on B2 receptors to induce potent vasodilation through both direct mechanisms and by stimulating endothelial NO release[6][3][5]. The combination has been used experimentally to dissect the contributions of exogenous nitrates, endogenous NO synthesis inhibition, and bradykinin-mediated vasodilation on vascular tone. This regimen has been studied in controlled settings such as forearm blood flow experiments or coronary flow studies but does not have established therapeutic use outside research contexts[1][2].
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