Tetrahydrobiopterin in Cardiovascular Health and Disease
Open accessAbstract
Tetrahydrobiopterin (BH4) functions as a cofactor for several important enzyme systems, and considerable evidence implicates BH4 as a key regulator of endothelial nitric oxide synthase (eNOS) in the setting of cardiovascular health and disease. BH4 bioavailability is determined by a balance of enzymatic de novo synthesis and recycling, versus degradation in the setting of oxidative stress. Augmenting vascular BH4 levels by pharmacological supplementation has been shown in experimental studies to enhance NO bioavailability. However, it has become more apparent that the role of BH4 in other enzymatic pathways, including other NOS isoforms and the aromatic amino acid hydroxylases, may have a bearing on important aspects of vascular homeostasis, inflammation, and cardiac function. This article reviews the role of BH4 in cardiovascular development and homeostasis, as well as in pathophysiological processes such as endothelial and vascular dysfunction, atherosclerosis, inflammation, and cardiac hypertrophy. We discuss the therapeutic potential of BH4 in cardiovascular disease states and attempt to address how this modulator of intracellular NO-redox balance may ultimately provide a powerful new treatment for many cardiovascular diseases. Antioxid. Redox Signal. 20, 3040–3077.
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BH4 plays a critical role in the catalytic cycle of NOS.
“In addition, BH4 plays a critical role in the catalytic cycle of NOS (87, 204, 377, 904, 933, 1000, 1007).”
From Sources of Vascular Nitric Oxide and Reactive Oxygen Species and Their Regulation (2019) · cites this paper as [87]
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Insights into Molecular Structure of Pterins Suitable for Biomedical Applications
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- Authors
- Bendall, J. K., Douglas, G., McNeill, E., Channon, K. M., & Crabtree, M. J.
- Affiliations
- John Radcliffe Hospital (GB)
- Venue
- Antioxidants & Redox Signaling
- Publisher
- SAGE Publications
- Published
- 2014-06
- Volume
- 20
- Issue
- 18
- Pages
- 3040-3077
- ISSN
- 1523-0864 (ISSN-L)
- 1557-7716
- PMC
- PMC4038990
- OpenAlex
- W2092784951
- Cited by
- 231
- References
- 340
- Citations by year
- 2026: 12 · 2025: 21 · 2024: 15 · 2023: 22 · 2022: 26 · 2021: 20 · 2020: 21 · 2019: 18 · 2018: 18 · 2017: 21 · 2016: 15 · 2015: 12 · 2014: 9 · 2013: 1
- FWCI
- 1.36
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Antioxidants and Redox Signaling (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust (090532)
- National Institute for Health and Care Research (NF-SI-0508-10247)
- British Heart Foundation (RE/08/004, RG/12/5/29756, RG/12/5/29576)
- Topics
- Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Keywords
- tetrahydrobiopterin, BH4, endothelial nitric oxide synthase, nitric oxide bioavailability, oxidative stress, aromatic amino acid hydroxylases, atherosclerosis, endothelial dysfunction, vascular dysfunction, inflammation, cardiac hypertrophy, cardiovascular disease, BH4 supplementation, cardiovascular homeostasis
- MeSH terms
- Biopterins, Cardiovascular Diseases, Cardiovascular System, Cardiomegaly, Humans, Inflammation, Oxidation-Reduction, Atherosclerosis, Nitric Oxide Synthase Type III
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