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The Biology of Nitrogen Oxides in the Airways
Abstract
Nitrogen oxides (NOx), regarded in the past primarily as toxic air pollutants, have recently been shown to be bioactive species formed endogenously in the human lung. The relationship between the toxicities and the bioactivities of NOx must be understood in the context of their chemical interactions in the pulmonary microenvironment. Nitric oxide synthase (NOS) is a newly identified enzyme system active in airway epithelial cells, macrophages, neutrophils, mast cells, autonomic neurons, smooth muscle cells, fibroblasts, and endothelial cells. The chemical products of NOS in the lung vary with disease states, and are involved in pulmonary neurotransmission, host defense, and airway and vascular smooth muscle relaxation. Further, certain patients with pulmonary hypertension, adult respiratory distress syndrome and asthma may experience physiologic improvement with NOx therapy, including inhalation of nitric oxide (NO.) gas. Both endogenous and exogenous NOx react readily with oxygen, superoxide, water, nucleotides, metalloproteins, thiols, amines, and lipids to form products with biochemical actions ranging from bronchodilation and bacteriostasis (S-nitrosothiols) to cytotoxicity and pulmonary capillary leak (peroxynitrite), as well as those with frank mutagenic potential (nitrosamines). Recent discoveries demonstrating the relevance of these species to the lung have provided new insights into the pathophysiology of pulmonary disease, and they have opened a new horizon of therapeutic possibilities for pulmonary medicine.
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“The hallmark feature of PAH and other forms of PH is reduced bioavailability of NO signaling and poor endothelial responsiveness to triggers of vasodilatation[28–34].”
From Enterosalivary nitrate metabolism and the microbiome: Intersection of microbial metabolism, nitric oxide and diet in cardiac and pulmonary vascular health (2017) · cites this paper as [28]
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“When vascular endothelial cells are stimulated to increase their production of nitric oxide (NO), the NO rapidly diffuses into subjacent vascular smooth muscle cells, where it causes relaxation and vasodilation ( 1 ).”
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“PEROXYNITRITE (ONOO ) is a potent oxidant generated by the rapid nonenzymatic interaction between nitric oxide (NO ) and the superoxide anion radical (O2 ), both of which are generated during inflammatory stress (10).”
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BackgroundXylitol nasal irrigation in the treatment of chronic rhinosinusitis
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Protein Nitration, Metabolites of Reactive Nitrogen Species, and Inflammation in Lung Allografts
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“In normal lungs, NO is synthesized by two constitutive NOS (cNOS) isoforms expressed in nonadrenergic noncholinergic neurones (nNOS), vascular endothelial cells (eNOS) and airway epithelial cells (nNOS and eNOS) (Gaston et al., 1994).”
BackgroundMattes, J., Gravesande, K. S. V., Reining, U., Alving, K., Ihorst, G., Henschen, M., & Kuehr, J. (1999) · European Respiratory Journal · doi:10.1183/09031936.99.13613969 · Cited by 37
Inhaled lead affects lung pathology and inflammation in sensitized and control guinea pigs
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“The increased serum ET-1, EPO, and NO levels (Gaston et al., 1994; Trakada et al., 2000; Hyung Cho et al., 2010) and lung histopathological changes have been reported in OA-sensitized guinea pigs (Boskabady et al.”
BackgroundImmunomodulatory properties of surfactant preparations
Bersani, I., Kunzmann, S., & Speer, C. P. (2012) · Expert Review of Anti-infective Therapy · doi:10.1586/eri.12.156 · Cited by 37
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Béloucif, S., Payen, D. M., & the Working Group on Inhaled NO in the ICU of the European Society of Intensive Care Medicine (1998) · Intensive Care Medicine · doi:10.1007/s001340050679 · Cited by 37
“However, inhaled NO may also worsen lung injury, especially when combined with high inspired oxygen fractions via the rapid formation of toxic NO derivatives such as nitrogen dioxide (NO2) or peroxynitrite (ONOO) [ 22 , 23].”
BackgroundZeidler, P. C., Roberts, J. R., Castranova, V., et al. (2003) · Journal of Toxicology and Environmental Health · doi:10.1080/15287390306395 · Cited by 37
“On the other hand, data suggest that low levels of iNOS are present in cells of the upper airways in rat and humans under normal physiologic conditions (Gaston et al., 1994; Kobzik et al., 1993; Castranova, 1998a).”
BackgroundNasal and lower airway level of nitric oxide in children with primary ciliary dyskinesia
Karadag, B. T., James, A. J., Gültekin, E., Wilson, N. M., & Bush, A. (1999) · European Respiratory Journal · doi:10.1034/j.1399-3003.1999.13f28.x · Cited by 37
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“It has been suggested that the role of NO formation in response to silica is related to the ability of NO to combine rapidly with O2(2) to form peroxynitrite (ONOO(2)), a potent oxidant capable of oxidizing an array of biomolecules (28, 29).”
BackgroundNitric Oxide in the Developing Lung
Shaul, P. W. (1995) · Advances in Pediatrics · doi:10.1016/s0065-3101(24)00120-8 · Cited by 36
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BackgroundModeling of the Nitric Oxide Transport in the Human Lungs
Karamaoun, C., Muylem, A. V., & Haut, B. (2016) · Frontiers in Physiology · doi:10.3389/fphys.2016.00255 · Cited by 36
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“In response to infection, neutrophils also produce O2 via NADPH oxidase (51).”
BackgroundEpigallocatechin-3-Gallate Reduces Allergen-Induced Asthma-Like Reaction in Sensitized Guinea Pigs
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“Conversely, high NO levels, reflecting iNOS up-regulation by proinflammatory cytokines, can produce deleterious effects, including increased vascular permeability, airway epithelium damage, and leukocyte infiltration (Gaston et al., 1994).”
BackgroundInducible nitric oxide synthase in the lung and exhaled nitric oxide after hyperoxia
Cucchiaro, G., Tatum, A. H., Brown, M. C., Camporesi, E. M., Daucher, J. W., & HAKIM, T. S. (1999) · American Journal of Physiology-Lung Cellular and Molecular Physiology · doi:10.1152/ajplung.1999.277.3.l636 · Cited by 35
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Exhaled nitric oxide corresponds with office evaluation of asthma control
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“There is increasing evidence that inflammatory cytokines involved in asthmatic airway inflammation induce expression of NOS.(7,8) Moreover, inducible NOS was detected immunohistochemically in the bronchial epithelium of asthmatic patients.”
BackgroundKwon, S., Newcomb, R. L., & George, S. C. (2001) · Nitric Oxide · doi:10.1006/niox.2001.0387 · Cited by 35
“There is currently considerable interest in inhibiting NO production as a therapeutic intervention in inflammatory diseases (5, 6); hence, it is crucial to understand the mechanisms underlying its production.”
BackgroundIncreased nitric oxide metabolites in exhaled breath condensate after exposure to tobacco smoke
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“It is widely assumed that NO diffuses passively from the cytosol of its cell of origin into distant target cells to elicit a response (Gaston et al. 1994).”
BackgroundNitric Oxide and Airway Reactivity
zkan, M., & Dweik, R. A. (2001) · Clinical Pulmonary Medicine · doi:10.1097/00045413-200107000-00001 · Cited by 34
“Analogues of l-arginine act as false substrates for the enzyme and therefore block the formation of endogenous NO (9).”
BackgroundMarkers of active airway inflammation and remodelling in chronic obstructive pulmonary disease
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Arginine and Nitric Oxide Pathways in Obesity-Associated Asthma
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“These results may be explained on the basis that NO, which is constitutively produced by the airway epithelium, contributes to maintaining adequate airway function; for example, NO has been implicated in ciliary beating, maintaining bronchodilation through the formation of s-nitrosothiol compounds, and in bactericidal…”
BackgroundEffect of inhaled nitric oxide on pulmonary function in cystic fibrosis
Ratjen, F. A., Gärtig, S., Wiesemann, H. G., & Grasemann, H. (1999) · Respiratory Medicine · doi:10.1016/s0954-6111(99)90158-0 · Cited by 33
“In addition, other potentially harmful toxic metabolites such as nitrous acid, nitric acid and peroxynitrite may be formed and retained in respiratory secretion (23).”
BackgroundExhaled Nitric Oxide and Bronchoalveolar Lavage Nitrite/Nitrate in Active Pulmonary Sarcoidosis
O'DONNELL, D. M., Moynihan, J. B., Finlay, G. A., et al. (1997) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.156.6.9705013 · Cited by 34
“However, in biologic systems, the half-life of NO is between 0.1 and 5 s and the presence of NO at air-aqueous interfaces results in the generation of intermediate nitrogen oxides and the stable end products of NO metabolism, i.e., NO3 2 and NO22 ( 1 ).”
BackgroundInfluentialInhaled and exhaled nitric oxide
Thébaud, B., Arnal, J., Mercier, J., & Dinh‐Xuan, A. T. (1999) · Cellular and Molecular Life Sciences · doi:10.1007/s000180050360 · Cited by 34
“NO also inhibits platelet aggregation and prolongs bleeding time.”
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Tworetzky, W., Moore, P., Bekker, J. M., Bristow, J. D., Black, S. M., & Fineman, J. R. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00576-8 · Cited by 33
“Within the respiratory tract, all three isoforms of NOS have been found (22,23).”
BackgroundExpression of Inducible Nitric Oxide Synthase by Macrophages in Rat Lung
Liu, H., ANAND, A., Bloch, K. D., Christiani, D. C., & Kradin, R. L. (1997) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.156.1.9609140 · Cited by 33
“IM but not AM from the normal lung were judged to be a source of NO, as judged by (1) the detection of immunoreactive cytoplasmic iNOS protein in IM in the noninflamed germ-free lung and (2) the secretion of NO by IM purified from normal lung in the absence of ex vivo stimulation.”
BackgroundMethodNitric oxide and anti-cancer therapy
Sagar, S. M., Singh, G., Hodson, D. I., & Whitton, A. C. (1995) · Cancer Treatment Reviews · doi:10.1016/0305-7372(95)90025-x · Cited by 34
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Macrolide antibiotics inhibit nitric oxide generation by rat pulmonary alveolar macrophages
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“iNOS is upregulated upon various inflammatory stimuli ( 30 ), is a key enzyme in the synthesis of nitric oxide (NO) (31) and in regulating neutrophil migration during inflamma tion (32; 33).”
BackgroundEndogenous nitric oxide in the airways of different animal species
KHEDIN, U., Röken, B. O., Nyman, G. C., FROSTELL, C. G., & Gustafsson, L. E. (1997) · Acta Anaesthesiologica Scandinavica · doi:10.1111/j.1399-6576.1997.tb04855.x · Cited by 33
“the redox, pH and biochemical milieu in the mucosa and the lining fluid of the respiratory tract (31-33), resulting in other nitrogen-oxygen species than gas-”
BackgroundExhaled Nitric Oxide (NO), NO Synthase Activity, and Regulation of Nuclear Factor (NF)-κ B
Marshall, H. E., & Stamler, J. S. (1999) · American Journal of Respiratory Cell and Molecular Biology · doi:10.1165/ajrcmb.21.3.f164 · Cited by 33
“Nitric oxide (NO) and related molecules are produced in the lung by virtually all cellular constituents, including the epithelium, the endothelium, neurons, neuroendocrine cells, resident inflammatory cells, and alveolar macrophages ( 1 ).”
BackgroundSelf-citationEmerging role of nitric oxide in cancer
Brennan, P. A., Downie, I. P., Langdon, J., et al. (1999) · British Journal of Oral and Maxillofacial Surgery · doi:10.1054/bjom.1999.0201 · Cited by 32
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“Along with free NO, these other NO-related species, which are either derived from NO or capable of generating free NO, are termed bioactive NO (34, 40, 153).”
Acute effects of inhaled nitric oxide in adult respiratory distress syndrome
Iotti, G., Olivei, M., Palo, A., et al. (1998) · European Respiratory Journal · doi:10.1183/09031936.98.12051164 · Cited by 32
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Exhaled nitric oxide in COPD: glancing through a smoke screen
Sterk, P. J., de Gouw, H. W. F. M., Ricciardolo, F. L. M., & Rabe, K. F. (1999) · Thorax · doi:10.1136/thx.54.7.565 · Cited by 32
“35 Such paradoxical worsening of tuberculosis has been reported by others 36 37 and we have observed it to be associated with an intense granulomatous reaction (data not shown).”
BackgroundEndogenous nitric oxide inhibits leukotriene B4 release from rat alveolar macrophages
Brunn, G., Hey, C., Wessler, I. K., et al. (1997) · European Journal of Pharmacology · doi:10.1016/s0014-2999(97)00136-2 · Cited by 32
Tuberculosis in AIDS: past or new problems?
Mayaud, C. M., & Cadranel, J. L. (1999) · Thorax · doi:10.1136/thx.54.7.567 · Cited by 30
Arimilli, S., Schmidt, E., Damratoski, B. E., & Prasad, G. L. (2017) · Inflammation · doi:10.1007/s10753-017-0602-9 · Cited by 31
Degano, B., Genestal, M., Serrano, É., RAMI, J., & Arnal, J. (2005) · CHEST Journal · doi:10.1378/chest.128.3.1699 · Cited by 31
Jyothi, & Khar (2000) · Scandinavian Journal of Immunology · doi:10.1046/j.1365-3083.2000.00762.x · Cited by 31
Anti‐inflammatory effect of augmented nitric oxide production in chronic lung infection
Hopkins, N. O., Gunning, Y., O’Croinin, D. F., Laffey, J. G., & McLoughlin, P. (2006) · The Journal of Pathology · doi:10.1002/path.1963 · Cited by 32
Air Contamination with Nitric Oxide: Effect on Exhaled Nitric Oxide Response
Therminarias, A., Flore, P., Favre‐Juvin, A., Oddou-Chirpaz, M. F., Delaire, M., & Grimbert, F. (1998) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.157.3.9706091 · Cited by 31
“It exists in several inflammatory cells or in cells such as endothelial and smooth muscle cells, and it is generated in response to proinflammatory cytokines and endotoxin (4, 8 ). Thus, an increase in EC NO or in EV NO values has been found in patients with pulmonary diseases such as asthma (9‐16), respiratory tract…”
BackgroundKlinger, J. R. (2002) · Critical Care Clinics · doi:10.1016/s0749-0704(03)00064-2 · Cited by 29
Metabolites of nitric oxide in the lower respiratory tract of children
Grasemann, H., IOANNIDIS, I., de GROOT, H., & Ratjen, F. A. (1997) · European Journal of Pediatrics · doi:10.1007/s004310050667 · Cited by 30
“In the airways rapid interconversion among the nitrogen oxide species can occur, resulting in formation of the stable metabolites nitrate and nitrite [10].”
Nitric oxide metabolites in induced sputum: a marker of airway inflammation in asthmatic subjects
Jang, Choi, Lee, et al. (1999) · Clinical & Experimental Allergy · doi:10.1046/j.1365-2222.1999.00595.x · Cited by 30
Gao, X., Ray, R., Xiao, Y., & Ray, P. (2008) · Basic & Clinical Pharmacology & Toxicology · doi:10.1111/j.1742-7843.2008.00255.x · Cited by 29
Matthiesen, S., Lindemann, D., Warnken, M., Juergens, U. R., & Racké, K. (2007) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2007.10.043 · Cited by 29
Huffman, L. J., Prugh, D. J., Millecchia, L., et al. (2003) · Journal of Biosciences · doi:10.1007/bf02970129 · Cited by 29
“NO is a free radical and appears to play an important role in the defense against pathogens, and appears to be involved in the tissue damage associated with inflammatory processes (Ialenti et al 1992; Gaston et al 1994; Moilanen and Vapaatalo 1995).”
Background
Metadata
- Authors
- Gaston, B., Drazen, J. M., Loscalzo, J., & Stamler, J. S.
- Affiliations
- Boston Children's Hospital (US)
- Venue
- American Journal of Respiratory and Critical Care Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 1994-02-01
- Volume
- 149
- Issue
- 2
- Pages
- 538-551
- ISSN
- 1073-449X (ISSN-L)
- 1535-4970
- OpenAlex
- W2054510493
- Cited by
- 918
- References
- 0
- Citations by year
- 2025: 6 · 2024: 4 · 2023: 4 · 2022: 10 · 2021: 13 · 2020: 5 · 2019: 6 · 2018: 10 · 2017: 9 · 2016: 15 · 2015: 16 · 2014: 19 · 2013: 27 · 2012: 16
- FWCI
- 37.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Respiratory and Critical Care Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hl040411-02, 5p50hl019170-20, 5r01hl043344-04)
- National Heart, Lung, and Blood Institute (HL43344, HL-40411, HL 19170)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nitric Oxide and Endothelin Effects
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Redox biology and oxidative stress
- Keywords
- nitrogen oxides, nitric oxide, nitric oxide synthase, airway epithelial cells, S-nitrosothiols, peroxynitrite, nitrosamines, pulmonary hypertension, acute respiratory distress syndrome, asthma, nitric oxide inhalation therapy, bronchodilation, host defense, smooth muscle relaxation
- MeSH terms
- Amino Acid Oxidoreductases, Animals, Humans, Lung, Lung Diseases, Nitric Oxide, Nitrogen Oxides, Nitrous Oxide, Nitric Oxide Synthase
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