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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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Wasson, S., Govindarajan, G., Reddy, H. K., et al. (2004) · Journal of Cardiovascular Pharmacology and Therapeutics · doi:10.1177/107424840400900i102 · Cited by 11
“Inhaled nitric oxide (iNO) is formed in the endothelial cell from L-arginine via the constitutively expressed enzyme endothelial nitric oxide synthase (eNOS, type III NOS) (4).”
BackgroundExhaled nitric oxide in patients with PiZZ Phenotype-related α 1-anti-trypsin deficiency
Malerba, M., Clini, E. M., Cremona, G., Radaeli, A., Bianchi, L. N. C., Corda, L., Pini, L., RICClARDOLO, F., Grassi, V., & Ambrosino, N. (2001) · Respiratory Medicine · doi:10.1053/rmed.2001.1082 · Cited by 11
Reduction of variability of exhaled nitric oxide in healthy volunteers
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“In the past years many studies were conducted to unravel the role and origin of nitric oxide (NO) in pulmonary diseases (1).”
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“Nitric oxide is produced endogenously by a family of nitric oxide synthases (NOSs) and is thought to be an important modulator of airway function in normal and inflamed airways [1].”
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Increased airway osmolarity inhibits the action of nitric oxide in the rabbit
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“Recent observations suggest that inhaled NO also reacts with thiol constituents in the surface liquid layer of the airway wall, forming stable bioactive S-nitrosothiols [17].”
BackgroundInfluentialThe Relationship of Fractional Exhaled Nitric Oxide in Patients with AECOPD
Xu, X., Zhou, L., & Tong, Z. (2023) · International Journal of COPD · doi:10.2147/copd.s434040 · Cited by 10
“When the lung receives inflammatory lesions caused by a virus or a bacterial infection, it induces the production of inducible nitric oxide synthase 11,12 (iNOS).”
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Self-citationÓxido nítrico exalado no diagnóstico e acompanhamento das doenças respiratórias
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“Hence, a cheap and simple method like NO metabolites (nitrites, nitrates, peroxynitrite, and possible L-citrulline) measurements could be a good alternative.(32) Comparing with FeNO determinations, although nitrite measure in induced sputum is TABLE 2—Comparison of Nitrites in Sputum, EBC and Asthma Symptoms at Admiss…”
MethodGuo, H., Yang, W., Jiang, L., Lyu, Y., Cheng, T., Gao, B., & Li, X. (2018) · Ecotoxicology and Environmental Safety · doi:10.1016/j.ecoenv.2018.10.094 · Cited by 10
Zegdi, R., Fabre, O. H., Cambillau, M., et al. (2002) · Critical Care Medicine · doi:10.1097/00003246-200209000-00024 · Cited by 10
“We also cannot exclude a difference between the two groups regarding NO metabolism into peroxynitrite, S-nitrosyl, or S-nitrosothiol compounds within the lungs (37, 38).”
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“Thus, enhancing NO production in the lungs may counteract the elevated smooth muscle tone via a direct effect [23] or prevent against the development of chronic lung inflammation and subsequent airway remodeling [24].”
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Torretta, S., Marchisio, P., Esposito, S., Garavello, W., Cappadona, M., Clemente, I., & Pignataro, L. (2011) · International Journal of Immunopathology and Pharmacology · doi:10.1177/039463201102400220 · Cited by 9
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“2004), upregulating iNOS and contributing to the increase in eNO (Gaston et al. 1994).”
InfluentialAbuelezz, S. A. (2018) · Canadian Journal of Physiology and Pharmacology · doi:10.1139/cjpp-2017-0230 · Cited by 9
Banasiewicz, A. (2021) · IOP Conference Series Earth and Environmental Science · doi:10.1088/1755-1315/684/1/012018 · Cited by 9
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“However, NO has a short half-life (Gaston et al., 1994) and combined with a high affinity for haemoglobin (Ricciardolo, 2003), and changes in systemic and/or pulmonary vascular formation of NO is not necessarily detectable in exhaled breath (St Croix et al.”
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“Three isoenzymes of NOS have been described: type I (neuronal isoform, nNOS), type II (inducible isoform, iNOS), and type III (endothelial isoform, eNOS), displaying about 50% amino acid sequence homology (Gaston et al., 1994).”
BackgroundAirway epithelial cells: Barrier and much more
Kale, S. L., & Arora, N. (2013) · Indian Journal of Allergy Asthma and Immunology · doi:10.4103/0972-6691.124390 · Cited by 8
“[47,48] NO is produced by the enzyme nitric oxide synthase (NOS) from the guanidine nitrogen of L‐arginine.”
BackgroundAcute Neonatal Respiratory Failure
BOHN, D. J., Dargaville, P. A., Davis, P. G., Hutchison, A. A., & Owen, L. S. (2014) · Springer eBooks · doi:10.1007/978-3-642-01219-8_47 · Cited by 9
“Nitric oxide is a potent pulmonary vasodilator and has been shown to have profound effects on gas exchange (Gaston et al.”
BackgroundNon-Asthmatic Patients Show Increased Exhaled Nitric Oxide Concentrations
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“NO participates in the physiologic regulation of bronchomotor tonus, but is also involved in diseases, such as asthma.(6) An increase in the concentration of exhaled NO (ENO) has been described with bronchial asthma.”
BackgroundExhaled nitric oxide concentration in the period of 60 min after submaximal exercise in the cold
Stensrud, T., Stang, J. S., Thorsen, E., & Bråten, V. (2014) · Clinical Physiology and Functional Imaging · doi:10.1111/cpf.12196 · Cited by 8
“However, NO has a short half-life (Gaston et al., 1994), and combined with a high affinity to haemoglobin (Ricciardolo, 2003), it has been argued that changes in systemic and/or pulmonary vascular formation of NO are not necessarily detectable in exhaled breath (St Croix et al., 1999).”
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“The levels of products of the L-arginine-NO pathway in biologic fluids may become clinical markers for monitoring certain pathologic conditions and their treatment (26).”
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“NO can be generated enzymatically by oxidation of L-arginine to L-citrulline, catalysed by NOS found in a number of cell types (Gaston et al 1994).”
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“Therefore, a cheap and simple method like NO metabolites (nitrites, nitrates, peroxynitrite and possible l-citrulline) measurements could be a good alternative (32).”
MethodBarbosa, A. D. S., Temple, M. C. R., Varela, E. L. P., Gomes, A. R. Q., Silveira, E. L., de Carvalho, E. P., Dolabela, M. F., & Percário, S. (2021) · Research Society and Development · doi:10.33448/rsd-v10i1.11805 · Cited by 7
“Another important factor to be considered is the existence of a complex system of non-adrenergic non-cholinergic (NANC) neural fibres in mammalian lungs capable of producing significant quantities of NO (Gaston et al., 1994) that overcome malaria-derived NO synthesis in this tissue.”
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“NOx-containing molecules may react with oxygen, superoxides, water, nucleotides, metalloproteins, thiols, amines, and lipids to form products with biochemical actions [2] in the peripheral lung tissue.”
Place de la mesure du NO expiré dans l’asthme
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“Among the mediators released, ROS such as superoxide radicals (O2 d)), hydrogen peroxide (H2O2), and hydroxyl radicals (dOH), in addition to NO (Doelman and Bast 1990; Gaston et al. 1994), are important in airway damage.”
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RETRACTED ARTICLE: Improved treatment of Asthma by using natural sources of antioxidants
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“In living organisms, the levels of free radicals and other 'reactive species' are controlled by a complex web of antioxidant defences, which minimize (but do not completely prevent) oxidative damage to biomolecules (Roberfroid and Calderon 1995; Gaston et al. 1994; Halliwell (2005).”
RetractedNO-Inhibiting and Vasotropic Activity of Some Compounds with Thioamidine Group
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“Nitric oxide is a reactive molecule formed from arginine by the activation of inducible nitric oxide synthase in the respiratory epithelium in response to inflammatory cytokines.(6) The level of nitric oxide in expired breath has been widely touted as a useful biomarker of inflammation in the diagnosis and management…”
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“2004), NOx is mainly produced from alveolar macrophages and plays an important role in defending against airborne pathogens, is involved in tissue damage, and is associated with inflammatory processes in the lungs (Ialenti et al. 1992; Gaston et al. 1994; Moilanen and Vapaatalo 1995).”
BackgroundTachykinins stimulate nitric oxide generation by canine cultured tracheal epithelium
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“NO NO is formed in the endothelial cell from L-arginine via the enzyme type III NO synthase (NOS).(106) Its vasodilator effects result from the increase in cGMP that subsequently leads to reduced intracellular calcium levels, producing smooth muscle relaxation in precapillary resistance arterioles.”
BackgroundFracaso de los músculos respiratorios en la sepsis
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Sumi, M. P., Tupta, B., Song, K., Mavrakis, L. A., COMHAIR, S. A. A., ERZURUM, S. C., Liu, X., Stuehr, D. J., & Ghosh, A. (2024) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2024.11.009 · Cited by 4
Ibuprofen attenuates early lung injury in endotoxemic, neutropenic rats
Daphtary, K. M., Heidemann, S. M., & Glibetić, M. (2001) · Prostaglandins Leukotrienes and Essential Fatty Acids · doi:10.1054/plef.2001.0289 · Cited by 5
OXIDATIVE STRESS STATUS DUE TO METAL EXPOSURE IN WELDING
Ananian, F. B., A, S. R., Helal, S. F., et al. (2013) · Egyptian Journal of Occupational Medicine · doi:10.21608/ejom.2013.768 · Cited by 5
“The blood metal levels showed a statistically significant increase among the exposed group as (Pb=81.6±35.8, Mn=3.2±2.1, Cr=6.9±2.1, Fe=156.4±17.3, Cd=3.2±3.6) and showed a statistically significant reduction in the level of SOD (=148.7±30.2) in the exposed group compared to the control group (Table1) (Fig1).”
BackgroundInfluentialMcMullan, D. M., Bekker, J. M., Parry, A., et al. (2000) · Circulation · doi:10.1161/circ.102.suppl_3.iii-172 · Cited by 5
Airway Gas Exchange and Exhaled Biomarkers
George, S. C., & Hlastala, M. P. (2011) · Comprehensive physiology · doi:10.1002/j.2040-4603.2011.tb00372.x · Cited by 5
“The challenge facing the field of exhaled biomarkers is twofold: (i) reliable and affordable detection and (ii)”
Lee, M.-Y., Tsai, Y., Yang, K. D., et al. (2006) · PubMed · Cited by 5
The effect of exercise on exhaled nitric oxide depends on allergic rhinoconjunctivitis in children
Evjenth, B., Hansen, T. E., & Holt, J. (2015) · Journal of Asthma · doi:10.3109/02770903.2015.1014099 · Cited by 5
“It is unlikely that increased pulmonary vascular NO production affects FENO post-exercise due to the short half-life of NO and the high affinity of NO to hemoglobin [35].”
BackgroundGas-phase oxidation and disproportionation of nitric oxide
Tsukahara, H., Ishida, T., & Mayumi, M. (2002) · Methods in enzymology on CD-ROM/Methods in enzymology · doi:10.1016/s0076-6879(02)59181-3 · Cited by 5
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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