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Nitric oxide: modulation of the pulmonary circulation
1Department of Anesthesia and Critical Care, Massachussets General Hospital, Harvard Medical School, Boston, USA.
Minerva Anestesiologica
|August 31, 2000
Summary
Nitric oxide (NO), synthesized by NO synthase (NOS), offers therapeutic potential. Inhaled NO selectively dilates pulmonary vessels, approved for infant respiratory failure and showing promise in adult conditions like pulmonary hypertension.
Area of Science:
- Biochemistry
- Physiology
- Pharmacology
Background:
- Nitric oxide (NO) is synthesized by NO synthase (NOS) enzymes.
- NO mediates crucial physiological processes including pulmonary vasodilation, anti-platelet aggregation, and leukocyte adhesion inhibition.
- Inducible NOS (iNOS) is expressed in leukocytes during inflammation and can be suppressed by corticosteroids.
Purpose of the Study:
- To review the role of nitric oxide (NO) in physiological processes.
- To discuss the therapeutic applications of inhaled NO, particularly in pulmonary conditions.
- To highlight the need for further clinical investigations in adult patients.
Main Methods:
- Literature review of NO synthesis and function.
- Analysis of FDA-approved uses of inhaled NO.
- Discussion of potential clinical applications in adult medicine.
Main Results:
- Inhaled NO is a selective pulmonary vasodilator.
- The U.S. FDA has approved inhaled NO for treating hypoxemic respiratory failure in infants and children.
- NO's mechanism involves the cyclic GMP transduction pathway.
Conclusions:
- Inhaled NO is a proven therapy for specific pediatric respiratory conditions.
- Further clinical research is warranted to establish the efficacy of inhaled NO in adult pulmonary hypertension, lung transplantation, and ARDS.
- NO plays a significant role in cardiovascular and inflammatory regulation.