The role of nuclear factor kappa B and nitric oxide interaction in heart remodelling

Hypertrophy of the myocardium is induced by haemodynamic and humoral alterations, which in turn stimulate the production of factors triggering protein synthesis, thus initiating myocardial growth. It has recently been documented that nuclear factor kappa B (NF-kappaB) represents a key factor that mediates both neurohormonal and proinflammatory signals leading finally to hypertrophic and/or fibrotic processes in the cardiovascular system. It was suggested that blockade of NF-kappaB may exert a protective effect against pathological myocardial growth. Recent data indicate that increased activity of NF-kappaB, besides its deleterious effects, leads to the increased production of nitric oxide, which as a result of its hypotensive and antigrowth activity exerts protection against the hypertrophic and proliferative processes. This ambivalent nature of NF-kappaB might limit the use of NF-kappaB inhibitors for therapeutic purposes and should evoke further studies to clarify unequivocally the nature of NF-kappaB inhibition in the haemodynamically overloaded circulation.