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Year : 1998  |  Volume : 30  |  Issue : 6  |  Page : 351-366

Nitric oxide: concepts, current perspectives and future therapeutic implications

Correspondence Address:
Chandran Sajeev

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Source of Support: None, Conflict of Interest: None

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Nitric oxide (NO) in the last decade has witnessed rapid metamorphism from being a dreaded environmental pollutant to a fundamental physiological mediator and effector. The biological activity of endothelium derived relaxing factor was attributed to NO and this led to the understanding of various physiological processes in which NO is implicated. NO is synthesized endogenously by the enzymes Nitric Oxide Synthase (NOS) in specialized tissues from its precursor L-arginine. It is released by constitutive and inducible modes and elicits its action as a neurotransmitter, physiological regulator and in host defence. NO mediates an active state of vasodilation, memory, neuroprotection, peristalsis, penile erection, immune defence and various endocrine & exocrine secretions. However excess of NO production can lead to endothelial dysfunction, platelet aggregation, atherosclerosis, reperfusion injury, septic shock, glomerular nephritis, neurodegeneration and mutagenesis. In disease conditions associated with hypoactive L-arginine/NO system and hyperactive L-arginine/NO system, NO donors and NOS inhibitors have significant therapeutic potential respectively. The future lies in the design of NO donors that lack the propensity to tolerance development and do not need cellular metabolic pathways for the release of NO. Also development of selective inhibitors of NOS would facilitate treatment in case of hyperactive L-arginine/NO pathway. This review describes the recent conceptual aspects of this new therapeutic entity and its clinical relevance.


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