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2014 ; 20
(18
): 3040-77
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Tetrahydrobiopterin in cardiovascular health and disease
#MMPMID24294830
Bendall JK
; Douglas G
; McNeill E
; Channon KM
; Crabtree MJ
Antioxid Redox Signal
2014[Jun]; 20
(18
): 3040-77
PMID24294830
show ga
Tetrahydrobiopterin (BH4) functions as a cofactor for several important enzyme
systems, and considerable evidence implicates BH4 as a key regulator of
endothelial nitric oxide synthase (eNOS) in the setting of cardiovascular health
and disease. BH4 bioavailability is determined by a balance of enzymatic de novo
synthesis and recycling, versus degradation in the setting of oxidative stress.
Augmenting vascular BH4 levels by pharmacological supplementation has been shown
in experimental studies to enhance NO bioavailability. However, it has become
more apparent that the role of BH4 in other enzymatic pathways, including other
NOS isoforms and the aromatic amino acid hydroxylases, may have a bearing on
important aspects of vascular homeostasis, inflammation, and cardiac function.
This article reviews the role of BH4 in cardiovascular development and
homeostasis, as well as in pathophysiological processes such as endothelial and
vascular dysfunction, atherosclerosis, inflammation, and cardiac hypertrophy. We
discuss the therapeutic potential of BH4 in cardiovascular disease states and
attempt to address how this modulator of intracellular NO-redox balance may
ultimately provide a powerful new treatment for many cardiovascular diseases.