Vanhoutte · Circulation research 2016 · narrative review · n=?

Thirty Years of Saying NO: Sources, Fate, Actions, and Misfortunes of the Endothelium-Derived Vasodilator Mediator.

Cited 391 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review of biological mechanisms without systematic search methodology or new empirical human data.

PubMed 27390338 · doi:10.1161/CIRCRESAHA.116.306531 · record verified 2026-08-29

What was done

This narrative review summarizes 30 years of research regarding the synthesis, regulation, downstream targets, and pathophysiological degradation of endothelial nitric oxide (NO), focusing on endothelial NO synthase (eNOS) signaling, causes of endothelial dysfunction, and potential therapeutic targets.

What was found

The abstract presents a mechanistic overview without quantitative data or statistical effect estimates. It outlines that eNOS activity is regulated by calcium, post-translational modifications, circulating agonists, autacoids, and shear stress, acting primarily via soluble guanylyl cyclase to produce cGMP. Mechanisms driving NO dysfunction in aging, obesity, diabetes, and hypertension include oxidative stress from reactive oxygen species, elevated asymmetrical dimethylarginine, substrate and cofactor depletion, mineralocorticoid receptor stimulation, and Rho-kinase activation. Interventions that support eNOS function include estrogen maintenance, adiponectin upregulation, and SIRT1 induction.

Why it matters

Understanding the multi-factorial biochemical mechanisms causing eNOS uncoupling and NO destruction helps identify therapeutic targets to restore endothelial vasodilation and mitigate early atherosclerotic progression.

Limits

As a narrative review, the paper does not use systematic literature search methods or quantitative meta-analytic pooling. The abstract provides purely qualitative mechanistic descriptions with no human clinical trial outcomes, sample sizes, or numerical effect sizes reported.

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