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Circulation Research. 2000;86:1184-1186

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(Circulation Research. 2000;86:1184.)
© 2000 American Heart Association, Inc.


Editorials

Carbon Monoxide in Vasoregulation

The Promise and the Challenge

Flavio Coceani

From the Scuola Superiore S. Anna and Istituto di Fisiologia Clinica CNR, Pisa, Italy.

Correspondence to Dr Flavio Coceani, Scuola Superiore S. Anna, Via Carducci 40, 56127 Pisa, Italy. E-mail coceani@sssup.it


Key Words: carbon monoxide • oxygen • vasoregulation • pulmonary hypertension


*    Introduction
 
Less than 10 years have elapsed since the possibility of carbon monoxide (CO) being a novel signaling agent was first discussed.1 In this time, a wealth of data has accrued supporting this idea and providing the foundation for physiological and pathophysiological schemes. Originating from heme through the action of specific oxygenases (heme oxygenase [HO]), which are both inducible (HO-1) and constitutive (HO-2 and HO-3) in character, CO may be formed at rest and, to a greater degree, on exposure to a host of HO-1–directed stimuli (ie, hypoxia, hyperoxia, shear stress, pyrogens, and metals, among the pertinent ones).2 3 It then exerts several effects within and without the vasculature. Blood vessels, in particular, have a complete system for the generation of CO and may dilate under the influence of the agent.4 5 6 Their actual response, however, varies with the vascular bed, and there are also instances of vessels failing unexpectedly to respond. Of relevance here is the recent observation of CO being ineffective on the pulmonary circulation in the fetus7 and hence on a system reproducing well, with a naturally high resistance, the condition of the hypertensive adult. The issue of apparent inconsistencies in CO action is intertwined with questions about the identity of the target for the compound. By analogy with nitric oxide (NO), the guanylate cyclase/cGMP system is commonly, and perhaps too hastily, regarded as the only messenger for CO inside cells, notwithstanding the relatively low affinity of the enzyme for the agent and the reported unresponsiveness of certain vessels. However, . . . [Full Text of this Article]




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