Nitric oxide and regulators of its synthesis in chronic obstructive pulmonary disease

The clinical picture and long-term prognosis of chronic obstructive pulmonary disease (COPD) largely depend on comorbid conditions, thereby prompting a relevant search for predictive and preventive methods in the pathogenesis of the disease. Cardiovascular diseases are highly prevalent among patients with COPD. Cardiovascular risks in patients with COPD are associated with changes in the activity of vasoactive mediators, with nitric oxide (NO) being the most important. The important role of nitric oxide in the body prompts it being studied as a biomarker of many diseases; however, its short half-life and rapid clearance prevent its direct assessment in the blood. In the body, nitric oxide is formed from L-arginine with the help of enzymes of NO-synthase group. NO oxide synthesis depends on the concentration of L-arginine, arginase and asymmetric dimethylarginine (inhibitory effect on NO-synthase). The presented literature review highlights modern views on the importance of nitric oxide and regulators of its synthesis in the pathogenesis of chronic obstructive pulmonary disease. It also indicates their role in the formation of comorbid conditions, and highlights processes of NO formation in the body. CONCLUSION: The components of the nitric oxide system (nitric oxide metabolites, L-arginine, arginase, dimethylarginine dimethylaminohydrolase, asymmetric and symmetric dimethylarginine) can be considered as potential biomarkers of COPD, especially in conditions of cardiovascular comorbidity. Further studies on the nitric oxide system are recommended for assessing the prognosis of the course of diseases and the effectiveness of the current therapy.