Effects of inhaled nitric oxide on hypoxic pulmonary vasoconstriction in dogs and a case report of venae cavae syndrome

Emerging Mechanisms of Pulmonary Vasoconstriction in SARS-CoV-2-Induced Acute Respiratory Distress Syndrome (ARDS) and Potential Therapeutic Targets

The 1918 influenza killed approximately 50 million people in a few short years, and now, the world is facing another pandemic. In December 2019, a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused an international outbreak of a respiratory illness termed coronavirus disease 2019 (COVID-19) and rapidly spread to cause the worst pandemic since 1918. Recent clinical reports highlight an atypical presentation of acute respiratory distress syndrome (ARDS) in COVID-19 patients characterized by severe hypoxemia, an imbalance of the renin-angiotensin system, an increase in thrombogenic processes, and a cytokine release storm. These processes not only exacerbate lung injury but can also promote pulmonary vascular remodeling and vasoconstriction, which are hallmarks of pulmonary hypertension (PH). PH is a complication of ARDS that has received little attention; thus, we hypothesize that PH in COVID-19-induced ARDS represents an important target for disease amelioration. The mechanisms that can promote PH following SARS-CoV-2 infection are described. In this review article, we outline emerging mechanisms of pulmonary vascular dysfunction and outline potential treatment options that have been clinically tested.

Nitric oxide: a review for veterinary surgeons

Nitric oxide (NO) is an endogenous gas that serves as a biologic messenger in many physiologic processes including neurotransmission, blood-pressure control, the immune system's ability to kill tumor cells, and wound healing. NO is produced after oxidation of L-arginine by a family of nitric oxide synthase (NOS) enzymes. Two of the NOS enzymes are present continuously and are thereby termed constitutive NOS. One of the enzymes, inducible NOS, is not typically expressed in resting cells and is induced by various substances including endotoxin, some cytokines, and microbial products. Thus, NO often has paradoxical activities. When NO is over- or underproduced, it can result in potentiation of disease states with disastrous results. This review discusses the biochemistry of NO, its functions in normal and disease states, and therapy for modulating NO production in disease states.