Physiological concentrations of
nitric oxide (NO) and
carbon monoxide (CO) have multiple protective effects in the cardiovascular system. Recent studies have implicated
hydrogen sulfide (H2S) as a new member of vasculoprotective
gasotransmitter family, behaving similarly to NO and CO. H2S has been demonstrated to inhibit multiple key aspects of
atherosclerosis, including atherogenic modification of
LDL, monocytes adhesion to the endothelial cells, macrophage-derived foam cell formation and
inflammation, smooth muscle cell proliferation, neointimal
hyperplasia,
vascular calcification, and thrombogenesis. H2S also decreases plasma
homocysteine levels in experimental animal models. In the human body, H2S production is predominantly catalyzed by
cystathionine-β-synthase (CBS) and
cystathionine γ-
lyase (CSE). CSE is the primary H2S-producing
enzyme in the vasculature. Growing evidence suggests that
atherosclerosis is associated with vascular CSE/H2S deficiency and that H2S supplementation by exogenous H2S donors (such as
NaHS and
GYY4137) attenuates, and H2S synthesis suppression by inhibitors (such as D, L-
propargylglycine) aggravates the development of
atherosclerotic plaques. However, it remains elusive whether CSE deficiency plays a causative role in
atherosclerosis. A recent study (Circulation. 2013; 127: 2523-2534) demonstrates that decreased endogenous H2S production by CSE genetic deletion accelerates
atherosclerosis in athero-prone
ApoE-/- mice, pinpointing that endogenously produced H2S by CSE activation may be of benefit in the prevention and treatment of
atherosclerosis. This study will facilitate the development of H2S-based
pharmaceuticals with therapeutic applications in
atherosclerosis-related
cardiovascular diseases.