Academic & Clinical Publications on Nitric Oxide

The Nobel Prize in Physiology or Medicine was awarded in 1998 to Robert F. Furchgott, Ferid Murad, MD, and Louis J. Ignarro for the discovery of Nitric oxide as a signal molecule. The official press release can be found here: Nobel Prize. This article provides the following highlights: 

"Heart: In atherosclerosis, the endothelium has a reduced capacity to produce NO. However, NO can be furnished by treatment with nitroglycerin. Large efforts in drug discovery are currently aimed at generating more powerful and selective cardiac drugs based on the new knowledge of NO as a signal molecule.

Shock: Bacterial infections can lead to sepsis and circulatory shock. In this situation, NO plays a harmful role. White blood cells react to bacterial products by releasing enormous amounts of NO that dilate the blood vessels. The blood pressure drops and the patient may become unconscious. In this situation, inhibitors of NO synthesis may be useful in intensive care treatment.

Lungs: Intensive care patients can be treated by inhalation of NO gas. This has provided good results and even saved lives. For instance, NO gas has been used to reduce dangerously high blood pressure in the lungs of infants. But the dosage is critical since the gas can be toxic at high concentrations.

Cancer: White blood cells use NO not only to kill infectious agents such as bacteria, fungi and parasites, but also to defend the host against tumours. Scientists are currently testing whether NO can be used to stop the growth of tumours since this gas can induce programmed cell death, apoptosis.

Impotence: NO can initiate erection of the penis by dilating the blood vessels to the erectile bodies. This knowledge has already led to the development of new drugs against impotence.

Diagnostic analyses: Inflammatory diseases can be revealed by analysing the production of NO from e.g. lungs and intestines. This is used for diagnosing asthma, colitis, and other diseases.

NO is important for the olfactory sense and our capacity to recognise different scents. It may even be important for our memory."

The British Journal of Clinical Pharmacology published a text titled "Vascular effects of dietary nitrate (as found in green leafy vegetables and beetroot) via the nitrate-nitrite-nitric oxide pathway." The abstract is provided below:

"The discovery that dietary (inorganic) nitrate has important vascular effects came from the relatively recent realization of the 'nitrate-nitrite-nitric oxide (NO) pathway'. Dietary nitrate has been demonstrated to have a range of beneficial vascular effects, including reducing blood pressure, inhibiting platelet aggregation, preserving or improving endothelial dysfunction, enhancing exercise performance in healthy individuals and patients with peripheral arterial disease. Pre-clinical studies with nitrate or nitrite also show the potential to protect against ischaemia-reperfusion injury and reduce arterial stiffness, inflammation and intimal thickness. However, there is a need for good evidence for hard endpoints beyond epidemiological studies. Whilst these suggest reduction in cardiovascular risk with diets high in nitrate-rich vegetables (such as a Mediterranean diet), others have suggested possible small positive and negative associations with dietary nitrate and cancer, but these remain unproven. Interactions with other nutrients, such as vitamin C, polyphenols and fatty acids may enhance or inhibit these effects. In order to provide simple guidance on nitrate intake from different vegetables, we have developed the Nitrate 'Veg-Table' with 'Nitrate Units' [each unit being 1 mmol of nitrate (62 mg)] to achieve a nitrate intake that is likely to be sufficient to derive benefit, but also to minimize the risk of potential side effects from excessive ingestion, given the current available evidence. The lack of data concerning the long term effects of dietary nitrate is a limitation, and this will need to be addressed in future trials."

A publication in Cardiovascular Research, Volume 89, Issue 3, 15 Februrary 2011, Pages 525-532 can be found here: Roles of dietary inorganic nitrate in cardiovascular health and disease. The abstract can be found below:

Inorganic nitrate from dietary and endogenous sources is emerging as a substrate for in vivo generation of nitric oxide (NO) and other reactive nitrogen oxides. Dietary amounts of nitrate clearly have robust NO-like effects in humans, including blood pressure reduction, inhibition of platelet aggregation, and vasoprotective activity. In animal models, nitrate protects against ischaemia–reperfusion injuries and several other types of cardiovascular disorders. In addition, nitrate most surprisingly decreases whole body oxygen cost during exercise with preserved or even enhanced maximal performance. Oxidative stress and reduced NO bioavailability are critically linked to development of hypertension and other forms of cardiovascular diseases. Mechanistically, a central target for the effects of nitrate and its reaction products seems to be the mitochondrion and modulation of oxidative stress. All in vivo effects of nitrate are achievable with amounts corresponding to a rich intake of vegetables, which are particularly rich in this anion. A theory is now emerging suggesting nitrate as an active component in vegetables contributing to the beneficial health effects of this food group, including protection against cardiovascular disease and type-2 diabetes.

A publication in Science News from November 2, 2010 out of Wake Forest University can be found here: Daily dose of beet juice promotes brain health in older adults. A summary can be found below:

Researchers for the first time have shown that drinking beet juice can increase blood flow to the brain in older adults -- a finding that could hold great potential for combating the progression of dementia.

WebMD published the following article: The Truth About Beet Juice. This article highlights the following:

"Beet juice may boost stamina to help you exercise longer, improve bloodflow, and help lower blood pressure, some research shows...

One cup of raw beets has 58 calories and 13 grams of carbohydrates. A cup of beet juice is usually around 100 calories and 25 grams of carbohydrates, because of the way it is processed."

The CDC highights heart disease Facts here: Heart Disease in the United States.

"About 610,000 people die of heart disease in the United States every year - that's 1 in ever 4 deaths....Every year about 735,000 Americans have a heart attack."

Furthermore, high blood pressure facts can be found here: High Blood Pressure. The CDC highlights:

"About 1 of 3 U.S. adults-or about 75 million people- have high blood pressure. Only about half (54%) of these people have their high blood pressure under control."

Here are some helpful links to the CDC's resources:

Preventing High Blood Pressure: Health Living Habits

Preventing High Blood Pressure: Other Medical Conditions

Controlling Blood Pressure