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In the vasculature, nitric oxide (NO) is produced from the endothelium mainly by endothelial NO synthase (eNOS), which is activated by agonists such as bradykinin and acetylcholine or by shear stress produced by the flowing blood. NO is a potent vasodilator and protects blood vessels from thrombosis by inhibiting platelet aggregation and adhesion. In addition, endothelial NO possesses multiple anti-atherosclerotic properties, which include (i) prevention of leukocyte adhesion to the vascular endothelium and leukocyte migration into the vascular wall; (ii) decreased endothelial permeability, reduced influx of lipoproteins into the vascular wall and inhibition of low density lipoprotein (LDL) oxidation; and (iii) inhibition of DNA synthesis, mitogenesis, and proliferation of vascular smooth muscle cells [1, 2]. Recent studies suggest that eNOS is also involved in mitochondrial biogenesis, anti-aging effects and extension of lifespan in mammals [3, 4]. Based on the abovementioned protective effects of eNOS-derived NO, a pharmacological enhancement of NO production is of therapeutic interest. Indeed, numerous Chinese medicinal plants, herbal preparations, or isolated compounds thereof have been shown to stimulate endothelial NO production, which is likely to be a contributing mechanism for their therapeutic effects.

Effects of Vasoactive Chinese Herbs on the Endothelial NO System