Table Of ContentCARBON MONOXIDE
AND
CARDIOVASCULAR
FUNCTIONS
Edited by
Rui Wang, M.D., Ph.D.
CRC PR ESS
Boca Raton London New York Washington, D.C.
© 2002 by CRC Press LLC
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Library of Congress Cataloging-in-Publication Data
Carbon monoxide and cardiovascular functions / Rui Wang, editor.
p. ; cm.
Includes bibliographical references and index.
ISBN 0-8493-1041-5 (alk. paper)
1. Cardiovascular system--Physiology. 2. Carbon monoxide--Physiological effect. I.
Wang, Rui, M.D.
[DNLM: 1. Cardiovascular Physiology--Congresses. 2. Carbon
Monoxide--metabolism--Congresses. WG 102 C264 2001]
QP101 .C28 2001
612.1--dc21
2001037767
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Dedications
To my parents, Chunmin Wang and Zhenyuan Li
To my wife, Lingyun Wu, and my daughters, Jennifer Wang and Jessica Wang
Also to the Magnificent Five:
Guangnan Wen, my supervisor of M.Sc. study, a Doctor of Never Give Up
Peter K. Pang, my supervisor of Ph.D. study, a Doctor of Energy
Ed Karpinski, my co-supervisor of Ph.D. study, a Doctor of Good Fellas
Jacques de Champlain, my supervisor of post-doctoral study, a Doctor of
Doctors
Remy Sauvé, my co-supervisor of post-doctoral study, a Doctor of
Finding the Needle in the Haystack
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Preface
Carbon monoxide (CO) assumed its “silent killer” image as early as the 17th century
and this image remains in the 21st century. For the most part, this conception arises
because: (1) CO is produced by the incomplete combustion of organic materials
including the most abundant air pollutants; (2) it is the most extensively studied and
the best understood component of either mainstream or side-stream cigarette smoke;
and (3) environmental exposure to CO is consistently associated with life-threatening
hypoxic intoxication.
The first indication of a vascular effect of CO was provided by Duke and Killick
(1952), who showed a decrease in pulmonary vascular resistance in the presence of
CO. It was, however, not recognized until the early 1990s that CO-induced vasore-
laxation might play a physiological role. The last ten years witnessed an astonishing
surge of discoveries and re-discoveries of the physiological effects of CO. The
cardiovascular effects of CO have been systematically mapped for the heart and the
various vascular components. Heme oxygenases, which cleave the heme rings to
form biliverdin and CO, have been located in the cardiovascular system and cloned.
The endogenous production and induction of CO from the cardiovascular system
have been documented. Advancements in the pharmacology of CO have provided
an array of drugs that modulate CO metabolism. The altered functions and metab-
olism of CO have been related to many cardiovascular diseases. Thus, the status of
CO has been transformed from a purely toxic gas to a dual-function compound
involved in the homeostatic control of cardiovascular functions.
What makes the resurgence of interest in CO possible are the continuous
advances in chemistry, biochemistry, biology, molecular biology, physiology, and
electrophysiology. These advances demanded an arena to bring together the expertise
of all these basic disciplines to enable practitioners to keep up with the explosive
developments in this field. To meet the challenge, in December of 1998 an interna-
tional symposium entitled “Carbon Monoxide and Cardiovascular Function” brought
together a panel of distinguished scientists to exchange thoughts and generate new
ideas about the cardiovascular effects of CO. Interestingly, this important event later
took center stage at the Fifth Internet World Congress for Biomedical Sciences. The
enthusiastic responses received from far and beyond after this virtual symposium
encouraged me to take the mandate to use another medium to disseminate this
important information. This book on the biological effects of CO on the cardiovas-
cular system, the first of its kind, was thus produced. This idea was further encour-
aged by the First International Symposium on Heme Oxygenase held in July of
2000, which once again highlighted the physiological and pathophysiological impor-
tance of the cardiovascular effects of CO.
This book is the product of the collected wisdom of many respected scientists
around the world. Concise up-to-date reviews of the fundamentals of the biological
© 2002 by CRC Press LLC
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actions of CO on the cardiovascular system include all the most recent developments,
scientific controversies, and future directions. The comprehensive coverage is main-
tained throughout the book without minimizing the complexity of the subject. To
broaden our understanding of the biological roles of CO, a number of disorders in
which the cardiovascular effects of CO are suspected to have been altered, including
hypertension, diabetes, inflammation, and ischemic heart damage are addressed. This
book also combines cutting-edge explanations of the mechanisms of CO actions with
practical approaches to study the biological roles of CO under different conditions.
We may argue that earlier studies on the biological effects of CO were incomplete
and oversimplified, but we cannot deny that today’s understanding of the novel
cardiovascular actions of CO has developed from the zigzag path of trial and error.
Only time will tell whether what we know today about CO will still be valid or
require modification. In this context, the progress reported in this book should be
viewed as the beginning rather than the end of the exploration of the cardiovascular
effects of CO.
Rui Wang, M.D., Ph.D.
© 2002 by CRC Press LLC
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Editor
Rui Wang, M.D., Ph.D., is a professor of physiology at the University of
Saskatchewan, Canada. He graduated in 1982 from Weifang Medical College and
completed his M.Sc. graduate study in 1984 at the Fourth Military Medical Univer-
sity, both in the People’s Republic of China. In 1990, Dr. Wang obtained his Ph.D.
with distinction from the University of Alberta, Canada. Thereafter, he pursued post-
doctoral training at the Marine Biology Laboratory of the Woods Hole Oceano-
graphic Institution in the U.S. and at the University of Montreal, Canada. He served
as a faculty member at the University of Montreal from 1993 to 1997.
Dr. Wang is an expert on ion channel regulation of vascular smooth muscle
functions. His research interests encompass hypertension and cardiovascular com-
plications of diabetes. In recent years, Dr. Wang focused his investigations on the
physiological roles of endogenous vasoactive gaseous molecules, including carbon
monoxide, hydrogen sulfide, and nitric oxide. He organized the First International
Internet Symposium entitled “Carbon Monoxide and Cardiovascular Function” in
1998. He has published more than 60 peer-reviewed articles, reviews, and book
chapters covering many areas of health sciences and biology. Dr. Wang’s academic
achievements have been recognized internationally. Among the impressive honors
and awards he has received is the Canadian Institutes of Health Research Scientist
Award (2000–2005). He was named McDonald Scholar by the Heart and Stroke
Foundation of Canada (1994–1999). He also received the Young Investigator Award
of the Canadian Cardiovascular Society (1995) and the Stevenson Visiting Profes-
sorship of the Canadian Physiology Society (1996).
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Contributors
Nader G. Abraham, Ph.D. Roberta Foresti, Ph.D.
Department of Pharmacology Department of Surgical Research
New York Medical College Northwich Park Institute for Medical
Valhalla, New York Research
Harrow, Middlesex, England
James F. Brien, Ph.D.
Department of Pharmacology and Colin J. Green, M.D.
Toxicology Department of Surgical Research
Queen’s University Northwich Park Institute for Medical
Kingston, Ontario, Canada Research
Harrow, Middlesex, England
Kun Cao, M.D., Ph.D.
Department of Physiology Fruzsina K. Johnson, M.D.
University of Saskatchewan, Department of Physiology
Saskatoon, Saskatchewan, Canada Tulane University Medical Center
School of Medicine
Dipak K. Das, Ph.D. New Orleans, Louisiana
Cardiovascular Research Center
University of Connecticut School of Robert A. Johnson, Ph.D.
Medicine Department of Physiology
Farmington, Connecticut Tulane University Medical Center
School of Medicine
Phyllis A. Dennery, M.D. New Orleans, Louisiana
Division of Neonatal and Developmental
Medicine Attallah Kappas, Ph.D.
Stanford University School of Medicine Department of Pharmacology
Palo Alto, California Gene Therapy Program
New York Medical College
William Durante, Ph.D. Valhalla, New York
Department of Medicine and
Pharmacology A. Kawashima, M.D.
Houston VA Medical Center Department of Pediatrics
Baylor College of Medicine Kanazawa University
Houston, Texas Kanazawa, Japan
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S. Koizumi, M.D. Kanji Nakatsu, Ph.D.
Department of Pediatrics Department of Pharmacology and
Kanazawa University Toxicology
Kanazawa, Japan Queen’s University
Kingston, Ontario, Canada
Pier Francesco Mannanoni, M.D.
Department of Preclinical and Clinical Joseph Fomusi Ndisang, Ph.D.
Pharmacology Department of Physiology
University of Florence University of Saskatchewan
Florence, Italy Saskatoon, Saskatchewan, Canada
Gerald S. Marks, Ph.D.
K. Ohta, M.D.
Department of Pharmacology and
Department of Pediatrics
Toxicology
Kanazawa University
Queen’s University
Kanazawa, Japan
Kingston, Ontario, Canada
Shuo Quan, M.D., Ph.D.
Emanuela Masini, M.D.
Department of Pharmacology
Department of Preclinical and Clinical
New York Medical College
Pharmacology
Valhalla, New York
University of Florence
Florence Italy
Y. Saikawa, M.D.
Department of Pediatrics
Nilanjana Maulik, Ph.D.
Kanazawa University
Center for Cardiovascular Research
Kanazawa, Japan
University of Connecticut School of
Medicine
Farmington, Connecticut Sylvia Shenouda, Ph.D.
Department of Pharmacology
Brian E. McLaughlin, Ph.D. Gene Therapy Program
Department of Pharmacology and New York Medical College
Toxicology Valhalla, New York
Queen’s University
Kingston, Ontario, Canada David K. Stevenson, M.D.
Department of Pediatrics
Roberto Motterlini, M.D. Neonatal and Developmental
Department of Surgical Research Medicine
Northwich Park Institute for Medical Stanford University School
Research of Medicine
Harrow, Middlesex, England Stanford, California
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Hendrik J. Vreman, Ph.D. Lingyun Wu, M.D., Ph.D.
Department of Pediatrics Department of Anatomy and Cell
Neonatal and Developmental Medicine Biology
Stanford University School of Medicine University of Saskatchewan
Stanford, California Saskatoon, Saskatchewan, Canada
Rui Wang, M.D., Ph.D.
Akihiro Yachie, M.D.
Department of Physiology
Department of Laboratory
College of Medicine
Sciences
University of Saskatchewan
Kanazawa University
Saskatoon, Saskatchewan, Canada
Kanazawa, Japan
Ronald J. Wong, M.Sc.
Department of Pediatrics Weimin Zhao, M.D., Ph.D.
Neonatal and Developmental Medicine Department of Physiology
Stanford University School of Medicine University of Saskatchewan
Stanford, California Saskatoon, Saskatchewan, Canada
© 2002 by CRC Press LLC
Description:Akin to nitric oxide, carbon monoxide (CO) was initially viewed as a pure toxic gas, yet it has been recently demonstrated to be an important endogenous molecule of gas that has profound physiological and pathophysiological effects on the cardiovascular system. In spite of the growing understanding