Department of Cardiology, The Second Hospital of Lanzhou University, 82 Cuiyingmen Street, Lanzhou, Gansu 730030, China.
Evid Based Complement Alternat Med. 2014;2014:850312. doi: 10.1155/2014/850312. Epub 2014 Dec 4.
Background. Tetrahydrobiopterin (BH4) is a cofactor of nitric oxide synthase (NOS). Nitric oxide (NO) bioavailability is reduced during the early stage of vascular diseases, such as coronary artery disease, hypercholesterolemia, hypertension, and diabetic vasculopathy, and even throughout the entire progression of atherosclerosis. Methods. A literature search was performed using electronic databases (up to January 31, 2014), including MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL), using an established strategy. Results. Fourteen articles were selected with a total of 370 patients. Ten of the fourteen studies showed a significant improvement in the endothelial dysfunction of various cardiovascular disease groups with BH4 supplementation compared with the control groups or placebos. Three studies showed no positive outcome, and one study showed that low-dose BH4 had no effect but that high-dose BH4 did have a significantly different result. Conclusions. This review concludes that supplementation with BH4 and/or augmentation of the endogenous levels of BH4 will be a novel approach to improve the endothelial dysfunction observed in various cardiovascular diseases. BH4 might be considered to be a new therapeutic agent to prevent the initiation and progression of cardiovascular disease.
四氢生物蝶呤（BH4）是一氧化氮合酶（NOS）的辅因子。在血管疾病的早期阶段，如冠心病、高胆固醇血症、高血压和糖尿病血管病变，甚至在动脉粥样硬化的整个进展过程中，一氧化氮（NO）的生物利用度都会降低。
使用电子数据库（截至 2014 年 1 月 31 日），包括 MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库（CENTRAL），按照既定策略进行文献检索。
共纳入 14 篇文章，总计 370 例患者。与对照组或安慰剂相比，14 项研究中的 10 项显示 BH4 补充可显著改善各种心血管疾病患者的内皮功能障碍。3 项研究未显示阳性结果，1 项研究表明低剂量 BH4 无作用，但高剂量 BH4 有显著不同的结果。
本综述得出结论，补充 BH4 和/或增加 BH4 的内源性水平将是改善各种心血管疾病中观察到的内皮功能障碍的一种新方法。BH4 可能被认为是预防心血管疾病发生和进展的一种新的治疗剂。
