Biochemistry and therapeutic potential of hydrogen sulfide - reality or fantasy?

Hydrogen sulfide (H2S) is a signaling gasotransmitter, involved in different physiological and pathological processes. H2S regulates apoptosis, the cell cycle and oxidative stress. H2S exerts powerful effects on smooth muscle cells, endothelial cells, inflammatory cells, endoplasmic reticulum, mitochondria and nuclear transcription factors. H2S is known to be produced from L-cysteine, D-cysteine and L-homocysteine in the body. Four enzymes - cystathionine-b synthase (CBS), mercaptopyruvate sulfurtransferase (3-MST), cystathionine-γ lyase (CSE) and cysteine aminotransferase (CAT) - are involved in H2S synthesis. The biosynthetic pathway for the production of H2S from D-cysteine involves 3-MST and D-amino acid oxidase (DAO). The therapeutic potential of H2S is not clear. However, recently results have demonstrated that H2S has protective action for ischemic heart disease or hypertension, and protects against ischemia of the brain. This review summarizes the negative and the positive roles of H2S in various biological systems, for example the cardiovascular system and nervous system. We also discuss the function of classical, therapeutic and natural (for example garlic) donors of H2S in pre-clinical and clinical studies.