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The NOS3/eNOS (Nitric oxide synthase 3, endothelial) gene product, eNOS, regulates the production of nitric oxide (NO) in endothelial blood vessel cells. The gasotransmitter NO, produced by eNOS, inhibits platelet aggregation, results in relaxation and inhibition of cell proliferation of endothelial smooth muscle, stimulates angiogenesis, acts as an anti-inflammatory, and prevents oxidative damage.

Nitric oxide is a reactive free radical which acts as a biologic mediator in several processes, including neurotransmission, antimicrobial and antitumoral activities. Nitric oxide is synthesized from L-arginine by nitric oxide synthases. Variations in this gene are associated with susceptibility to coronary spasm.

The T allele affects proteolytic cleavage of the enzyme, thereby reducing nitric oxide bioavailability in the blood vessel wall. As a result, it is associated with atherosclerosis, essential hypertension, end-stage renal disease, and preeclampsia.

Increase the intake of omega 3 fatty acids and dietary antioxidant sources. Increase intake of foods such as spinach and beetroot that contain nitrates and are converted naturally in the body to nitric oxide. Avoid all forms of smoke and engage in regular, moderate-intensity, physical activity. Arginine, citrulline, iron, omega3, vitamin Bs, C, and E are all considered important nutrient co-factors to this pathway.