Sudden infant death syndrome and superoxide/nitric oxide.

In a sudden infant death syndrome review Valdès-Dapena describes Naeye's report of increased medial muscle mass in walls of small pulmonary arteries and increased weight of cardiac right ventricles. These findings point to cardiorespiratory insufficiency, a problem in fast growing chicks raised at high altitudes. The vascular epithelium lining all blood vessels synthesises nitric oxide which induces relaxation of smooth muscle in vessel walls, and is possibly an important neurotransmitter. Others demonstrate that nitric oxide is involved in regulating vessel calibre, blood pressure and blood flow, as well as falls in ventricular outputs. Superoxide interacts with nitric oxide and removes it from the circulation. Superoxide is thus a vasoconstrictor. Superoxide is produced by activated phagocytes and possibly lymphocytes and other cell types in the immune response. Elevated immunoglobulins in mucus secretions are a hallmark in sudden infant death syndrome and hypoxic chicks. Our approach therefore is that cardiorespiratory insufficiency may be induced by superoxide in small pulmonary arteries preventing nitric oxide from acting as a muscle relaxant in vascular walls.