“…In normal conditions, NOS catalyzes the transformation of arginine, O 2 , and NADPH-derived electrons to NO and citrulline ( Figure 1 ). However, in the presence of pathologic conditions like atherosclerosis and diabetes, the NOS function is altered, and the enzyme catalyzes the reduction of O 2 to superoxide (O 2 − ), a phenomenon that is generally referred to as “NOS uncoupling” [ 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ], and has been linked to a limited bioavailability of tetrahydrobiopterin (BH4, also known as sapropterin) [ 42 , 43 , 44 , 45 , 46 , 47 ]. Indeed, the donation of an electron by BH4 to produce a transient BH4 •+ radical is required for the oxidation of arginine to citrulline and the associated formation of a ferrous iron–NO complex at the NOS heme catalytic center [ 48 , 49 , 50 , 51 ].…”