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Inhaled nitrite, often administered as nebulized sodium nitrite (e.g., AIR001), is a pharmaceutical agent primarily investigated for its vasodilatory and anti-proliferative effects, particularly in the pulmonary vasculature. It acts as a prodrug, being converted to nitric oxide (NO) within the body, a process that can be enhanced under hypoxic conditions and is dependent on enzymes such as xanthine oxidoreductase. The generated NO leads to a reduction in pulmonary artery pressure and improved hemodynamics. Additionally, inhaled nitrite has shown to inhibit hypoxia-induced proliferation of pulmonary artery smooth muscle cells, partly via NO-dependent induction of p21(Waf1/Cip1). It has been studied for conditions such as pulmonary hypertension, heart failure with preserved ejection fraction (HFpEF), and pulmonary hypertension associated with thalassemia.
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