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s-Nitrosylated human serum albumin is a chemically modified form of human serum albumin (HSA) in which nitric oxide (NO) is attached to cysteine residues, predominantly Cys-34, as an S-nitrosothiol. This modification enables HSA to function as an endogenous reservoir and slow-release donor of nitric oxide, exerting vasoprotective and cytoprotective effects. It is studied primarily as a pharmacological nitric oxide donor for the treatment or prevention of ischemia–reperfusion (I/R) injury in organs such as the heart, skeletal muscle, and liver. s-Nitrosylated albumin is noted to enhance left ventricular function, reduce oxidative stress, preserve energetic substrates (like phosphocreatine and ATP), diminish tissue damage, and inhibit platelet activation and apoptosis, primarily through replenishing or enhancing local NO bioavailability and stabilizing eNOS function. It is generated by preparation steps that ensure S-nitrosylation at key reactive thiols and has a relatively prolonged half-life for NO delivery compared to low-molecular-weight S-nitrosothiols.
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