KIU Publications

Hydrogen sulfide (H₂S) was once considered a toxic environmental pollutant, but scientific thinking has shifted, and it is now recognized as the third endogenous gasotransmitter, alongside nitric oxide and carbon monoxide.1 This transition to a central signaling molecule was catalyzed by the discovery of key endogenous enzymes, cystathionine β-synthase (CBS), cystathionine γ-lyase (CSE), and 3-mercaptopyruvate sulfurtransferase, producing H₂S at physiological concentrations.2 Since then, biomedical research has discovered that H₂S in physiological concentrations within the nanomolar to low micromolar range is a key regulator of vascular tone, mitochondrial respiration, redox balance, and inflammatory response.3 The expanding preclinical evidence base supports the therapeutic potential of H₂S in an expansive range of pathological conditions, e.g., cardiovascular and neurodegenerative diseases, metabolic disorders, and inflammatory disorders.4 However, there is little clinical use of H₂S-based therapy. This perspective presents a concise summary of the recent development in the therapeutic discovery of H₂S, the translational issues, and the tools to progress clinical application, in particular in the era of precision medicine