Therapeutic Gases in Biomedicine: Updates on Nitric Oxide and Beyond

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Gaseous mediators are increasingly recognized as critical regulators of human physiology and pathology, offering unique therapeutic opportunities that are fundamentally constrained by challenges in controlled delivery, spatial targeting, and biological specificity when harnessed through advanced delivery technologies. Among them, nitric oxide (NO) has emerged as a central player. Recent advancements have transitioned from conventional donor-based systems with limited control over dose and localization to wearable gas-delivery platforms capable of real-time, patient-specific dosing and frequently coupling with embedded diagnostic functionalities for dynamic feedback and precision control. Importantly, the therapeutic scope of gas biology is expanding beyond NO to encompass other clinically relevant and emerging gases, including O 2 , CO, H 2 S, H 2 , CO 2 , SO 2 , and Xe. These gases exhibit multifaceted biological effects ranging from cytoprotection and vasoregulation to antimicrobial and anti-inflammatory actions, thereby necessitating innovative material-based and bioresponsive delivery strategies that can interface dynamically with biological systems. By critically assessing progress in material platforms, responsive release mechanisms, and multimodal delivery approaches, this review bridges fundamental gas biology with clinically translatable therapeutic design. We further

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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