Mechanism of NO synthesis Mechanism of NO synthesis. NOS catalyzes a five-electron oxidation of a guanidine nitrogen of L-arginine to generate NO and L-citrulline. L-Hydroxyarginine is formed as an intermediate that is tightly bound to the enzyme. Both steps in the reaction are dependent on calcium and calmodulin and are enhanced by tetrahydrobiopterin. Source: Nitric Oxide Synthases, The Online Metabolic and Molecular Bases of Inherited Disease Citation: Valle D, Beaudet AL, Vogelstein B, Kinzler KW, Antonarakis SE, Ballabio A, Gibson K, Mitchell G. The Online Metabolic and Molecular Bases of Inherited Disease; 2014 Available at: https://ommbid.mhmedical.com/DownloadImage.aspx?image=/data/Books/971/ch168fg3.png&sec=62649586&BookID=971&ChapterSecID=62649552&imagename= Accessed: November 12, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved