H 2 S, the most recently discovered gasotransmitter, might in fact be the evolutionary matriarch of this family, being both ancient and highly reduced. Disruption of ␥-cystathionase in mice leads to cardiovascular dysfunction and marked hypertension, suggesting a key role for this enzyme in H 2 S production in the vasculature. However, patients with inherited deficiency in ␥-cystathionase apparently do not present vascular pathology. A mitochondrial pathway disposes sulfide and couples it to oxidative phosphorylation while also exposing cytochrome c oxidase to this metabolic poison. This report focuses on the biochemistry of H 2 S biogenesis and clearance, on the molecular mechanisms of its action, and on its varied biological effects.Sulfur cycles through several biologically relevant oxidation states ranging from Ϫ2 as in hydrogen and metal sulfides to ϩ6 in sulfate. H 2 S, a colorless gas with the odor of rotten eggs, is important in the biogeochemical sulfur cycle and is used as an energy source by microbes such as the purple and green sulfur bacteria. It is a weak acid with pK a1 and pK a2 of 6.9 and Ͼ12 (1) and an aqueous solubility of ϳ80 mM at 37°C. Hence, at the physiological pH of 7.4, the ratio of HS Ϫ :H 2 S is 3:1. For brevity, H 2 S is used to refer to the total free sulfide pool (i.e. H 2 S ϩ HS Ϫ ϩ S 2Ϫ ) in this report unless noted otherwise. The ready ionization of H 2 S at physiological pH suggests impeded permeation through the lipid bilayer when compared with other gases, viz. NO or CO. On the other hand, transport of the gas, H 2 S, across the membrane does not appear to be facilitated (2).The toxicity of H 2 S is thought to have influenced evolution. The presence of a metastable H 2 S-enriched oceanic stratum is postulated to have limited early metazoan colonization of the continental shelf (3), and an increase in H 2 S has been implicated in the Permian-Triassic extinction Ͼ250 million years ago (4). However, the reputation of H 2 S as a toxic gas is enjoying a facelift, with increasing numbers of reports that it modulates a range of biological processes. Despite the rising interest in H 2 S biochemistry, fundamental questions regarding regulation of its production, its mechanism of action, and its destruction remain. In addition, perhaps most critical to the field is the issue of what constitutes biologically relevant levels of H 2 S with reports varying over a 10 5 -fold concentration range. Using a gas chromatography-based chemiluminescent sulfur detection method, free H 2 S (H 2 S ϩ HS Ϫ ) in blood was estimated to be ϳ100 pM, and in tissues, it was estimated to be ϳ15 nM (5). These values are considerably lower than the ϳ30 -300 M concentrations reported in a spate of recent studies (reviewed in Ref. 6). The high values can be ascribed to technical artifacts introduced by long processing times and harsh (either acidic or alkaline) conditions used to shift the equilibrium toward H 2 S or S 2Ϫ , respectively. Under these conditions, sulfide leaches from iron-sulfur cluster-containing p...