Hemoglobin (Hb) undergoes a well-documented R[Formula: see text]T quaternary transition from a high [Formula: see text] affinity R state to a low [Formula: see text] affinity T state to optimize [Formula: see text] delivery to tissues. Also, red blood cells (RBCs) release a nitrovasodilator that increases blood flow to boost [Formula: see text] delivery. Hb’s R[Formula: see text]T transition coordinates its [Formula: see text] desaturation and RBC nitrovasodilator release by much-debated mechanisms. Here we investigate the allosterically controlled [Formula: see text]-nitrosation of Hb at its conserved βCys93 (i.e., SNO-Hb formation) for nitrovasodilator release. First, we examined NO[Formula: see text]/deoxyHb (HbFeII) incubations following aeration to mimic RBC NO production by the nitrite reductase activity of HbFeII and trapping of the nascent NO by βCys93 to give SNO-Hb on HbFeII conversion to oxyHb (HbFeO2). We confirmed SNO-Hb formation in the incubations with yields modulated by RBC antioxidant enzymes and [Formula: see text] but not CO. Since FeO2 hemes scavenge free NO, we hypothesized NO channeling within Hb and found by molecular dynamics simulations that most unligated NO molecules placed in the β-distal heme pocket (βDP) rapidly diffuse into a wide β-tunnel connecting the βDP to Hb’s central cavity and βCys93. Contraction of the central cavity brings NO closer to βCys93 in R-state plus βPhe71 and βTyr145 adopt conformations favorable to thiol access and SNO-Hb formation. In T-state, the SNO group is surface-exposed and destabilized to extrude NO. Thus, its structure, dynamics and conserved reactive thiol (βCys93) suggest that the β-subunit evolved to synergize [Formula: see text] and nitrovasoactivity delivery to tissues as a function of Hb [Formula: see text] saturation.
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