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Calvani R, Gervasoni J, Picca A, Ciciarello F, Galluzzo V, Coelho-Júnior HJ, Di Mario C, Gremese E, Lomuscio S, Paglionico AM, Santucci L, Tolusso B, Urbani A, Marini F, Marzetti E, Landi F, Tosato M. Effects of l-Arginine Plus Vitamin C Supplementation on l-Arginine Metabolism in Adults with Long COVID: Secondary Analysis of a Randomized Clinical Trial. Int J Mol Sci 2023; 24:ijms24065078. [PMID: 36982151 PMCID: PMC10049539 DOI: 10.3390/ijms24065078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/28/2023] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
Altered l-arginine metabolism has been described in patients with COVID-19 and has been associated with immune and vascular dysfunction. In the present investigation, we determined the serum concentrations of l-arginine, citrulline, ornithine, monomethyl-l-arginine (MMA), and symmetric and asymmetric dimethylarginine (SDMA, ADMA) in adults with long COVID at baseline and after 28-days of l-arginine plus vitamin C or placebo supplementation enrolled in a randomized clinical trial, compared with a group of adults without previous history of SARS-CoV-2-infection. l-arginine-derived markers of nitric oxide (NO) bioavailability (i.e., l-arginine/ADMA, l-arginine/citrulline+ornithine, and l-arginine/ornithine) were also assayed. Partial least squares discriminant analysis (PLS–DA) models were built to characterize systemic l-arginine metabolism and assess the effects of the supplementation. PLS–DA allowed discrimination of participants with long COVID from healthy controls with 80.2 ± 3.0% accuracy. Lower markers of NO bioavailability were found in participants with long COVID. After 28 days of l-arginine plus vitamin C supplementation, serum l-arginine concentrations and l-arginine/ADMA increased significantly compared with placebo. This supplement may therefore be proposed as a remedy to increase NO bioavailability in people with long COVID.
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Affiliation(s)
- Riccardo Calvani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Correspondence: ; Tel.: +39-(06)-3015-5559
| | - Jacopo Gervasoni
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Department of Medicine and Surgery, LUM University, 70010 Casamassima, Italy
| | | | - Vincenzo Galluzzo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Hélio José Coelho-Júnior
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Clara Di Mario
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Elisa Gremese
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Sara Lomuscio
- Metabolomics Research Core Facility, Gemelli Science and Technology Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | | | - Lavinia Santucci
- Metabolomics Research Core Facility, Gemelli Science and Technology Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Barbara Tolusso
- Immunology Core Facility, Gemelli Science Technological Park (GSTeP), Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
| | - Andrea Urbani
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Federico Marini
- Department of Chemistry, Sapienza University of Rome, 00185 Rome, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Francesco Landi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
- Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Matteo Tosato
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
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Guo X, Xing Y, Jin W. Role of ADMA in the pathogenesis of microvascular complications in type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14:1183586. [PMID: 37152974 PMCID: PMC10160678 DOI: 10.3389/fendo.2023.1183586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/11/2023] [Indexed: 05/09/2023] Open
Abstract
Diabetic microangiopathy is a typical and severe problem in diabetics, including diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, and diabetic cardiomyopathy. Patients with type 2 diabetes and diabetic microvascular complications have significantly elevated levels of Asymmetric dimethylarginine (ADMA), which is an endogenous inhibitor of nitric oxide synthase (NOS). ADMA facilitates the occurrence and progression of microvascular complications in type 2 diabetes through its effects on endothelial cell function, oxidative stress damage, inflammation, and fibrosis. This paper reviews the association between ADMA and microvascular complications of diabetes and elucidates the underlying mechanisms by which ADMA contributes to these complications. It provides a new idea and method for the prevention and treatment of microvascular complications in type 2 diabetes.
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Affiliation(s)
| | | | - Wei Jin
- *Correspondence: Yiqiao Xing, ; Wei Jin,
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Top WMC, Lehert P, Schalkwijk CG, Stehouwer CDA, Kooy A. Effect of metformin on arginine and dimethylarginines in patients with advanced type 2 diabetes: A post hoc analysis of a randomized trial. Diabetes Obes Metab 2022; 24:1983-1988. [PMID: 35789192 DOI: 10.1111/dom.14784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/25/2022] [Accepted: 06/06/2022] [Indexed: 11/28/2022]
Abstract
AIM To study the effect of metformin on plasma levels of arginine, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), indicators of the nitric oxide pathway. MATERIALS AND METHODS In this post hoc analysis of the HOME trial, we analysed plasma levels of arginine, ADMA and SDMA during the 4.3-year follow-up (comparing the effects of metformin versus placebo on top of insulin therapy). Statistical analysis was performed with a mixed model approach, in which simultaneously constant treatment effects were estimated, as well as time-dependent treatment effects. RESULTS We found that metformin compared with placebo did not affect ADMA or SDMA plasma levels but rapidly decreased arginine plasma levels and hence the arginine to ADMA ratio. The constant treatment effect on ADMA was 0.99 (95% CI 0.97, 1.00) relative to placebo and the time-dependent treatment effect was 1.00 (95% CI 1.00, 1.01). By contrast, the constant treatment effect on arginine was 0.86 (95% CI 0.84, 0.88), with only a minimal time-dependent change of 1.01 (95% CI 1.00, 1.01). CONCLUSIONS The potential benefits of metformin on endothelial function cannot be explained by a decrease in ADMA or by improved global arginine availability. The clinical significance of the decreased arginine plasma levels is not clear and can be harmful or beneficial, depending on the mechanism involved. However, a potential effect of metformin on the nitric oxide pathway is not restricted to the studied metabolites.
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Affiliation(s)
- Wiebe M C Top
- Department of Internal Medicine, Treant Care Group, Hoogeveen, The Netherlands
- Bethesda Diabetes Research Center, Hoogeveen, The Netherlands
| | - Philippe Lehert
- Department of Statistics, Faculty of Economics, Facultés Universitaires Catholiques de Mons, Louvain Academy, Mons, Belgium
| | - Casper G Schalkwijk
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Adriaan Kooy
- Department of Internal Medicine, Treant Care Group, Hoogeveen, The Netherlands
- Bethesda Diabetes Research Center, Hoogeveen, The Netherlands
- Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
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The Role of Amino Acids in Endothelial Biology and Function. Cells 2022; 11:cells11081372. [PMID: 35456051 PMCID: PMC9030017 DOI: 10.3390/cells11081372] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/08/2022] [Accepted: 04/16/2022] [Indexed: 12/20/2022] Open
Abstract
The vascular endothelium acts as an important component of the vascular system. It is a barrier between the blood and vessel wall. It plays an important role in regulating blood vessel tone, permeability, angiogenesis, and platelet functions. Several studies have shown that amino acids (AA) are key regulators in maintaining vascular homeostasis by modulating endothelial cell (EC) proliferation, migration, survival, and function. This review summarizes the metabolic and signaling pathways of AAs in ECs and discusses the importance of AA homeostasis in the functioning of ECs and vascular homeostasis. It also discusses the challenges in understanding the role of AA in the development of cardiovascular pathophysiology and possible directions for future research.
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Ertelt A, Stumpff F, Merle R, Kuban S, Bollinger L, Liertz S, Gehlen H. Asymmetric dimethylarginine-A potential cardiac biomarker in horses. J Vet Cardiol 2020; 33:43-51. [PMID: 33360109 DOI: 10.1016/j.jvc.2020.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 11/06/2020] [Accepted: 11/17/2020] [Indexed: 12/22/2022]
Abstract
INTRODUCTION/OBJECTIVES Asymmetric dimethylarginine (ADMA) is a cardiac biomarker in humans, symmetric dimethylarginine (SDMA) a renal biomarker in humans, cats, and dogs. The purpose of this prospective study was to investigate if measuring serum ADMA and SDMA concentrations via ELISA allows detection of cardiac disease in horses in a routine laboratory setting. In this context, reference values in horses were established. ANIMALS, MATERIALS, AND METHODS Seventy-eight horses with no known medical history were compared to 23 horses with confirmed structural cardiac disease with/or without arrhythmias. Horses underwent physical examination, electrocardiography, echocardiography and venous blood sampling and were staged based on the severity of cardiac disease from 0 to II. Asymmetric dimethylarginine and SDMA were measured via ELISA and crosschecked using liquid chromatograph triple quadrupole mass spectrometry. Reference intervals with 90th percent confidence intervals were evaluated and standard software was used to test for significant differences in ADMA, SDMA, and the l-arginine/ADMA ratio between groups. RESULTS The reference ranges were 1.7-3.8 μmol/L and 0.3-0.8 μmol/L for ADMA and SDMA, respectively. Serum ADMA was higher in horses with heart disease compared to healthy horses (p < 0.01) and highest in horses with stage II heart disease (p = 0.02). The l-Arginine/ADMA ratio was significantly higher in healthy animals than those with cardiac disease (p = 0.001). CONCLUSIONS Reference values for serum ADMA and SDMA using ELISA methods are presented in horses. This study confirms the association between heart disease and increased serum ADMA concentration as well as a decreased l-Arginine/ADMA ratio in horses.
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Affiliation(s)
- A Ertelt
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany.
| | - F Stumpff
- Institute of Veterinary Physiology, Freie Universitaet Berlin, Oertzenweg 19b, 14163, Berlin, Germany
| | - R Merle
- Institute for Veterinary Epidemiology and Biostatistics, Freie Universitaet Berlin, Koenigsweg 67, 14163, Berlin, Germany
| | - S Kuban
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany
| | - L Bollinger
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany
| | - S Liertz
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany
| | - H Gehlen
- Equine Clinic, Internal Medicine, Freie Universitaet Berlin, Oertzenweg 19b, 14193, Berlin, Germany
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Effects of tree nut and groundnut consumption compared with those of l-arginine supplementation on fasting and postprandial flow-mediated vasodilation: Meta-analysis of human randomized controlled trials. Clin Nutr 2020; 40:1699-1710. [PMID: 32980186 DOI: 10.1016/j.clnu.2020.09.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/21/2020] [Accepted: 09/09/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION l-arginine supplementation may improve vascular endothelial function. As tree nuts and groundnuts are a source of the amino acid l-arginine, we performed a meta-analysis of human randomized controlled trials (RCTs) to compare effects of tree nut and groundnut consumption with those of l-arginine supplementation on fasting and postprandial endothelial function as assessed by flow-mediated vasodilation of the brachial artery (FMD). METHODS Summary estimates of weighted mean differences (WMDs) in FMD and 95% confidence intervals (CIs) were calculated using random-effect meta-analyses. RESULTS A total of thirteen RCTs focusing on tree nut and groundnut consumption and nineteen RCTs investigating effects of l-arginine supplementation were included. Longer-term consumption of tree nuts and groundnuts increased fasting FMD by 1.09 %-point (PP) (95% CI: 0.49, 1.69, P < 0.001; I2: 76.7%, P < 0.001), while l-arginine supplementation (daily range: 3-21 g) increased fasting FMD by 0.53 PP (95% CI: 0.12, 0.93; P = 0.012; I2: 91.6%, P < 0.001). Effects between treatments were not statistically different (P = 0.31). Tree nut and groundnut consumption did not affect postprandial FMD responses (1.25 PP, 95% CI: -0.31, 2.81, P = 0.12; I2: 91.4%, P < 0.001), whereas l-arginine supplementation (range: 3-15 g) improved FMD during the postprandial phase by 2.02 PP (95% CI: 0.92, 3.13, P < 0.001; I2: 99.1%, P < 0.001). However, treatment effects did not differ significantly (P = 0.60). Overall, these results derive from high-quality evidence. CONCLUSION Longer-term consumption of tree nuts and groundnuts, as well as l-arginine supplementation did improve fasting endothelial function, as assessed by FMD. However, the positive effects of tree nuts and groundnuts could not be fully explained by the amount of l-arginine in these nuts. Only l-arginine supplementation did improve postprandial FMD, but effects were not different from those of tree nuts and groundnuts. Future studies should focus on the identifications of the bioactive nutrients in tree nuts and groundnuts and mechanistic pathways behind differences in postprandial and longer-term fasting changes in FMD.
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The effect of oral L-arginine supplementation on asymmetric dimethylarginine levels: A systematic review and meta-analysis of randomized clinical trials. ADVANCES IN INTEGRATIVE MEDICINE 2020. [DOI: 10.1016/j.aimed.2019.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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De La Cruz JA, Mihos CG, Horvath SA, Santana O. The Pleiotropic Effects of Statins in Endocrine Disorders. Endocr Metab Immune Disord Drug Targets 2020; 19:787-793. [PMID: 30924424 DOI: 10.2174/1871530319666190329115003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 02/19/2019] [Accepted: 02/26/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The 3-Hydroxy-3-MethylGlutaryl-CoA reductase inhibitors, better known as statins, are used extensively in the treatment of dyslipidemia and cardiovascular risk reduction. They have also demonstrated a variety of non-lipid lowering, or pleiotropic effects. Pertaining to the endocrine system the benefits of statins can extend to patients with the polycystic ovarian syndrome and thyroid disease. However, there is also increasing evidence that statin use can lead to deleterious effects in different organs, including worsening glycemia and the development of diabetes mellitus. OBJECTIVE The aim of this review is to describe the most relevant and updated evidence regarding the pleiotropic effects of statins in endocrine disorders. METHODS We did a systematic review of scientific articles published in PubMed regarding the effects of statins on the different aspects of the endocrine system up until June 5th of 2018. RESULTS We identified preliminarily 61 publications, of which 4 were excluded due to having abstract format only, and 5 were excluded for not containing pertinent information to the study. CONCLUSION Several aspects of the endocrine system have been shown to be influenced by the pleiotropic effects that statins exert, however, the benefits of statins on cardiovascular morbidity and mortality largely outweigh this deleterious effect, and statin therapy should continue to be recommended.
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Affiliation(s)
- Javier A De La Cruz
- Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, Florida, United States
| | - Christos G Mihos
- Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida, FL, United States
| | - Sofia A Horvath
- Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida, FL, United States
| | - Orlando Santana
- Columbia University Division of Cardiology, Mount Sinai Heart Institute, Miami Beach, Florida, FL, United States
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Abstract
PURPOSE OF REVIEW Because arginine is the substrate for nitric oxide synthesis, which is pivotal to vascular homeostasis and linked to the insulin response, it has long been posited that supplemental arginine could benefit cardiometabolic health. RECENT FINDINGS Recent data have supported the view that supplemental arginine could alleviate the initiation and development of endothelial dysfunction and also shown that it may reduce the risk of type 2 diabetes. One important finding is that these effects may indeed vary as a function of the amount of arginine, its form and notably the metabolic status of the population. Some studies have shown that low doses of slow-release arginine are better used for nitric oxide synthesis and beneficial in individuals with abnormal arginine metabolism/bioavailability. Pathophysiological data in rodents have emphasized the importance of arginase activation during the development of cardiometabolic risk, which lends credence to a potential benefit for arginine supplements. Likewise, epidemiological evidence suggests that alterations to arginine bioavailability are important regarding the cardiometabolic risk. However, other metabolic mechanisms linked to the multiple pathways of arginine metabolism may also play a role. SUMMARY Further studies are needed to confirm and analyze how and when supplemental arginine is beneficial to cardiometabolic health.
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Affiliation(s)
- François Mariotti
- UMR PNCA, AgroParisTech, INRA, Université Paris-Saclay, 75005, Paris, France
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Effect of l-arginine supplementation on C-reactive protein and other inflammatory biomarkers: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2019; 47:102226. [DOI: 10.1016/j.ctim.2019.102226] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 12/14/2022] Open
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Pánczél Z, Kukor Z, Supák D, Kovács B, Kecskeméti A, Czizel R, Djurecz M, Alasztics B, Csomó KB, Hrabák A, Valent S. Pravastatin induces NO synthesis by enhancing microsomal arginine uptake in healthy and preeclamptic placentas. BMC Pregnancy Childbirth 2019; 19:426. [PMID: 31747921 PMCID: PMC6868828 DOI: 10.1186/s12884-019-2507-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 09/12/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Pravastatin, a known inducer of endothelial nitric-oxide synthase (eNOS) was demonstrated in human placenta, however the exact mechanism of it's action is not fully understood. Since placental NO (nitric oxide) synthesis is of primary importance in the regulation of placental blood flow, we aimed to clarify the effects of pravastatin on healthy (n = 6) and preeclamptic (n = 6) placentas (Caucasian participants). METHODS The eNOS activity of human placental microsomes was determined by the conversion rate of C14 L-arginine into C14 L-citrulline with or without pravastatin and Geldanamycin. Phosphorylation of eNOS (Ser1177) was investigated by Western blot. Microsomal arginine uptake was measured by a rapid filtration method. RESULTS Pravastatin significantly increased total eNOS activity in healthy (28%, p<0.05) and preeclamptic placentas (32%, p<0.05) using 1 mM Ca2+ promoting the dissociation of a eNOS from it's inhibitor caveolin. Pravastatin and Geldanamycin (Hsp90 inhibitor) cotreatment increased microsomal eNOS activity. Pravastatin treatment had no significant effects on Ser1177 phosphorylation of eNOS in either healthy or preeclamptic placentas. Pravastatin induced arginine uptake of placental microsomes in both healthy (38%, p < 0.05) and preeclamptic pregnancies (34%, p < 0.05). CONCLUSIONS This study provides a novel mechanism of pravastatin action on placental NO metabolism. Pravastatin induces the placental microsomal arginine uptake leading to the rapid activation of eNOS independently of Ser1177 phosphorylation. These new findings may contribute to better understanding of preeclampsia and may also have a clinical relevance.
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Affiliation(s)
- Zita Pánczél
- 2nd Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/A, Budapest, 1088, Hungary
| | - Zoltán Kukor
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Tűzoltó u. 37-47, Budapest, 1094, Hungary.
| | - Dorina Supák
- 2nd Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/A, Budapest, 1088, Hungary
| | - Bence Kovács
- 2nd Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/A, Budapest, 1088, Hungary.,Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Tűzoltó u. 37-47, Budapest, 1094, Hungary
| | - András Kecskeméti
- 2nd Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/A, Budapest, 1088, Hungary.,Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Tűzoltó u. 37-47, Budapest, 1094, Hungary
| | - Rita Czizel
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Tűzoltó u. 37-47, Budapest, 1094, Hungary
| | - Magdolna Djurecz
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Tűzoltó u. 37-47, Budapest, 1094, Hungary
| | - Bálint Alasztics
- 2nd Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/A, Budapest, 1088, Hungary.,Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Tűzoltó u. 37-47, Budapest, 1094, Hungary
| | - Krisztián Benedek Csomó
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Tűzoltó u. 37-47, Budapest, 1094, Hungary
| | - András Hrabák
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Tűzoltó u. 37-47, Budapest, 1094, Hungary
| | - Sándor Valent
- 2nd Department of Obstetrics and Gynecology, Semmelweis University, Üllői út 78/A, Budapest, 1088, Hungary
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Mirhafez SR, Hariri M. L-arginine effect on inflammatory mediators: A systematic review of randomized controlled clinical trials. INT J VITAM NUTR RES 2019; 91:562-570. [PMID: 31699008 DOI: 10.1024/0300-9831/a000619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
L-arginine is an important factor in several physiological and biochemical processes. Recently, scientists studied L-arginine effect on inflammatory mediators such as C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). We conducted a systematic review on randomized controlled trials assessing L-arginine effect on inflammatory mediators. We searched data bases including Google scholar, ISI web of science, SCOPUS, and PubMed/Medline up to April 2019. Randomized clinical trials assessing the effect of L-arginine on inflammatory mediators in human adults were included. Our search retrieved eleven articles with 387 participants. Five articles were on patients with cancer and 6 articles were on adults without cancer. L-arginine was applied in enteral form in 5 articles and in oral form in 6 articles. Eight articles were on both genders, two articles were on women, and one article was on men. L-arginine could not reduce inflammatory mediators among patients with and without cancer except one article which indicated that taking L-arginine for 6 months decreased IL-6 among cardiopathic nondiabetic patients. Our results indicated that L-arginine might not be able to reduce selected inflammatory mediators, but for making a firm decision more studies are needed to be conducted with longer intervention duration, separately on male and female and with different doses of L-arginine.
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Affiliation(s)
- Seyed Reza Mirhafez
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mitra Hariri
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
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Schreiber C, Eilenberg MS, Panzenboeck A, Winter MP, Bergmeister H, Herzog R, Mascherbauer J, Lang IM, Bonderman D. Combined oral administration of L-arginine and tetrahydrobiopterin in a rat model of pulmonary arterial hypertension. Pulm Circ 2017; 7:89-97. [PMID: 28680568 PMCID: PMC5448548 DOI: 10.1086/689289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 09/12/2016] [Indexed: 11/26/2022] Open
Abstract
Alterations in the nitric oxide (NO) pathway play a major role in pulmonary arterial hypertension (PAH). L-arginine (LA) and tetrahydrobiopterin (BH4) are main substrates in the production of NO, which mediates pulmonary vasodilation. Administration of either LA or BH4 decrease pulmonary artery pressure (PAP). A combined administration of both may have synergistic effects in the therapy of PAH. In a telemetrically monitored model of unilateral pneumonectomy and monocrotaline-induced PAH, male Sprague-Dawley rats received either LA (300 mg/kg; n = 15), BH4 (20 mg/kg; n = 15), the combination of LA and BH4 (300 mg/kg, 20 mg/kg; n = 15), or vehicle (control group; n = 10) from day 28 after monocrotaline induction. Therapy was orally administered once daily over consecutive 14 days. LA, BH4, or both equally lowered PAP, increased pulmonary vascular elasticity, restored spontaneous locomotoric activity, prevented body weight loss and palliated small vessel disease of severely pulmonary hypertensive rats. BH4 substitution lowered asymmetric dimethylarginine levels sustainably at 60 min after administration and downregulated endothelial NO synthase mRNA expression. No significant survival, macro- and histomorphologic or hemodynamic differences were found between therapy groups at the end of the study period. Administration of LA and BH4 both mediated a decrease of mean PAP, attenuated right ventricular hypertrophy and small vessel disease in monocrotaline-induced pulmonary hypertensive rats, though a combined administration of both substances did not reveal any synergistic therapy effects in our animal model.
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Affiliation(s)
- C Schreiber
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - M S Eilenberg
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - A Panzenboeck
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - M P Winter
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - H Bergmeister
- Institute of Biomedical Research, Medical University of Vienna, Austria
| | - R Herzog
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - J Mascherbauer
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - I M Lang
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - D Bonderman
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
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14
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Schreiber C, Eilenberg M, Panzenboeck A, Winter M, Bergmeister H, Herzog R, Mascherbauer J, Lang I, Bonderman D. Combined oral administration of L-arginine and tetrahydrobiopterin in a rat model of pulmonary arterial hypertension. Pulm Circ 2017. [DOI: 10.1177/2045893216677519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- C. Schreiber
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - M.S. Eilenberg
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - A. Panzenboeck
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - M.P. Winter
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - H. Bergmeister
- Institute of Biomedical Research, Medical University of Vienna, Austria
| | - R. Herzog
- Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Austria
| | - J. Mascherbauer
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - I.M. Lang
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - D. Bonderman
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
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15
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Kahraman A, Mutlu E, Aldağ M. ADMA, SDMA and L-arginine may be Novel Targets in Pharmacotherapy for Complications due to Cardiopulmonary Bypass. J Med Biochem 2017; 36:8-17. [PMID: 28680344 PMCID: PMC5471654 DOI: 10.1515/jomb-2016-0025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 07/15/2016] [Indexed: 12/29/2022] Open
Abstract
Background In this study, the effects of olmesartan therapy on asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), L-arginine and inducible nitric oxide synthase (iNOS) levels were investigated in patients undergoing cardiopulmonary bypass. Methods Patients were randomly allocated to two groups, control and olmesartan. Olmesartan was administered 30 mg once a day beginning from preoperative day 5 to postoperative day 28 and on operation day. Blood was drawn from all patients and ADMA, SDMA, L-arginine and iNOS levels were analyzed at six time points (T1: before anesthesia induction, T2: during cardiopulmonary bypass, T3: five min after the cross-clamp was removed, T4: after protamine infusion, T5: on postoperative day 3 and T6: on postoperative day 28). Results In the olmesartan treated group, iNOS levels exhibited significant decreases at T2, T3, T4, T5 and T6 time points compared with control group (p<0.001, p<0.05, p<0.001, p<0.01, p<0.05 respectively). ADMA levels were significantly lower in olmesartan treated group than in control group at T3, T4, T5 and T6 time points (p<0.05, p<0.05, p<0.05, p<0.01 respectively). SDMA levels at T2, T3 and T6 time points were higher in control group than olmesartan group. L-Arginine levels were significantly higher at T2 and T3 time points in olmesartan treated group than control group (p<0.001, p<0.01). Conclusions It was concluded that administration of olmesartan reduced plasma ADMA, SDMA, iNOS levels and enhanced L-arginine level in CPB time and it could reduce potential postoperative complications through reducing oxidative stress and inflammatory response in the postoperative period after coronary bypass surgery.
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Affiliation(s)
- Aydın Kahraman
- Firat University, Faculty of Medicine, Department of Cardiovascular Surgery, Elazig, Turkey
| | - Emre Mutlu
- Firat University, Faculty of Medicine, Department of Pharmacology, Elazig, Turkey
| | - Mustafa Aldağ
- Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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16
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Zhang J, Bottiglieri T, McCullough PA. The Central Role of Endothelial Dysfunction in Cardiorenal Syndrome. Cardiorenal Med 2016; 7:104-117. [PMID: 28611784 DOI: 10.1159/000452283] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Endothelial dysfunction (ED) has emerged as a critical process in cardiorenal syndrome (CRS). The concept that ED is closely linked with cardiac and renal dysfunction has become an important target for CRS-related research and clinical practice. SUMMARY The sequence of events leading to ED is initiated by type I endothelial activation (almost immediately) and type II endothelial activation (over hours, days, and even months), followed by endothelial apoptosis and endothelial necrosis. The fact that ED is a continual cellular event divides this process into reversible ED (endothelial activation) and irreversible ED (endothelial apoptosis and necrosis). This basic research-defined concept may have clinical implications. Although most antihypertensive drugs (ACE inhibitors, statins, etc.) are effective in patients with hypertension and diabetes, some of them have proved to be ineffective, which may partly be attributed to irreversible ED. Even though the etiology of ED consists mainly of asymmetric dimethylarginine, nitric oxide, oxidative stress, and anti-endothelial cell antibodies, many other inducers of ED have been identified. In addition, a distinct role of ED has been reported for each type of CRS in humans. KEY MESSAGES Further study is warranted to prove whether ED holds promise as a pharmacological target in CRS patients.
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Affiliation(s)
- Jun Zhang
- Baylor Heart and Vascular Institute, TX, USA
| | | | - Peter A McCullough
- Baylor Heart and Vascular Institute, TX, USA.,Department of Internal Medicine, Baylor University Medical Center, TX, USA.,Baylor Jack and Jane Hamilton Heart and Vascular Hospital, Dallas, TX, TX, USA.,The Heart Hospital Baylor Plano, Plano, TX, USA
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17
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Pruneda-Alvarez LG, Ruíz-Vera T, Ochoa-Martínez AC, Pérez-Vázquez FJ, González Palomo AK, Ilizaliturri-Hernández CA, Pérez-Maldonado IN. Plasma asymmetric dimethylarginine (ADMA) levels in Mexican women exposed to polycyclic aromatic hydrocarbons (PAHs): A preliminary study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 572:1195-1202. [PMID: 27522294 DOI: 10.1016/j.scitotenv.2016.08.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/01/2016] [Accepted: 08/05/2016] [Indexed: 06/06/2023]
Abstract
Recent studies indicate that exposure to environmental pollutants (as polycyclic aromatic hydrocarbons) is a very important risk factor for development of cardiovascular diseases (CVDs). Correspondingly, in recent times asymmetric dimethylarginine (ADMA) has been proposed as a new and meaningful biomarker predictor for the risk of CVDs. Therefore, the objective of this study was to evaluate plasma ADMA concentrations in Mexican women (n=155) exposed to polycyclic aromatic hydrocarbons (PAHs). Urinary 1-hydroxypyrene [(1-OHP), exposure biomarker for PAHs] levels were quantified using a high performance liquid chromatography (HPLC) technique and plasma ADMA concentrations were analyzed using a commercially available ELISA kit. Urinary 1-OHP levels in all women assessed ranged from <LOD to 8.80μmol/mol creatinine. Regarding plasma ADMA concentrations, the mean levels ranged from 0.66 to 1.00μmol/L. Moreover, a significantly relationship was found between plasma ADMA concentrations and urinary 1-OHP levels (p=0.005; r=0.390). In conclusion, the results showed in this study demonstrated that the urinary 1-OHP levels were significant predictors of plasma ADMA concentrations in Mexican women exposed to PAHs. Although with due caution regarding the low representativeness of the present screening, it can be considered as a preliminary work to perform prospective studies including greater number of individuals and focusing in a more complete characterization of the effects produced by PAHs exposure on cardiovascular health.
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Affiliation(s)
- Lucía G Pruneda-Alvarez
- Laboratorio de Toxicología Molecular, Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico; Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Tania Ruíz-Vera
- Laboratorio de Toxicología Molecular, Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico; Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Angeles C Ochoa-Martínez
- Laboratorio de Toxicología Molecular, Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico; Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Francisco J Pérez-Vázquez
- Laboratorio de Toxicología Molecular, Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico; Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Ana K González Palomo
- Laboratorio de Toxicología Molecular, Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico; Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Cesar A Ilizaliturri-Hernández
- Laboratorio de Toxicología Molecular, Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico; Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico
| | - Iván N Pérez-Maldonado
- Laboratorio de Toxicología Molecular, Centro de Investigación Aplicada en Ambiente y Salud (CIAAS), Coordinación para la Innovación y Aplicación de la Ciencia y la Tecnología (CIACYT), Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico; Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico; Unidad Académica Multidisciplinaria Zona Media, Universidad Autónoma de San Luis Potosí, Rio Verde, San Luis Potosí, Mexico.
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18
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Menzel D, Haller H, Wilhelm M, Robenek H. L-Arginine and B vitamins improve endothelial function in subjects with mild to moderate blood pressure elevation. Eur J Nutr 2016; 57:557-568. [PMID: 27817128 PMCID: PMC5845626 DOI: 10.1007/s00394-016-1342-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 10/24/2016] [Indexed: 02/05/2023]
Abstract
Purpose The aim of this trial was to investigate the influence of a dietetic product consisting of a unique combination of l-arginine with the vitamins B6, folic acid and B12 (Telcor® Arginin plus) on endothelial dysfunction. Methods Subjects aged 40–65 years with mild to moderate blood pressure (BP) elevation not treated with anti-hypertensive drugs were randomly assigned to either the dietetic product (n = 40) or a matching placebo (n = 41) for 3 months with open follow-up for a further 3 months. Postprandial change in endothelial function was assessed using the validated reactive hyperaemia index (RHI) at 3 months compared to the study onset (RHI post–pre, visit 3–visit 1; ΔΔRHI). Secondary parameters included BP and plasma homocysteine concentration. Results The primary efficacy analysis revealed superiority of the nutritional intervention over placebo (p = 0.0349) in reducing the deterioration of endothelial function. While in the active group ΔΔRHI increased (0.371 ± 0.122), almost no change could be detected in the placebo group (0.031 ± 0.100), thus demonstrating a significant improvement in vascular function in the intervention group. Moreover, the intervention reduced BP and homocysteine levels. Non-serious adverse events were equally distributed in both groups, and none of the events were assessed as possibly intervention-related by the investigators. Conclusions This trial confirmed the effective and safe use of dietary management with l-arginine in combination with B vitamins. The primary efficacy analysis demonstrated a statistically significant superiority of the combination of l-arginine with B vitamins over placebo in improving and restoring impaired endothelial function and lowering BP in patients with mild to moderate blood pressure elevation.
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Affiliation(s)
| | - Hermann Haller
- Department of Nephrology and Hypertension Medicine, Hannover Medical School, University of Hannover, Hannover, Germany
| | | | - Horst Robenek
- University Clinic Münster, Albert-Schweitzer-Campus 1, Domagkstr. 3, 48149, Münster, Germany.
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Deveaux A, Fouillet H, Petzke KJ, Hermier D, André E, Bunouf P, Lantoine-Adam F, Benamouzig R, Mathé V, Huneau JF, Mariotti F. A Slow- Compared with a Fast-Release Form of Oral Arginine Increases Its Utilization for Nitric Oxide Synthesis in Overweight Adults with Cardiometabolic Risk Factors in a Randomized Controlled Study. J Nutr 2016; 146:1322-9. [PMID: 27281799 DOI: 10.3945/jn.116.231910] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/05/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Oral l-arginine supplements can have a beneficial effect on nitric oxide (NO)-related functions when subjects have cardiovascular disease risk factors. OBJECTIVE The study was designed to determine the utilization for NO synthesis of oral l-arginine as a function of the cardiometabolic risk and the speed of absorption by comparing immediate-release arginine (IR-Arg), as in supplements, and sustained-release arginine (SR-Arg), which mimics the slow release of dietary arginine. METHODS In a randomized, single-blind, 2-period crossover, controlled trial (1 wk of treatment, >2 wk of washout), using [(15)N-(15)N-(guanidino)]-arginine for the first morning dose, we compared the bioavailability (secondary outcome) and utilization for NO synthesis (primary outcome) of 1.5 g IR- and SR-Arg 3 times/d in 12 healthy overweight [body mass index (BMI; in kg/m(2)): 25-30] adults with the hypertriglyceridemic waist phenotype [HTW; plasma triglycerides (TGs): >150 mg/dL; waist circumference: >94 cm (men) or >80 cm (women)] and 15 healthy control adults (CON; BMI: 18.5-25; no elevated TGs and waist circumference). RESULTS Plasma oral arginine areas under the curve were lower after supplementation with SR-Arg than with IR-Arg (112 ± 52.3 and 142 ± 50.8 μmol ⋅ h/L; P < 0.01). The utilization of oral arginine for NO synthesis was 58% higher in HTW subjects than in CON subjects and higher with SR-Arg than with IR-Arg (P < 0.05 both), particularly in HTW subjects (group-by-treatment interaction, P < 0.05). In HTW subjects administered the SR form, utilization for NO synthesis was 32% higher than with the IR form and 87% higher than in CON subjects who were administered the SR form. CONCLUSION In overweight adults with the HTW phenotype, a slow- compared with a fast-release form of oral arginine markedly favors the utilization of arginine for NO synthesis. The utilization of low-dose, slow-release arginine for NO synthesis is higher in overweight adults with the HTW phenotype than in healthy controls, suggesting that the sensitivity of NO synthesis to the dietary arginine supply increases with cardiometabolic risk. The trial was registered at clinicaltrials.gov as NCT02352740.
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Affiliation(s)
- Ambre Deveaux
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Hélène Fouillet
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Klaus J Petzke
- German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany; and
| | - Dominique Hermier
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Etienne André
- Institut de Recherche Pierre Fabre, Boulogne-Billancourt, France
| | - Pierre Bunouf
- Institut de Recherche Pierre Fabre, Boulogne-Billancourt, France
| | | | - Robert Benamouzig
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Véronique Mathé
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Jean-François Huneau
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - François Mariotti
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France;
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20
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Deveaux A, Pham I, West SG, André E, Lantoine-Adam F, Bunouf P, Sadi S, Hermier D, Mathé V, Fouillet H, Huneau JF, Benamouzig R, Mariotti F. l-Arginine Supplementation Alleviates Postprandial Endothelial Dysfunction When Baseline Fasting Plasma Arginine Concentration Is Low: A Randomized Controlled Trial in Healthy Overweight Adults with Cardiometabolic Risk Factors. J Nutr 2016; 146:1330-40. [PMID: 27281800 DOI: 10.3945/jn.115.227959] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 04/19/2016] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vascular endothelial dysfunction, the hallmark of early atherosclerosis, is induced transiently by a high-fat meal. High doses of free l-arginine supplements reduce fasting endothelial dysfunction. OBJECTIVE We sought to determine the effects of a low dose of a sustained-release (SR) l-arginine supplement on postprandial endothelial function in healthy overweight adults with cardiometabolic risk factors and to investigate whether this effect may vary by baseline arginine status. METHODS In a randomized, double-blind, 2-period crossover, placebo-controlled trial (4-wk treatment, 4-wk washout), we compared the effects of 1.5 g SR-l-arginine 3 times/d (4.5 g/d) with placebo in 33 healthy overweight adults [body mass index (BMI, in kg/m(2)): 25 to >30] with the hypertriglyceridemic waist (HTW) phenotype [plasma triglycerides > 150 mg/dL; waist circumference > 94 cm (men) or > 80 cm (women)]. The main outcome variable tested was postprandial endothelial function after a high-fat meal (900 kcal), as evaluated by use of flow-mediated dilation (FMD) and Framingham reactive hyperemia index (fRHI), after each treatment. By use of subgroup analysis, we determined whether the effect was related to the baseline plasma arginine concentration. RESULTS In the total population, the effects of SR-arginine supplementation on postprandial endothelial function were mixed and largely varied with baseline fasting arginine concentration (P-interaction < 0.05). In the lower half of the population (below the median of 78.2 μmol arginine/L plasma), but not the upper half, SR-arginine supplementation attenuated the postprandial decrease in both FMD (29% decrease with SR-arginine compared with 50% decrease with placebo) and fRHI (5% increase with SR-arginine compared with 49% decrease with placebo), resulting in significantly higher mean ± SEM values with SR-arginine (FMD: 4.0% ± 0.40%; fRHI: 0.41 ± 0.069) than placebo (FMD: 2.9% ± 0.31%; fRHI: 0.21 ± 0.060) at the end of the postprandial period (P < 0.05). CONCLUSIONS Supplementation with low-dose SR-arginine alleviates postprandial endothelial dysfunction in healthy HTW adults when the baseline plasma arginine concentration is relatively low. The benefits of arginine supplementation may be linked to a lower ability to mobilize endogenous arginine for nitric oxide synthesis during a postprandial challenge. This trial was registered at clinicaltrials.gov as NCT02354794.
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Affiliation(s)
- Ambre Deveaux
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Isabelle Pham
- Department of Physiology and Functional Investigations, Jean Verdier Hospital, Assistance Publique-Hôpitaux Paris, Bondy, France
| | - Sheila G West
- Departments of Nutritional Sciences and Biobehavioral Health, Pennsylvania State University, University Park, PA; and
| | - Etienne André
- Institut de Recherche Pierre Fabre, Boulogne-Billancourt, France
| | | | - Pierre Bunouf
- Institut de Recherche Pierre Fabre, Boulogne-Billancourt, France
| | - Samira Sadi
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Dominique Hermier
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Véronique Mathé
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Hélène Fouillet
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Jean-François Huneau
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - Robert Benamouzig
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France
| | - François Mariotti
- UMR Physiologie de la Nutrition et du Comportement Alimentaire, AgroParisTech, INRA, Université Paris-Saclay, Paris, France;
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21
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Garcia VP, Rocha HN, Silva GM, Amaral TA, Secher NH, Nóbrega AC, Vianna LC, Rocha NG. Exogenous l-arginine reduces matrix metalloproteinase-2 and -9 activities and oxidative stress in patients with hypertension. Life Sci 2016; 157:125-130. [DOI: 10.1016/j.lfs.2016.06.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/03/2016] [Accepted: 06/06/2016] [Indexed: 11/29/2022]
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Hsu CP, Zhao JF, Lin SJ, Shyue SK, Guo BC, Lu TM, Lee TS. Asymmetric Dimethylarginine Limits the Efficacy of Simvastatin Activating Endothelial Nitric Oxide Synthase. J Am Heart Assoc 2016; 5:e003327. [PMID: 27091343 PMCID: PMC4843600 DOI: 10.1161/jaha.116.003327] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of endothelial nitric oxide synthase (eNOS), is considered a risk factor for the pathogenesis of cardiovascular diseases. Simvastatin, a lipid‐lowering drug with other pleiotropic effects, has been widely used for treatment of cardiovascular diseases. However, little is known about the effect and underlying molecular mechanisms of ADMA on the effectiveness of simvastatin in the vascular system. Methods and Results We conducted a prospective cohort study to enroll 648 consecutive patients with coronary artery disease for a follow‐up period of 8 years. In patients with plasma ADMA level ≥0.49 μmol/L (a cut‐off value from receiver operating characteristic curve), statin treatment had no significant effect on cardiovascular events. We also conducted randomized, controlled studies using in vitro and in vivo models. In endothelial cells, treatment with ADMA (≥0.5 μmol/L) impaired simvastatin‐induced nitric oxide (NO) production, endothelial NO synthase (eNOS) phosphorylation, and angiogenesis. In parallel, ADMA markedly increased the activity of NADPH oxidase (NOX) and production of reactive oxygen species (ROS). The detrimental effects of ADMA on simvastatin‐induced NO production and angiogenesis were abolished by the antioxidant, N‐acetylcysteine, NOX inhibitor, or apocynin or overexpression of dimethylarginine dimethylaminohydrolase 2 (DDAH‐2). Moreover, in vivo, ADMA administration reduced Matrigel plug angiogenesis in wild‐type mice and decreased simvastatin‐induced eNOS phosphorylation in aortas of apolipoprotein E–deficient mice, but not endothelial DDAH‐2‐overexpressed aortas. Conclusions We conclude that ADMA may trigger NOX‐ROS signaling, which leads to restricting the simvastatin‐conferred protection of eNOS activation, NO production, and angiogenesis as well as the clinical outcome of cardiovascular events.
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Affiliation(s)
- Chiao-Po Hsu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Division of Cardiovascular Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jin-Feng Zhao
- Department of Physiology, Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Shing-Jong Lin
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Song-Kun Shyue
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Bei-Chia Guo
- Department of Physiology, Genome Research Center, National Yang-Ming University, Taipei, Taiwan
| | - Tse-Min Lu
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Tzong-Shyuan Lee
- Department of Physiology, Genome Research Center, National Yang-Ming University, Taipei, Taiwan
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Wang Y, Dong X. Nebivolol ameliorates asymmetric dimethylarginine-induced vascular response in rat aorta via β3 adrenoceptor-mediated mechanism. Clin Exp Hypertens 2016; 38:252-9. [PMID: 26825432 DOI: 10.3109/10641963.2015.1081233] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase (NOS) inhibitor, induces endothelial dysfunction. Nebivolol, a highly selective β1-adrenergic receptor (AR) blocker, is the only beta-blocker known to induce vascular production of nitric oxide. OBJECTIVE The present study was designed to evaluate the effect and mechanism of nebivolol on ADMA-induced vascular response in rat aorta in vitro. METHODS In vitro, the effects of nebivolol and ADMA on resting tone or contraction induced by phenylephrine (PE, 10(-6 )mol/L) and relaxation induced by acetylcholine (Ach, 10(-10)-10(-5 )mol/L) were evaluated. RESULTS ADMA in a concentration-dependent manner increased the resting and PE-induced tone and reduced Ach-induced relaxation. Nebivolol inhibited the ADMA-induced enhancements in tone and reversed the effects of ADMA on Ach-induced relaxation. These effects of nebivolol were blocked by selective β3 receptor blocker cyanopindolol (1 μM), but not by selective β2 receptor blocker butoxamine (50 μM). CONCLUSIONS Nebivolol ameliorates the ADMA-induced vascular responses in rat aorta, at least in part, by mechanisms involving β3 adrenoceptor.
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Affiliation(s)
- Yan Wang
- a Department of Pharmacology , Shanxi Medical University , Taiyuan, Shanxi Province , People's Republic of China and
| | - Xiushan Dong
- b Department of General surgery , Shanxi Academy of Medical Sciences & Shanxi Dayi Hospital , Taiyuan, Shanxi Province , People's Republic of China
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Willeit P, Freitag DF, Laukkanen JA, Chowdhury S, Gobin R, Mayr M, Di Angelantonio E, Chowdhury R. Asymmetric dimethylarginine and cardiovascular risk: systematic review and meta-analysis of 22 prospective studies. J Am Heart Assoc 2015; 4:e001833. [PMID: 26021436 PMCID: PMC4599532 DOI: 10.1161/jaha.115.001833] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/20/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Asymmetric dimethylarginine (ADMA) inhibits the production of nitric oxide, a key regulator of the vascular tone, and may be important in the development of cardiovascular disease (CVD). Our aim was to reliably quantify the association of ADMA and its isomer symmetric dimethylarginine (SDMA) with the risk of CVD outcomes in long-term cohort studies. METHODS AND RESULTS Data were collated from 22 prospective studies involving a total of 19 842 participants, which have recorded 2339 CVD, 997 coronary heart disease, and 467 stroke outcomes during a mean follow-up of 7.1 years. In a comparison of individuals in the top with those in the bottom third of baseline ADMA values, the combined risk ratios were 1.42 (95% confidence interval: 1.29 to 1.56) for CVD, 1.39 for coronary heart disease (1.19 to 1.62), and 1.60 for stroke (1.33 to 1.91). Broadly similar results were observed according to participants' baseline disease status (risk ratios for CVD: 1.35 [1.18 to 1.54] in general populations; 1.47 [1.16 to 1.87] in individuals with pre-existing CVD; and 1.52 [1.26 to 1.84] in individuals with pre-existing kidney disease) and by different study characteristics, including geographical location, sample type, assay method, number of incident outcomes, and level of statistical adjustment (all P values>0.05). In contrast, in 8 prospective studies involving 9070 participants and 848 outcomes, the corresponding estimate for SDMA concentration was 1.32 (0.92 to 1.90) for CVD. CONCLUSIONS Available prospective studies suggest associations between circulating ADMA concentration and CVD outcomes under a broad range of circumstances. Further research is needed to better clarify these associations, particularly in large general population studies.
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Affiliation(s)
- Peter Willeit
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of CambridgeUnited Kingdom (P.W., D.F.F., R.G., E.D.A., R.C.)
- King’s British Heart Foundation Centre, King’s College LondonUnited Kingdom (P.W., M.M.)
- Department of Neurology, Medical University InnsbruckAustria (P.W.)
| | - Daniel F Freitag
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of CambridgeUnited Kingdom (P.W., D.F.F., R.G., E.D.A., R.C.)
| | - Jari A Laukkanen
- Institute of Public Health, School and Clinical Nutrition, University of Eastern FinlandKuopio, Finland (J.A.L.)
| | | | - Reeta Gobin
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of CambridgeUnited Kingdom (P.W., D.F.F., R.G., E.D.A., R.C.)
- School of Medicine, University of GuyanaGuyana (R.G.)
| | - Manuel Mayr
- King’s British Heart Foundation Centre, King’s College LondonUnited Kingdom (P.W., M.M.)
| | - Emanuele Di Angelantonio
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of CambridgeUnited Kingdom (P.W., D.F.F., R.G., E.D.A., R.C.)
| | - Rajiv Chowdhury
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of CambridgeUnited Kingdom (P.W., D.F.F., R.G., E.D.A., R.C.)
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Symmetric dimethylarginine as predictor of graft loss and all-cause mortality in renal transplant recipients. Transplantation 2015; 98:1219-25. [PMID: 24999963 PMCID: PMC4240460 DOI: 10.1097/tp.0000000000000205] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Supplemental digital content is available in the text. Background Elevated symmetric dimethylarginine (SDMA) has been shown to predict cardiovascular events and all cause mortality in diverse populations. The potential role of SDMA as a risk marker in renal transplant recipients (RTR) has not been investigated. Methods We analyzed SDMA in the placebo arm of the Assessment of Lescol in Renal Transplantation study, a randomized controlled trial of fluvastatin in RTR. Mean follow-up was 5.1 years. Patients were grouped into quartiles based on SDMA levels at study inclusion. Relationships between SDMA and traditional risk factors for graft function and all-cause mortality were analyzed in 925 RTR using univariate and multivariate survival analyses. Results In univariate analysis, SDMA was significantly associated with renal graft loss, all-cause death, and major cardiovascular events. After adjustment for established risk factors including estimated glomerular filtration rate, an elevated SDMA-level (4th quartile, >1.38 μmol/L) was associated with renal graft loss; hazard ratio (HR), 5.51; 95% confidence interval (CI), 1.95–15.57; P=0.001, compared to the 1st quartile. Similarly, SDMA in the 4th quartile was independently associated with all-cause mortality (HR, 4.56; 95% CI, 2.15–9.71; P<0.001), and there was a strong borderline significant trend for an association with cardiovascular mortality (HR, 2.86; 95% CI, 0.99–8.21; P=0.051). Conclusion In stable RTR, an elevated SDMA level is independently associated with increased risk of all-cause mortality and renal graft loss.
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Das UN. Nutritional factors in the prevention and management of coronary artery disease and heart failure. Nutrition 2014; 31:283-91. [PMID: 25592005 DOI: 10.1016/j.nut.2014.08.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 08/18/2014] [Accepted: 08/18/2014] [Indexed: 11/26/2022]
Abstract
Nutritional factors such as magnesium, folic acid, vitamins B12 and B6, L-arginine, and polyunsaturated fatty acids (PUFAs) appear to be significantly beneficial for patients with coronary artery disease (CAD), and in the prevention and arresting the progression of HF and cardiac arrhythmias. Additionally, ingestion of adequate amounts of protein and maintaining normal concentrations of plasma albumin seem to be essential for these patients. These nutrients closely interact with the metabolism of L-arginine-nitric oxide (NO) system, essential fatty acids, and eicosanoids such that beneficial products such as NO, prostaglandin E1, prostacyclin, prostaglandin I3, lipoxins, resolvins, and protectins are generated and synthesis of proinflammatory cytokines is suppressed that results in platelet anti-aggregation, vasodilation, angiogenesis, and prevention of CAD, cardiac arrhythmias, and stabilization of HF. This implies that individuals at high risk for CAD, cardiac arrhythmias, and HF and those who have these diseases need to be screened for plasma levels of magnesium, folic acid, vitamins B12 and B6, L-arginine, NO, various PUFAs, lipoxin A4, resolvins, protectins, asymmetrical dimethylarginine (an endogenous inhibitor of NO), albumin, and various eicosanoids and cytokines and correct their abnormalities to restore normal physiology.
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Affiliation(s)
- Undurti N Das
- UND Life Sciences, Federal Way, WA, USA and Department of Medicine and BioScience Research Centre, Gayatri Vidya Parishad Hospital, Campus of GVP College of Engineering, Visakhapatnam, India.
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Eiselt J, Rajdl D, Racek J, Vostrý M, Rulcová K, Wirth J. Asymmetric dimethylarginine and progression of chronic kidney disease: a one-year follow-up study. Kidney Blood Press Res 2014; 39:50-7. [PMID: 24923294 DOI: 10.1159/000355776] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2014] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND/AIMS Asymmetric dimethylarginine (ADMA) is a prognostic factor in patients with chronic kidney disease (CKD). However, the relationships among factors influencing the metabolism of ADMA and the CKD progression are not fully understood. METHODS Serum ADMA, and variables related to the metabolism of ADMA were measured in 181 non-dialysis patients (CKD stages 3-5) and in 46 controls. Patients were assessed at baseline, and 6 and 12 months after the initiation of the study. RESULTS Patients had increased baseline ADMA, advanced glycation end products (AGE), and advanced oxidation protein products (AOPP) compared with controls (P<0.001). In a total of 164 patients who completed a one-year study, the estimated GFR (eGFR) declined from 23.5 (17.7-36) mL/min/1.73m(2) to 21 (14.7-31.5) (P=0.018), AGE rose from 1.58 (1.38-1.90) μmol/L to 1.76 (1.52-2.21) (P<0.001), while ADMA, AOPP, tubular function, and proteinuria remained stable. In a multiple regression model (adjusted R(2) = 0.49, P<0.0001), the interaction of relatively higher baseline eGFR, i.e. > 25 mL/min/1.73m(2), with higher ADMA (P=0.02) and higher AOPP (P=0.04) predicted the severest decrease in eGFR per year. Other predictors of progression were higher baseline AGE (P<0.001), proteinuria (P=0.003), hypertension (P=0.01), and higher baseline eGFR (P=0.03). CONCLUSION Elevated ADMA and markers of oxidative stress were strong predictors of progression in patients with eGFR between 25-40 mL/min/1.73m(2) , i.e. at the borderline of CKD stages 3-4.
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Affiliation(s)
- Jaromír Eiselt
- Department of Internal Medicine I, Charles University, Medical School and Teaching Hospital Plzeň, Czech Republic
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Dwyer NB, Hilland D, Traboulsi M, Anderson TJ. Ischemic postconditioning does not improve peripheral endothelial function in ST-segment elevation myocardial infarction patients. Vasc Med 2014; 19:160-166. [DOI: 10.1177/1358863x14534310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to determine whether ischemic postconditioning (IPC) could improve peripheral endothelial function in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Of 102 patients randomly assigned to an IPC or standard protocol to study infarct size utilizing cardiovascular magnetic resonance imaging, 84 patients had peripheral endothelial function assessed with brachial ultrasound measures and peripheral arterial tonometry (PAT) during reactive hyperemia 3 days after PCI. Overall IPC was not associated with a smaller infarct size compared to controls, though there was a trend towards greater myocardial salvage with IPC. Patients randomized to IPC (n=43; age 56 ± 11 years; 85% male) and standard protocol (n=41; age 56 ± 10 years; 88% male) underwent endothelial function assessment. Flow mediated vasodilatation was not significantly greater in the IPC group than in the standard group (7.4 ± 4.9% versus 6.6 ± 4.0% respectively, p=0.40) nor was peak hyperemic velocity-time integral (78 ± 26 cm versus 71 ± 30 cm respectively, p=0.28). Similarly, the PAT hyperemic ratio was not significantly greater in the IPC group than in the standard group (2.0 ± 0.9 versus 1.8 ± 0.6 respectively, p=0.14). In conclusion, IPC did not improve early peripheral endothelial function in patients with STEMI undergoing primary PCI.
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Affiliation(s)
- Nathan B Dwyer
- Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Darlene Hilland
- Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Mouhieddin Traboulsi
- Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
| | - Todd J Anderson
- Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, Alberta, Canada
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Margaritis M, Channon KM, Antoniades C. Statins as regulators of redox state in the vascular endothelium: beyond lipid lowering. Antioxid Redox Signal 2014; 20:1198-215. [PMID: 24111702 PMCID: PMC3934595 DOI: 10.1089/ars.2013.5430] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
SIGNIFICANCE Endothelial dysfunction and the imbalance between nitric oxide (NO) and reactive oxygen species production in the vascular endothelium are important early steps in atherogenesis, a major socioeconomic health problem. Statins have well-established roles in primary and secondary prevention of cardiovascular disease (CVD), due to both their lipid-lowering capacity and their pleiotropic properties. It is therefore important to understand the mechanisms by which statins can modify endothelial function and affect atherogenesis. RECENT ADVANCES In the last decade, the concept of statin pleiotropy has been reinforced by a large number of cell culture, animal, and translational studies. Statins have been shown to suppress the activity of pro-oxidant enzymes (such as NADPH oxidase) and pro-inflammatory transcriptional pathways in the endothelium. At the same time, they enhance endothelial NO synthase expression and activity while they also improve its enzymatic coupling. This leads to increased NO bioavailability and improved endothelial function. CRITICAL ISSUES Despite significant recent advances, the exact mechanisms of statin pleitropy are still only partially understood. The vast majority of the published literature relies on animal studies, while the actual mechanistic studies in humans are limited. FUTURE DIRECTIONS The success of statins as endothelium redox-modifying agents with a direct impact on clinical outcome highlights the importance of the endothelium as a therapeutic target in CVD. Better understanding of the mechanisms that underlie endothelial dysfunction could lead to the design of novel therapeutic strategies that target the vascular endothelium for the prevention and treatment of CVD.
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Affiliation(s)
- Marios Margaritis
- Division of Cardiovascular Medicine, University of Oxford , Oxford, United Kingdom
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Armitage ME, La M, Schmidt HHHW, Wingler K. Diagnosis and individual treatment of cardiovascular diseases: targeting vascular oxidative stress. Expert Rev Clin Pharmacol 2014; 3:639-48. [DOI: 10.1586/ecp.10.40] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Mariotti F, Huneau JF, Fouillet H. Reply to FS Dioguardi. Am J Clin Nutr 2013; 98:508-9. [PMID: 24027791 DOI: 10.3945/ajcn.113.065474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lorin J, Guilland JC, Korandji C, Touzery C, Bichat F, Chagnon A, Cottin Y, Rochette L, Vergely C, Zeller M. High levels of asymmetric dimethylarginine are strongly associated with low HDL in patients with acute myocardial infarction. PLoS One 2013; 8:e64796. [PMID: 23755144 PMCID: PMC3675048 DOI: 10.1371/journal.pone.0064796] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 04/18/2013] [Indexed: 01/24/2023] Open
Abstract
Objectives Low levels of high-density lipoprotein (HDL) cholesterol are associated with an increased risk of acute myocardial infarction possibly through impaired endothelial atheroprotection and decreased nitric oxide (NO) bioavailability. Asymmetric dimethylarginine (ADMA) mediates endothelial function by inhibiting nitric oxide synthase activity. In patients with acute myocardial infarction, we investigated the relationship between serum levels of HDL and ADMA. Approach and Results Blood samples from 612 consecutive patients hospitalized for acute MI <24 hours after symptom onset were taken on admission. Serum levels of ADMA, its stereoisomer, symmetric dimethylarginine (SDMA) and L-arginine were determined using high-performance liquid chromatography. Patients with low HDL (<40 mg/dL for men and <50 mg/dL for women) were compared with patients with higher HDL. Most patients (59%) had low HDL levels. Median ADMA levels were markedly higher in the low HDL group (0.69 vs. 0.50 µmole/L, p<0.001). In contrast, SDMA and L-arginine levels were similar for the two groups (p = 0.120 and p = 0.064). Notably, ADMA, but not SDMA or L-arginine, was inversely correlated with HDL (r = −0.311, p<0.001). In stratified analysis, this relationship was only found for low HDL levels (r = −0.265, p<0.001), but not when HDL levels were higher (r = −0.077, p = 0.225). By multivariate logistic regression analysis, ADMA level was strongly associated with low HDL levels (OR(95%CI):6.06(3.48–10.53), p<0.001), beyond traditional confounding factors. Conclusions Our large population-based study showed for the first time a strong inverse relationship between HDL and ADMA in myocardial infarction patients, suggesting a functional interaction between HDL and endothelium, beyond metabolic conditions associated with low HDL levels.
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Affiliation(s)
- Julie Lorin
- INSERM UMR866– Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Burgundy, Dijon, France
| | - Jean-Claude Guilland
- INSERM UMR866– Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Burgundy, Dijon, France
| | - Claudia Korandji
- INSERM UMR866– Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Burgundy, Dijon, France
| | - Claude Touzery
- Cardiology Department, University Hospital, Dijon, France
| | | | - Aline Chagnon
- Cardiology Department, University Hospital, Dijon, France
| | - Yves Cottin
- INSERM UMR866– Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Burgundy, Dijon, France
- Cardiology Department, University Hospital, Dijon, France
| | - Luc Rochette
- INSERM UMR866– Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Burgundy, Dijon, France
| | - Catherine Vergely
- INSERM UMR866– Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Burgundy, Dijon, France
| | - Marianne Zeller
- INSERM UMR866– Laboratory of Cardiometabolic Physiopathology and Pharmacology, University of Burgundy, Dijon, France
- * E-mail:
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ADMA and NOS regulation in chronic renal disease: beyond the old rivalry for l-arginine. Kidney Int 2012; 81:722-4. [PMID: 22460653 DOI: 10.1038/ki.2011.496] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Chronic kidney disease is associated with increased levels of assymetric N(G),N(G)-dimethylarginine (ADMA), which is predictive of increased mortality and cardiovascular disease. ADMA induces endothelial dysfunction through competitive inhibition of the endothelial nitric oxide (eNOS) substrate L-arginine. Kajimoto et al. show that ADMA may also reduce nitric oxide production via decreased eNOS phosphorylation; this effect is mediated by the MAPK pathway and can be reversed in vivo by increased catabolism of ADMA through dimethylarginine dimethylaminohydrolase-1 overexpression.
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Andreadou I, Farmakis D, Prokovas E, Sigala F, Zoga A, Spyridaki K, Papalois A, Papapetropoulos A, Anastasiou-Nana M, Kremastinos DT, Iliodromitis EK. Short-term statin administration in hypercholesterolaemic rabbits resistant to postconditioning: effects on infarct size, endothelial nitric oxide synthase, and nitro-oxidative stress. Cardiovasc Res 2012; 94:501-9. [PMID: 22411971 DOI: 10.1093/cvr/cvs121] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
AIMS The effectiveness of postconditioning (POC) in hypercholesterolaemia is in dispute. We investigated the effects of 3-day lipophilc (simvastatin) or hydrophilic (pravastatin) statin treatment, without or with POC in normocholesterolaemic (Norm) and hypercholesterolaemic (Chol) rabbits. METHODS AND RESULTS Norm or Chol rabbits were subjected to 30 min ischaemia and randomized in two series of 12 groups each: control, simvastatin (Sim), pravastatin (Prav), POC, Sim-POC, Prav-POC, Chol, Sim-Chol, Prav-Chol, POC-Chol, Sim-POC-Chol, Prav-POC-Chol. After ischaemia, rabbits of the first series underwent 3 h reperfusion, followed by infarct size, total cholesterol, and low density lipoprotein plasma level evaluation; animals of the second series underwent 10 min reperfusion followed by tissue sampling for nitrotyrosine (NT), malondialdehyde, endothelial nitric oxide synthase (eNOS), and Akt analyses. N-nitro-l-arginine methylester (L-NAME) was given in two additional groups (POC-L-NAME and Prav-Chol-L-NAME) for infarct size assessment. All interventions reduced infarction in Norm (24.3 ± 1.3, 25.9 ± 2.8, 27.9 ± 3.1, 23.3 ± 2.3, and 33.4 ± 2.5%, in POC, Sim, Prav, Sim-POC, and Prav-POC groups, respectively, vs. 49.3 ± 1.9% in control, P < 0.05), but only Prav did so in Chol animals (25.7 ± 3.3 and 25.3 ± 3.9% in Prav-Chol and Prav-POC-Chol vs. 50.9 ± 1.7, 44.8 ± 4.3, 41.5 ± 3.5, and 49.3 ± 5.5% in Chol, Sim-Chol, POC-Chol, and Sim-POC-Chol, respectively, P < 0.05). L-NAME abolished the infarct size-limiting effect of POC and Prav-Chol. Prav induced the greatest reduction in NT, while it was the only intervention that increased myocardial eNOS and Akt in Chol rabbits (P < 0.05 vs. all others). CONCLUSION Prav, in contrast to same-dose Sim or POC, reduces infarction in Chol rabbits independently of lipid lowering, potentially through eNOS activation and nitro-oxidative stress attenuation.
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Affiliation(s)
- Ioanna Andreadou
- Department of Pharmaceutical Chemistry, University of Athens School of Pharmacy, Panepistimiopolis, Zografou, Athens 15771, Greece.
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The effect of simvastatin on asymmetric dimethylarginine and flow-mediated vasodilation after optimizing the LDL level — A randomized, placebo-controlled study. Vascul Pharmacol 2012; 56:122-30. [DOI: 10.1016/j.vph.2011.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 10/02/2011] [Accepted: 10/30/2011] [Indexed: 01/06/2023]
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Thomazella MCD, Góes MFS, Andrade CR, Debbas V, Barbeiro DF, Correia RL, Marie SKN, Cardounel AJ, daLuz PL, Laurindo FRM. Effects of high adherence to mediterranean or low-fat diets in medicated secondary prevention patients. Am J Cardiol 2011; 108:1523-9. [PMID: 21890081 DOI: 10.1016/j.amjcard.2011.07.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Revised: 07/06/2011] [Accepted: 07/06/2011] [Indexed: 01/18/2023]
Abstract
Although the Mediterranean diet (MD) and the low-fat Therapeutic Lifestyle Changes Diet (TLCD) promote equivalent increases in event-free survival in secondary coronary prevention, possible mechanisms of such complete dietary patterns in these patients, usually medicated, are unclear. The aim of this study was to investigate the effects of the MD versus the TLCD in markers of endothelial function, oxidative stress, and inflammation after acute coronary syndromes. Comparison was made between 3 months of the MD (n = 21; rich in whole grains, vegetables, fruits, nuts, and olive oil, plus red wine) and the TLCD (n = 19; plus phytosterols 2 g/day) in a highly homogenous population of stable patients who experienced coronary events in the previous 2 years (aged 45 to 65 years, all men) allocated to each diet under a strategy designed to optimize adherence, documented as >90%. Baseline demographics, body mass index and clinical data, and use of statins and other drugs were similar between groups. The MD and TLCD promoted similar decreases in body mass index and blood pressure (p ≤0.001) and particularly in plasma asymmetric dimethylarginine levels (p = 0.02) and l-arginine/asymmetric dimethylarginine ratios (p = 0.01). The 2 diets did not further enhance flow-mediated brachial artery dilation compared to baseline (4.4 ± 4.0%). Compared to the TLCD, the MD promoted decreases in blood leukocyte count (p = 0.025) and increases in high-density lipoprotein levels (p = 0.053) and baseline brachial artery diameter. Compared to the MD, the TLCD decreased low-density lipoprotein and oxidized low-density lipoprotein plasma levels, although the ratio of oxidized to total low-density lipoprotein remained unaltered. Glucose, high-sensitivity C-reactive protein, triglycerides, myeloperoxidase, intercellular adhesion molecular, vascular cell adhesion molecule, and glutathione serum and plasma levels remained unchanged with either diet. In conclusion, medicated secondary prevention patients show evident although small responses to the MD and the TLCD, with improved markers of redox homeostasis and metabolic effects potentially related to atheroprotection.
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Berthe MC, Darquy S, Breuillard C, Lamoudi L, Marc J, Cynober L, Chaumeil JC, Couderc R. High plasma citrulline and arginine levels ensured by sustained-release citrulline supplementation in rats. Nutrition 2011; 27:1168-71. [DOI: 10.1016/j.nut.2010.12.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Revised: 11/08/2010] [Accepted: 12/01/2010] [Indexed: 11/30/2022]
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Sibal L, Agarwal SC, Home PD, Boger RH. The Role of Asymmetric Dimethylarginine (ADMA) in Endothelial Dysfunction and Cardiovascular Disease. Curr Cardiol Rev 2011; 6:82-90. [PMID: 21532773 PMCID: PMC2892080 DOI: 10.2174/157340310791162659] [Citation(s) in RCA: 296] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2009] [Revised: 10/14/2009] [Accepted: 10/25/2009] [Indexed: 02/07/2023] Open
Abstract
Endothelium plays a crucial role in the maintenance of vascular tone and structure. Endothelial dysfunction is known to precede overt coronary artery disease. A number of cardiovascular risk factors, as well as metabolic diseases and systemic or local inflammation cause endothelial dysfunction. Nitric oxide (NO) is one of the major endothelium derived vaso-active substances whose role is of prime importance in maintaining endothelial homeostasis. Low levels of NO are associated with impaired endothelial function. Asymmetric dimethylarginine (ADMA), an analogue of L-arginine, is a naturally occurring product of metabolism found in human circulation. Elevated levels of ADMA inhibit NO synthesis and therefore impair endothelial function and thus promote atherosclerosis. ADMA levels are increased in people with hypercholesterolemia, atherosclerosis, hypertension, chronic heart failure, diabetes mellitus and chronic renal failure. A number of studies have reported ADMA as a novel risk marker of cardiovascular disease. Increased levels of ADMA have been shown to be the strongest risk predictor, beyond traditional risk factors, of cardiovascular events and all-cause and cardiovascular mortality in people with coronary artery disease. Interventions such as treatment with L-arginine have been shown to improve endothelium-mediated vasodilatation in people with high ADMA levels. However the clinical utility of modifying circulating ADMA levels remains uncertain.
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Affiliation(s)
- Latika Sibal
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
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Kemény-Beke Á, Gesztelyi R, Bodnár N, Zsuga J, Kerekes G, Zsuga M, Biri B, Kéki S, Szodoray P, Berta A, Szekanecz Z, Szántó S. Increased production of asymmetric dimethylarginine (ADMA) in ankylosing spondylitis: association with other clinical and laboratory parameters. Joint Bone Spine 2011; 78:184-7. [PMID: 20620092 DOI: 10.1016/j.jbspin.2010.05.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2010] [Accepted: 05/21/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Asymmetric dimethylarginine (ADMA) has been associated with atherosclerosis, vascular diseases and, recently, also with arthritis including rheumatoid arthritis (RA) and ankylosing spondylitis (AS). METHODS Serum ADMA, arginine and symmetric dimethylarginine (SDMA) levels were assessed by liquid chromatography in 61 AS and 26 osteoarthritis (OA) patients with no known cardiovascular disease. RESULTS Serum ADMA levels were significantly increased in AS compared to OA patients (0.95 ± 0.17 μM versus 0.70 ± 0.25 μM; p < 0.001). There were no differences in serum arginine and SDMA levels. Serum ADMA levels also positively correlated with age (R = 0.258; p = 0.043), body mass index (R = 0.368; p = 0.003), erythrocyte sedimentation rate (R = 0.329; p = 0.009) and ADMA levels negative correlated with chest expansion (R = -0.251; p = 0.04). No correlations were found between ADMA levels and disease duration, pain intensity, BASDAI, BASFI, BASMI, quality of life, CRP, HLA-B27 positivity, endothelial dysfunction or carotid atherosclerosis. CONCLUSION ADMA may serve as a marker of systemic inflammation and may reflect functional immobility in AS. Further studies are needed to assess the possible role of ADMA in AS and AS-related vascular disease.
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Affiliation(s)
- Ádám Kemény-Beke
- Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, Debrecen 4032, Hungary
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Vladimirova-Kitova LG, Deneva-Koycheva T. Asymmetric dimethylarginine—a determinant of the effect of the high dose Simvastatin. Clin Biochem 2010; 43:843-50. [DOI: 10.1016/j.clinbiochem.2010.04.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Revised: 03/26/2010] [Accepted: 04/12/2010] [Indexed: 10/19/2022]
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Vladimirova-Kitova LG, Deneva TI, Marinov B. Effect of Moderate and High-Dose Simvastatin on Asymmetric Dimethylarginine-Homocysteine Metabolic Pathways in Patients with Newly Detected Severe Hypercholesterolemia. Cardiovasc Ther 2010; 29:340-8. [DOI: 10.1111/j.1755-5922.2010.00149.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Vladimirova-Kitova LG, Terzieva DD, Nikolov FP. Asymmetric dimethylarginine determines the effect of simvastatin on endothelium-dependent vasodilation in severe hypercholesterolemia. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/clp.09.76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Moss MB, Siqueira MA, Mann GE, Brunini TMC, Mendes-Ribeiro AC. Platelet aggregation in arterial hypertension: Is there a nitric oxide-urea connection? Clin Exp Pharmacol Physiol 2010; 37:167-72. [DOI: 10.1111/j.1440-1681.2009.05247.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Pope AJ, Karrupiah K, Kearns PN, Xia Y, Cardounel AJ. Role of dimethylarginine dimethylaminohydrolases in the regulation of endothelial nitric oxide production. J Biol Chem 2009; 284:35338-47. [PMID: 19820234 PMCID: PMC2790963 DOI: 10.1074/jbc.m109.037036] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2009] [Revised: 09/29/2009] [Indexed: 01/08/2023] Open
Abstract
Reduced NO is a hallmark of endothelial dysfunction, and among the mechanisms for impaired NO synthesis is the accumulation of the endogenous nitric-oxide synthase inhibitor asymmetric dimethylarginine (ADMA). Free ADMA is actively metabolized by the intracellular enzyme dimethylarginine dimethylaminohydrolase (DDAH), which catalyzes the conversion of ADMA to citrulline. Decreased DDAH expression/activity is evident in disease states associated with endothelial dysfunction and is believed to be the mechanism responsible for increased methylarginines and subsequent ADMA-mediated endothelial nitric-oxide synthase impairment. Two isoforms of DDAH have been identified; however, it is presently unclear which is responsible for endothelial ADMA metabolism and NO regulation. The current study investigated the effects of both DDAH-1 and DDAH-2 in the regulation of methylarginines and endothelial NO generation. Results demonstrated that overexpression of DDAH-1 and DDAH-2 increased endothelial NO by 24 and 18%, respectively. Moreover, small interfering RNA-mediated down-regulation of DDAH-1 and DDAH-2 reduced NO bioavailability by 27 and 57%, respectively. The reduction in NO production following DDAH-1 gene silencing was associated with a 48% reduction in l-Arg/ADMA and was partially restored with l-Arg supplementation. In contrast, l-Arg/ADMA was unchanged in the DDAH-2-silenced cells, and l-Arg supplementation had no effect on NO. These results clearly demonstrate that DDAH-1 and DDAH-2 manifest their effects through different mechanisms, the former of which is largely ADMA-dependent and the latter ADMA-independent. Overall, the present study demonstrates an important regulatory role for DDAH in the maintenance of endothelial function and identifies this pathway as a potential target for treating diseases associated with decreased NO bioavailability.
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Affiliation(s)
- Arthur J. Pope
- From the Department of Physiology and Functional Genomics, University of Florida College of Medicine, Gainesville, Florida 32607 and
| | - Kanchana Karrupiah
- From the Department of Physiology and Functional Genomics, University of Florida College of Medicine, Gainesville, Florida 32607 and
| | - Patrick N. Kearns
- From the Department of Physiology and Functional Genomics, University of Florida College of Medicine, Gainesville, Florida 32607 and
| | - Yong Xia
- the Davis Heart and Lung Research Institute, Ohio State University, Columbus, Ohio 43210
| | - Arturo J. Cardounel
- From the Department of Physiology and Functional Genomics, University of Florida College of Medicine, Gainesville, Florida 32607 and
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Blackwell S. The biochemistry, measurement and current clinical significance of asymmetric dimethylarginine. Ann Clin Biochem 2009; 47:17-28. [PMID: 19940201 DOI: 10.1258/acb.2009.009196] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide synthase and an important cause of endothelial dysfunction. Its increased plasma concentration is associated with a variety of traditional cardiovascular risk factors, and may mediate their effects on the vascular endothelium. ADMA is also an independent predictor of cardiovascular events and mortality, and predicts outcomes in critically ill patients in the intensive care unit. This work has provided insights into the role of ADMA as an endogenous regulator of nitric oxide synthesis. At present there is no specific therapy to modify ADMA concentration, but increasing interest and work on protein arginine methyltransferases and dimethylarginine dimethylaminohydrolase, which synthesize and metabolize ADMA, respectively, might provide novel therapeutic targets.
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Affiliation(s)
- Scott Blackwell
- Department of Clinical Biochemistry, Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.
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Schulze F, Glos S, Petruschka D, Altenburg C, Maas R, Benndorf R, Schwedhelm E, Beil U, Böger RH. L-Arginine enhances the triglyceride-lowering effect of simvastatin in patients with elevated plasma triglycerides. Nutr Res 2009; 29:291-7. [PMID: 19555809 DOI: 10.1016/j.nutres.2009.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 04/29/2009] [Accepted: 04/30/2009] [Indexed: 11/30/2022]
Abstract
We recently noticed a possible triglyceride-lowering effect during dietary supplementation with L-arginine. The major limitation of prior studies on L-arginine, however, was that triglyceride levels were not the primary end point, and patients were not necessarily hypertriglyceridemic. Therefore, we conducted a 2-arm, randomized, double-blind study in 33 hypertriglyceridemic patients to investigate the hypothesis that oral L-arginine may lower serum triglyceride levels in hypertriglyceridemic patients on and off statins. The study consisted of a 6-week run-in phase, 6 weeks of treatment with L-arginine (n = 22, 1.5 g bid) or placebo (n = 11), and a 6-week extension period where simvastatin (20 mg qd) was added. All patients received dietary advice during each study visit. Routine and lipid laboratory parameters were determined in the local routine clinical laboratory. Treatment with L-arginine alone had no effects on serum lipids compared to placebo. The combination of L-arginine with simvastatin led to a significantly stronger reduction in triglycerides compared to placebo plus simvastatin (-140.5 +/- 149.2 mg/dL vs -56.1 +/- 85.0 mg/dL; P = .048). In addition, we found simvastatin-induced increases in aspartate transaminase and fibrinogen to be attenuated by L-arginine as compared to placebo. We conclude from our data that L-arginine enhances the effects of simvastatin on lipid metabolism, but it has no triglyceride-lowering effects when given alone.
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Affiliation(s)
- Friedrich Schulze
- Center for Experimental Medicine, Institute for Experimental and Clinical Pharmacology, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
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Wingler K, Schmidt HHHW. Good stress, bad stress--the delicate balance in the vasculature. DEUTSCHES ARZTEBLATT INTERNATIONAL 2009; 106:677-84. [PMID: 19946436 DOI: 10.3238/arztebl.2009.0677] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2009] [Accepted: 10/22/2009] [Indexed: 12/14/2022]
Abstract
BACKGROUND Radicals have important physiological functions, for example, in immune defense and vasoprotection. However, they are also potentially dangerous waste products of cellular metabolism and they can contribute to the development of many different diseases. METHOD Selective literature review. RESULTS The scientific understanding of radicals has not yet led to any therapeutic application. For many years, scavenging already formed radicals with antioxidants was considered to be the most promising therapeutic approach, but clinical trials based on this principle have yielded mostly negative results. Thus, entirely new approaches are needed. The goal should be to prevent the formation of harmful radicals, or to treat radical-related damage if it has already occurred. New diagnostic tools have the potential to identify those patients that are most likely to benefit from this form of treatment, as well as to document its success. CONCLUSIONS A new generation of cardiovascular drugs is being developed for the prevention or the mechanism-based treatment of vascular damage caused by oxidative stress. This new therapy should go hand in hand with new diagnostics, in accordance with the principle of individualized medicine.
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Affiliation(s)
- Kirstin Wingler
- Monash University, Department of Pharmacology, Centre for Vascular Health, Melbourne, Australien
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Lucotti P, Monti L, Setola E, La Canna G, Castiglioni A, Rossodivita A, Pala MG, Formica F, Paolini G, Catapano AL, Bosi E, Alfieri O, Piatti P. Oral L-arginine supplementation improves endothelial function and ameliorates insulin sensitivity and inflammation in cardiopathic nondiabetic patients after an aortocoronary bypass. Metabolism 2009; 58:1270-6. [PMID: 19592054 DOI: 10.1016/j.metabol.2009.03.029] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2008] [Accepted: 03/26/2009] [Indexed: 01/11/2023]
Abstract
It is known that L-arginine treatment can ameliorate endothelial dysfunction and insulin sensitivity in type 2 diabetes mellitus patients, but little is known on L-arginine effects on these variables in nondiabetic patients with stable cardiovascular disease (coronary artery disease). We evaluated the effects of long-term oral L-arginine treatment on endothelial dysfunction, inflammation, adipokine levels, glucose tolerance, and insulin sensitivity in these patients. Sixty-four patients with cardiovascular disease previously submitted to an aortocoronary bypass and not known for type 2 diabetes mellitus had an oral glucose load to define their glucose tolerance. Thirty-two patients with nondiabetic response were eligible to receive, in a double-blind randomized parallel order, L-arginine (6.4 g/d) or placebo for 6 months. An evaluation of insulin sensitivity index during the oral glucose load, markers of systemic nitric oxide bioavailability and inflammation, and blood flow was performed before and at the end of the treatment in both groups. Compared with placebo, L-arginine decreased asymmetric dimethylarginine levels (P < .01), indices of endothelial dysfunction, and increased cyclic guanosine monophosphate (P < .01), L-arginine to asymmetric dimethylarginine ratio (P < .0001), and reactive hyperemia (P < .05). Finally, L-arginine increased insulin sensitivity index (P < .05) and adiponectin (P < .01) and decreased interleukin-6 and monocyte chemoattractant protein-1 levels. In conclusion, insulin resistance, endothelial dysfunction, and inflammation are important cardiovascular risk factors in coronary artery disease patients; and L-arginine seems to have anti-inflammatory and metabolic advantages in these patients.
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Affiliation(s)
- Pietro Lucotti
- Internal Medicine Department, Cardio-Diabetes Trials Unit, Scientific Institute San Raffaele, 20132 Milan, Italy.
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Pope AJ, Karuppiah K, Cardounel AJ. Role of the PRMT-DDAH-ADMA axis in the regulation of endothelial nitric oxide production. Pharmacol Res 2009; 60:461-5. [PMID: 19682581 DOI: 10.1016/j.phrs.2009.07.016] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2009] [Accepted: 07/31/2009] [Indexed: 01/22/2023]
Abstract
There is abundant evidence that the endothelium plays a crucial role in the maintenance of vascular tone and structure. One of the major endothelium-derived vasoactive mediators is nitric oxide (NO), formed in healthy vascular endothelium from the amino acid precursor l-arginine. Endothelial dysfunction is increased by various cardiovascular risk factors, metabolic diseases, and systemic or local inflammation. One mechanism that has been implicated in the development of endothelial dysfunction is the presence of elevated levels of asymmetric dimethylarginine (ADMA). Free ADMA, which is formed during proteolysis, is actively degraded by the intracellular enzyme dimethylarginine dimethylaminohydrolase (DDAH) which catalyzes the conversion of ADMA to citrulline and dimethylamine. It has been estimated that more than 70% of ADMA is metabolized by DDAH (Achan et al. [1]). Decreased DDAH expression/activity is evident in disease states associated with endothelial dysfunction and is believed to be the mechanism responsible for increased methylarginines and subsequent ADMA mediated eNOS impairment. However, recent studies suggest that DDAH may regulate eNOS activity and endothelial function through both ADMA-dependent and -independent mechanisms. In this regard, elevated plasma ADMA may serve as a marker of impaired methylarginine metabolism and the pathology previously attributed to elevated ADMA may be manifested, at least in part, through altered activity of the enzymes involved in ADMA regulation, specifically DDAH and PRMT.
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Affiliation(s)
- Arthur J Pope
- Department of Physiology and Functional Genomics, University of Florida College of Medicine, Gainesville, 32607, United States
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Vladimirova-Kitova L, Terzieva D, Marinov B. Intima-media thickness and flow-mediated vasodilation in asymptomatic subjects with newly detected severe hypercholesterolemia. Echocardiography 2009; 26:1060-8. [PMID: 19558516 DOI: 10.1111/j.1540-8175.2009.00926.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim was to establish the predictors of early functional and structural vascular alterations (using intima-media thickness (IMT)) and flow-mediated vasodilation (%FMD) as well as to investigate the interrelationship between IMT and %FMD in asymptomatic, never-treated, severe hypercholesterolemia (HH). METHODS One hundred and twenty patients with asymptomatic, severe, untreated HH and 100 controls were included. ELISA was used for asymmetric dimethylarginine (ADMA) and cellular adhesion molecules, and fluid chromatography for total homocysteine (tHcy). Hewlett Packard SONOS 5500 with a 7.5 MHz transducer and MedicaSoft IMT software were used for evaluation of %FMD and IMT of common carotid artery (CCA). RESULTS Patients and controls differ with respect to all tested biomarkers (P < 0.05), except for P-selectin and E-selectin (P < 0.05). %FMD was lower in patients (P < 0.001). The IMT of the CCA was higher in patients (P < 0.001). Inverse correlations were found between %FMD and IMT mean and age, ADMA, Apo-B, Apo-B/Apo-A(1), and tHcy. ADMA was established as the most important factor related to %FMD. Age and Apo-B were established as the most important factors related to IMT mean. An inverse correlation was established between %FMD and IMT mean (r(xy)= 0.546; P < 0.001)). If cases with IMT mean > or =1 were excluded, the correlation weakened. In patients with IMT mean > or =1 mm, the correlation did not change. CONCLUSION In conclusion, asymptomatic, untreated patients with severe hypercholesterolemia are at high risk of having increased IMT of the CCA, especially if there is endothelial dysfunction, verified by %FMD of the brachial artery.
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