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Yilmaz M, Yay E, Atalay N, Balci N, Kurgan Ş, Toygar H, Serdar MA. Do arginine metabolites have a role in periodontitis due to smoking? A new perspective. Oral Dis 2024; 30:743-753. [PMID: 36401797 DOI: 10.1111/odi.14448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/31/2022] [Accepted: 11/15/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Cigarette consumption is common around the world and besides its negative effects on health, and its effects on periodontitis draw attention. Arginine metabolites are involved in the pathogenesis of several systemic inflammatory diseases' including cardiovascular diseases. Our aim was to determine periodontitis and healthy individuals' arginine metabolites and IL-6 levels in saliva and serum and to evaluate those according to smoking status. MATERIALS AND METHODS The study consisted of four groups: healthy individuals (control [C]; n = 20), smokers with healthy periodontium (S-C; n = 20), nonsmokers with Stage-III Grade-B generalized periodontitis (P; n = 20) and smokers with Stage-III Grade-C generalized periodontitis (S-P; n = 18). Periodontal parameters were measured. Analysis of methylated arginine metabolites was performed by LC-MS/MS, and IL-6 levels were determined by ELISA kits. RESULTS In nonsmokers, salivary concentrations of asymmetric dimethylarginine (ADMA) and symmetrical dimethylarginine (SDMA) were higher in the periodontitis than control (p < 0.001, p = 0.010). Smokers with periodontitis exhibited higher ADMA (p = 0.033, p < 0.001) and arginine (p = 0.030, p = 0.001) saliva concentrations than smoking and nonsmoking controls. CONCLUSIONS Our results demonstrated that salivary concentrations of ADMA and SDMA were associated with periodontitis. Smoking increased ADMA, SDMA and NG -monomethyl L-arginine (L-NMMA) levels in serum only in periodontitis patients.
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Affiliation(s)
- Melis Yilmaz
- Department of Periodontology, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
- Department of Periodontology, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Ekin Yay
- Department of Periodontology, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
- Department of Periodontology, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Nur Atalay
- Department of Periodontology, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
- Department of Periodontology, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Nur Balci
- Department of Periodontology, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
- Department of Periodontology, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Şivge Kurgan
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Hilal Toygar
- Department of Periodontology, Institute of Health Sciences, Istanbul Medipol University, Istanbul, Turkey
- Department of Periodontology, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Muhittin A Serdar
- Department of Medical Biochemistry, School of Medicine, Acıbadem University, Ankara, Turkey
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Liu M, Shen J, Zhu X, Ju T, Willing BP, Wu X, Lu Q, Liu R. Peanut skin procyanidins reduce intestinal glucose transport protein expression, regulate serum metabolites and ameliorate hyperglycemia in diabetic mice. Food Res Int 2023; 173:113471. [PMID: 37803795 DOI: 10.1016/j.foodres.2023.113471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/05/2023] [Accepted: 09/10/2023] [Indexed: 10/08/2023]
Abstract
One of diabetic characteristics is the postprandial hyperglycemia. Inhibiting glucose uptake may be beneficial for controlling postprandial blood glucose levels and regulating the glucose metabolism Peanut skin procyanidins (PSP) have shown a potential for lowering blood glucose; however, the underlying mechanism through which PSP regulate glucose metabolism remains unknown. In the current study, we investigated the effect of PSP on intestinal glucose transporters and serum metabolites using a mouse model of diabetic mice. Results showed that PSP improved glucose tolerance and systemic insulin sensitivity, which coincided with decreased expression of sodium-glucose cotransporter 1 and glucose transporter 2 in the intestinal epithelium induced by an activation of the phospholipase C β2/protein kinase C signaling pathway. Moreover, untargeted metabolomic analysis of serum samples revealed that PSP altered arachidonic acid, sphingolipid, glycerophospholipid, bile acids, and arginine metabolic pathways. The study provides new insight into the anti-diabetic mechanism of PSP and a basis for further research.
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Affiliation(s)
- Min Liu
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430000, China; Wuhan Engineering Research Center of Bee Products on Quality and Safety Control, Wuhan 430000, China
| | - Jinxin Shen
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430000, China; Wuhan Engineering Research Center of Bee Products on Quality and Safety Control, Wuhan 430000, China
| | - Xiaoling Zhu
- Hubei Provincial Institute for Food Supervision and Test, Wuhan 430070, China
| | - Tingting Ju
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Benjamin P Willing
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2P5, Canada
| | - Xin Wu
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430000, China; Wuhan Engineering Research Center of Bee Products on Quality and Safety Control, Wuhan 430000, China
| | - Qun Lu
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430000, China; Wuhan Engineering Research Center of Bee Products on Quality and Safety Control, Wuhan 430000, China; Key Laboratory of Environment Correlative Dietology, Ministry of Education, Wuhan 430000, China
| | - Rui Liu
- College of Food Science and Technology, Huazhong Agricultural University, Wuhan 430000, China; Wuhan Engineering Research Center of Bee Products on Quality and Safety Control, Wuhan 430000, China; Key Laboratory of Environment Correlative Dietology, Ministry of Education, Wuhan 430000, China; Key Laboratory of Urban Agriculture in Central China, Ministry of Agriculture and Rural Affairs, China.
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Fujimori ASS, Ribeiro APD, Pereira AG, Dias-Audibert FL, Tonon CR, dos Santos PP, Dantas D, Zanati SG, Catharino RR, Zornoff LAM, Azevedo PS, de Paiva SAR, Okoshi MP, Lima EO, Polegato BF. Effects of Pera Orange Juice and Moro Orange Juice in Healthy Rats: A Metabolomic Approach. Metabolites 2023; 13:902. [PMID: 37623846 PMCID: PMC10456557 DOI: 10.3390/metabo13080902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Cardiovascular disease is a leading cause of death worldwide. Heart failure is a cardiovascular disease with high prevalence, morbidity, and mortality. Several natural compounds have been studied for attenuating pathological cardiac remodeling. Orange juice has been associated with cardiovascular disease prevention by attenuating oxidative stress. However, most studies have evaluated isolated phytochemicals rather than whole orange juice and usually under pathological conditions. In this study, we evaluated plasma metabolomics in healthy rats receiving Pera or Moro orange juice to identify possible metabolic pathways and their effects on the heart. METHODS Sixty male Wistar rats were allocated into 3 groups: control (C), Pera orange juice (PO), and Moro orange juice (MO). PO and MO groups received Pera orange juice or Moro orange juice, respectively, and C received water with maltodextrin (100 g/L). Echocardiogram and euthanasia were performed after 4 weeks. Plasma metabolomic analysis was performed by high-resolution mass spectrometry. Type I collagen was evaluated in picrosirius red-stained slides and matrix metalloproteinase (MMP)-2 activity by zymography. MMP-9, tissue inhibitor of metalloproteinase (TIMP)-2, TIMP-4, type I collagen, and TNF-α protein expression were evaluated by Western blotting. RESULTS We differentially identified three metabolites in PO (N-docosahexaenoyl-phenylalanine, diglyceride, and phosphatidylethanolamine) and six in MO (N-formylmaleamic acid, N2-acetyl-L-ornithine, casegravol isovalerate, abscisic alcohol 11-glucoside, cyclic phosphatidic acid, and torvoside C), compared to controls, which are recognized for their possible roles in cardiac remodeling, such as extracellular matrix regulation, inflammation, oxidative stress, and membrane integrity. Cardiac function, collagen level, MMP-2 activity, and MMP-9, TIMP-2, TIMP-4, type I collagen, and TNF-α protein expression did not differ between groups. CONCLUSION Ingestion of Pera and Moro orange juice induces changes in plasma metabolites related to the regulation of extracellular matrix, inflammation, oxidative stress, and membrane integrity in healthy rats. Moro orange juice induces a larger number of differentially expressed metabolites than Pera orange juice. Alterations in plasma metabolomics induced by both orange juice are not associated with modifications in cardiac extracellular matrix components. Our results allow us to postulate that orange juice may have beneficial effects on pathological cardiac remodeling.
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Affiliation(s)
- Anderson S. S. Fujimori
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Ana P. D. Ribeiro
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Amanda G. Pereira
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Flávia L. Dias-Audibert
- Innovare Biomarkers Laboratory, School of Pharmaceutical Sciences, University of Campinas, Campinas 13083-970, Brazil; (F.L.D.-A.); (R.R.C.)
| | - Carolina R. Tonon
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Priscila P. dos Santos
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Danielle Dantas
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Silmeia G. Zanati
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Rodrigo R. Catharino
- Innovare Biomarkers Laboratory, School of Pharmaceutical Sciences, University of Campinas, Campinas 13083-970, Brazil; (F.L.D.-A.); (R.R.C.)
| | - Leonardo A. M. Zornoff
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Paula S. Azevedo
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Sergio A. R. de Paiva
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Marina P. Okoshi
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Estela O. Lima
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
| | - Bertha F. Polegato
- Internal Medicine Department, Botucatu Medical School, São Paulo State University (UNESP), Botucatu 18618-687, Brazil; (A.S.S.F.); (A.P.D.R.); (A.G.P.); (C.R.T.); (P.P.d.S.); (D.D.); (S.G.Z.); (L.A.M.Z.); (P.S.A.); (S.A.R.d.P.); (M.P.O.); (E.O.L.)
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Ren G, Hwang PTJ, Millican R, Shin J, Brott BC, van Groen T, Powell CM, Bhatnagar S, Young ME, Jun HW, Kim JA. Subcutaneous Administration of a Nitric Oxide-Releasing Nanomatrix Gel Ameliorates Obesity and Insulin Resistance in High-Fat Diet-Induced Obese Mice. ACS APPLIED MATERIALS & INTERFACES 2022; 14:19104-19115. [PMID: 35467831 PMCID: PMC9233978 DOI: 10.1021/acsami.1c24113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Nitric oxide (NO) is a gaseous signaling molecule, which plays crucial roles in various biological processes, including inflammatory responses, metabolism, cardiovascular functions, and cognitive function. NO bioavailability is reduced with aging and cardiometabolic disorders in humans and rodents. NO stimulates the metabolic rate by increasing the mitochondrial biogenesis and brown fat activation. Therefore, we propose a novel technology of providing exogenous NO to improve the metabolic rate and cognitive function by promoting the development of brown adipose tissue. In the present study, we demonstrate the effects of the peptide amphiphiles-NO-releasing nanomatrix gel (PANO gel) on high-fat diet-induced obesity, insulin resistance, and cognitive functions. Eight-week-old male C57BL/6 mice were subcutaneously injected in the brown fat area with the PANO gel or vehicle (PA gel) every 2 weeks for 12 weeks. The PANO gel-injected mice gained less body weight, improved glucose tolerance, and decreased fasting serum insulin and leptin levels compared with the PA gel-injected mice. Insulin signaling in the muscle, liver, and epididymal white adipose tissue was improved by the PANO gel injection. The PANO gel reduced inflammation, increased lipolysis in the epididymal white adipose tissue, and decreased serum lipids and liver triglycerides. Interestingly, the PANO gel stimulated uncoupled protein 1 gene expression in the brown and beige fat tissues. Furthermore, the PANO gel increased the cerebral blood flow and improved learning and memory abilities. Our results suggest that using the PANO gel to supply exogenous NO is a novel technology to treat metabolic disorders and cognitive dysfunctions.
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Affiliation(s)
- Guang Ren
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Alabama at Birmingham, Birmingham, AL 35294
| | | | | | - Juhee Shin
- Department of Biomedical engineering, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Brigitta C. Brott
- Endomimetics, LLC, Birmingham, AL 35242
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Thomas van Groen
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Craig M. Powell
- Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Sushant Bhatnagar
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Alabama at Birmingham, Birmingham, AL 35294
- UAB Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Martin E. Young
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL 35294
- UAB Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Ho-Wook Jun
- Endomimetics, LLC, Birmingham, AL 35242
- Department of Biomedical engineering, University of Alabama at Birmingham, Birmingham, AL 35294
| | - Jeong-a Kim
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Alabama at Birmingham, Birmingham, AL 35294
- UAB Comprehensive Diabetes Center, University of Alabama at Birmingham, Birmingham, AL 35294
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Interactions among Endothelial Nitric Oxide Synthase, Cardiovascular System, and Nociception during Physiological and Pathophysiological States. Molecules 2022; 27:molecules27092835. [PMID: 35566185 PMCID: PMC9105107 DOI: 10.3390/molecules27092835] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/19/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022] Open
Abstract
Nitric oxide synthase (NOS) plays important roles within the cardiovascular system in physiological states as well as in pathophysiologic and specific cardiovascular (CV) disease states, such as hypertension (HTN), arteriosclerosis, and cerebrovascular accidents. This review discusses the roles of the endothelial NOS (eNOS) and its effect on cardiovascular responses that are induced by nociceptive stimuli. The roles of eNOS enzyme in modulating CV functions while experiencing pain will be discussed. Nociception, otherwise known as the subjective experience of pain through sensory receptors, termed “nociceptors”, can be stimulated by various external or internal stimuli. In turn, events of various cascade pathways implicating eNOS contribute to a plethora of pathophysiological responses to the noxious pain stimuli. Nociception pathways involve various regions of the brain and spinal cord, including the dorsolateral periaqueductal gray matter (PAG), rostral ventrolateral medulla (RVLM), caudal ventrolateral medulla, and intermediolateral column of the spinal cord. These pathways can interrelate in nociceptive responses to pain stimuli. The alterations in CV responses that affect GABAergic and glutamatergic pathways will be discussed in relation to mechanical and thermal (heat and cold) stimuli. Overall, this paper will discuss the aggregate recent and past data regarding pain pathways and the CV system.
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The effects of acute arginine supplementation on neuroendocrine, metabolic, cardiovascular, and mood outcomes in younger men: a double-blind placebo controlled trial. Nutrition 2022; 101:111658. [PMID: 35691183 PMCID: PMC9310054 DOI: 10.1016/j.nut.2022.111658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 11/23/2022]
Abstract
Objectives: Arginine is an amino-acid supplement and precursor for nitric-oxide synthesis, which affects various biologic processes. The objective of this study was to determine the effects of arginine supplementation on growth hormone (GH) and metabolic parameters. Methods: Thirty physically active, healthy men (age 18–39 y; body mass index: 18.5–25 kg/m2) were randomized in a double-blind, placebo-controlled, crossover trial. Arginine (10 g) and placebo (0 g) beverages were consumed after an overnight fast. Blood samples were collected at baseline and 1.5, 3.0, and 24 h after supplementation. The primary outcomes were serum GH and metabolomics. Also, amino acids, glucose, insulin, triacylglycerols, thyroid hormones, testosterone, cortisol, dehydroepiandrosterone, and mood state were assessed. Individuals with detectable increases in GH were analyzed separately (responders: n = 16; < 0.05 ng/mL at 1.5 h). Repeated-measure analyses of variance estimated the treatment effects at each timepoint. Results: Arginine levels increased at 1.5 h (146%) and 3.0 h (95%; P ≤ 0.001) and GH (193%) and thyroid-stimulating hormone (TSH; 10%) levels at 24 h (P < 0.05) after arginine versus placebo consumption. Arginine versus placebo increased glucose levels at 1.5 h (5%) and 3.0 h (3%; P ≤ 0.001). Arginine versus placebo did not affect other dependent measures, including mood state (P > 0.05), but changes in the urea, glutamate, and citric-acid pathways were observed. Among responders, arginine versus placebo increased GH at 1.5 h (37%), glucose at 1.5 h (4%) and 3.0 h (4%), and TSH at 24 h (9%; P < 0.05). Responders had higher levels of benzoate metabolites at baseline and 1.5 h, and an unknown compound (X-16124) at baseline, 1.5 h, and 24 h that corresponds to a class of gut microbes (P < 0.05). Conclusions: Arginine supplementation modestly increased GH, glucose, and TSH levels in younger men. Responders had higher benzoate metabolites and an unknown analyte attributed to the gut microbiome. Future studies should examine whether the increased prevalence of these gut microorganisms corresponds with GH response after arginine supplementation.
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Moyad MA. Nutraceuticals and Phytotherapy in Men's Health: Antioxidants, Pro-oxidants, and a Novel Opportunity for Lifestyle Changes. Urol Clin North Am 2022; 49:239-248. [DOI: 10.1016/j.ucl.2021.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Recommendations for specialized nutritional-metabolic treatment of the critical patient: Heart disease. Metabolism and Nutrition Working Group of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC). Med Intensiva 2021; 44 Suppl 1:77-80. [PMID: 32532417 DOI: 10.1016/j.medin.2019.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/21/2019] [Accepted: 12/09/2019] [Indexed: 11/24/2022]
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Appel D, Böger R, Windolph J, Heinze G, Goetz AE, Hannemann J. Asymmetric dimethylarginine predicts perioperative cardiovascular complications in patients undergoing medium-to-high risk non-cardiac surgery. J Int Med Res 2021; 48:300060520940450. [PMID: 32842812 PMCID: PMC7453459 DOI: 10.1177/0300060520940450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objectives Perioperative cardiovascular events remain an important factor that affects surgery outcome. We assessed if asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthesis, predicts perioperative risk, and if pre-operative supplementation with L-arginine/L-citrulline improves the plasma L-arginine/ADMA ratio. Methods In this prospective study, planned thoracic and/or abdominal surgery patients were randomized to receive L-arginine/L-citrulline (5 g/day) or placebo 1 to 5 days before surgery. We measured perioperative plasma ADMA and L-arginine levels. The primary outcome was a 30-day combined cardiovascular endpoint. Results Among 269 patients, 23 (8.6%) experienced a major adverse cardiovascular event. ADMA and C-reactive protein were significantly associated with the incidence of cardiovascular complications in the multivariable-adjusted analysis. The L-arginine plasma concentration was significantly higher on the day of surgery with L-arginine/L-citrulline supplementation compared with placebo. In patients with high pre-operative ADMA, there was a non-significant trend towards reduced incidence of the primary endpoint with L-arginine/L-citrulline supplementation (six vs. nine events). Conclusions ADMA is a predictor of major adverse cardiovascular complications in the perioperative period for patients who are undergoing major abdominal and/or thoracic surgery. Supplementation with L-arginine/L-citrulline increased the L-arginine plasma concentration, enhanced the L-arginine/ADMA ratio, and induced a trend towards fewer perioperative events.
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Affiliation(s)
- Daniel Appel
- University Medical Center Hamburg-Eppendorf, Department of Anesthesiology, Hamburg, DE, Germany
| | - Rainer Böger
- University Medical Center Hamburg-Eppendorf, Institute of Clinical Pharmacology and Toxicology, Hamburg, DE, Germany
| | - Julia Windolph
- University Medical Center Hamburg-Eppendorf, Institute of Clinical Pharmacology and Toxicology, Hamburg, DE, Germany
| | - Gina Heinze
- University Medical Center Hamburg-Eppendorf, Department of Anesthesiology, Hamburg, DE, Germany
| | - Alwin E Goetz
- University Medical Center Hamburg-Eppendorf, Department of Anesthesiology, Hamburg, DE, Germany
| | - Juliane Hannemann
- University Medical Center Hamburg-Eppendorf, Institute of Clinical Pharmacology and Toxicology, Hamburg, DE, Germany
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Karimi E, Hatami E, Ghavami A, Hadi A, Darand M, Askari G. Effects of L-arginine supplementation on biomarkers of glycemic control: a systematic review and meta-analysis of randomised clinical trials. Arch Physiol Biochem 2021; 129:700-710. [PMID: 33426939 DOI: 10.1080/13813455.2020.1863991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The present meta-analysis aimed to determine the effectiveness of L-arginine supplementation in improving biomarkers of glycemic control in adults. Electronic databases including PubMed, ISI Web of Science, Scopus, and the Cochrane Collaboration Library were searched up to January 2020. The meta-analysis of twelve randomised clinical trials indicated that L-arginine had no significant effect on serum fasting blood sugar (FBS) (weighted mean difference [WMD]: -3.38 mg/dl, 95% CI: -6.79 to 0.04, p = .53), serum insulin (WMD: -0.12 Hedges' g 95% CI: -0.33 to 0.09, p = .27), glycated haemoglobin A1c (HbA1c; WMD: -0.04%, 95% CI: -0.25 to 0.17, p = .71), and homeostasis model assessment for insulin resistance (WMD: -0.48, 95% CI: -1.15 to 0.19, p = .15). Although several animal studies have proposed that L-arginine supplementation might improve blood glucose control, the present study could not confirm this benefit in humans.
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Affiliation(s)
- Elham Karimi
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Research Development Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elaheh Hatami
- Department of Exercise Physiology, Sport Medicine Research Center, Sport Sciences Research Institute, Tehran, Iran
| | - Abed Ghavami
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran
| | - Mina Darand
- Student Research Committee, Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Chaliha DR, Vaccarezza M, Takechi R, Lam V, Visser E, Drummond P, Mamo JCL. A Paradoxical Vasodilatory Nutraceutical Intervention for Prevention and Attenuation of Migraine-A Hypothetical Review. Nutrients 2020; 12:E2487. [PMID: 32824835 PMCID: PMC7468811 DOI: 10.3390/nu12082487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/14/2020] [Accepted: 08/15/2020] [Indexed: 02/07/2023] Open
Abstract
Studies suggest that migraine pain has a vascular component. The prevailing dogma is that peripheral vasoconstriction activates baroreceptors in central, large arteries. Dilatation of central vessels stimulates nociceptors and induces cortical spreading depression. Studies investigating nitric oxide (NO) donors support the indicated hypothesis that pain is amplified when acutely administered. In this review, we provide an alternate hypothesis which, if substantiated, may provide therapeutic opportunities for attenuating migraine frequency and severity. We suggest that in migraines, heightened sympathetic tone results in progressive central microvascular constriction. Suboptimal parenchymal blood flow, we suggest, activates nociceptors and triggers headache pain onset. Administration of NO donors could paradoxically promote constriction of the microvasculature as a consequence of larger upstream central artery vasodilatation. Inhibitors of NO production are reported to alleviate migraine pain. We describe how constriction of larger upstream arteries, induced by NO synthesis inhibitors, may result in a compensatory dilatory response of the microvasculature. The restoration of central capillary blood flow may be the primary mechanism for pain relief. Attenuating the propensity for central capillary constriction and promoting a more dilatory phenotype may reduce frequency and severity of migraines. Here, we propose consideration of two dietary nutraceuticals for reducing migraine risk: L-arginine and aged garlic extracts.
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Affiliation(s)
- Devahuti Rai Chaliha
- Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia; (D.R.C.); (M.V.); (R.T.); (V.L.)
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia
| | - Mauro Vaccarezza
- Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia; (D.R.C.); (M.V.); (R.T.); (V.L.)
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia
| | - Ryu Takechi
- Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia; (D.R.C.); (M.V.); (R.T.); (V.L.)
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia
| | - Virginie Lam
- Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia; (D.R.C.); (M.V.); (R.T.); (V.L.)
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia
| | - Eric Visser
- School of Medicine, University of Notre Dame, Fremantle 6160, Australia;
| | - Peter Drummond
- College of Science, Health, Engineering and Education (SHEE), Murdoch University, Murdoch 6150, Australia;
| | - John Charles Louis Mamo
- Curtin Health Innovation Research Institute, Curtin University, Kent St., Bentley 6102, Australia; (D.R.C.); (M.V.); (R.T.); (V.L.)
- School of Public Health, Faculty of Health Sciences, Curtin University, Kent St., Bentley 6102, Australia
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12
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Pre-Analytical and Clinical Validation of a Dried Blood Spot Assay for Asymmetric Dimethylarginine and L-Arginine. J Clin Med 2020; 9:jcm9041072. [PMID: 32283799 PMCID: PMC7230730 DOI: 10.3390/jcm9041072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 02/07/2023] Open
Abstract
Asymmetric dimethylarginine (ADMA) inhibits nitric oxide (NO) synthesis. It is a risk marker for cardiovascular events and mortality in patients with cardiometabolic diseases and in population-based studies. Plasma or serum analysis of ADMA may be hampered by pre-analytical sample handling. We validated a dried blood spot (DBS) assay for ADMA and L-arginine and show here that this assay has excellent variabilities and reproducibilities. Filter paper is impregnated with the arginase inhibitor nor-NOHA (Nω-hydroxy-nor-Arginine) to avoid L-arginine degradation. Clinical validation of this DBS assay confirms elevated ADMA concentration in hemodialysis patients as compared to healthy controls, higher ADMA concentrations in men versus women, and elevated L-arginine concentration in subjects supplemented with L-arginine. The DBS assay was used in a cohort study involving 100 primarily healthy subjects in the Andean region to assess the impact of chronic intermittent hypoxia on ADMA and L-arginine; ADMA DBS concentration at sea level was prospectively associated with pulmonary hypertension after six months of exposure to 3500 m. In a cohort of 753 individuals, L-arginine/ADMA ratio significantly decreased with increasing number of traditional cardiovascular risk factors. Analysis of ADMA and L-arginine in DBS is a reliable and reproducible method for quantitation of these markers in field studies.
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13
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Dikalova A, Aschner JL, Kaplowitz MR, Cunningham G, Summar M, Fike CD. Combined l-citrulline and tetrahydrobiopterin therapy improves NO signaling and ameliorates chronic hypoxia-induced pulmonary hypertension in newborn pigs. Am J Physiol Lung Cell Mol Physiol 2020; 318:L762-L772. [PMID: 32073878 PMCID: PMC7191483 DOI: 10.1152/ajplung.00280.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 02/05/2020] [Accepted: 02/12/2020] [Indexed: 01/21/2023] Open
Abstract
Newborn pigs with chronic hypoxia-induced pulmonary hypertension (PH) have evidence of endothelial nitric oxide synthase (eNOS) uncoupling. In this model, we showed that therapies that promote eNOS coupling, either tetrahydrobiopterin (BH4), a NOS cofactor, or l-citrulline, a NO-l-arginine precursor, inhibit PH. We wanted to determine whether cotreatment with l-citrulline and a BH4 compound, sapropterin dihydrochloride, improves NO signaling and chronic hypoxia-induced PH more markedly than either alone. Normoxic (control) and hypoxic piglets were studied. Some hypoxic piglets received sole treatment with l-citrulline or BH4, or were cotreated with l-citrulline and BH4, from day 3 through day 10 of hypoxia. Catheters were placed for hemodynamic measurements, and pulmonary arteries were dissected to assess eNOS dimer-to-monomer ratios and NO production. In untreated hypoxic piglets, pulmonary vascular resistance (PVR) was higher and NO production and eNOS dimer-to-monomer ratios were lower than in normoxic piglets. Compared with the untreated hypoxic group, PVR was lower in hypoxic piglets cotreated with l-citrulline and BH4 and in those treated with l-citrulline alone but not for those treated solely with BH4. NO production and eNOS dimer-to-monomer ratios were greater for all three treated hypoxic groups compared with the untreated group. Notably, greater improvements in PVR, eNOS dimer-to-monomer ratios, and NO production were found in hypoxic piglets cotreated with l-citrulline and BH4 than in piglets treated with either alone. Cotreatment with l-citrulline and BH4 more effectively improves NO signaling and inhibits chronic hypoxia-induced PH than either treatment alone. Combination therapies may offer enhanced therapeutic capacity for challenging clinical conditions, such as chronic neonatal PH.
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Affiliation(s)
- Anna Dikalova
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Judy L Aschner
- Department of Pediatrics, Albert Einstein College of Medicine, New York, New York
- Department of Pediatrics, Hackensack Meridian Health School of Medicine at Seton Hall University, Nutley, New Jersey
| | - Mark R Kaplowitz
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Pediatrics, University of Utah Health, Salt Lake City, Utah
| | - Gary Cunningham
- Division of Genetics and Metabolism, Children's National Medical Center, Washington, District of Columbia
| | - Marshall Summar
- Division of Genetics and Metabolism, Children's National Medical Center, Washington, District of Columbia
| | - Candice D Fike
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
- Department of Pediatrics, University of Utah Health, Salt Lake City, Utah
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14
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Dillard J, Perez M, Chen B. Therapies that enhance pulmonary vascular NO-signaling in the neonate. Nitric Oxide 2019; 95:45-54. [PMID: 31870967 DOI: 10.1016/j.niox.2019.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 10/25/2019] [Accepted: 12/17/2019] [Indexed: 02/07/2023]
Abstract
There are several pulmonary hypertensive diseases that affect the neonatal population, including persistent pulmonary hypertension of the newborn (PPHN) and bronchopulmonary dysplasia (BPD)-associated pulmonary hypertension (PH). While the indication for inhaled nitric oxide (iNO) use is for late-preterm and term neonates with PPHN, there is a suboptimal response to this pulmonary vasodilator in ~40% of patients. Additionally, there are no FDA-approved treatments for BPD-associated PH or for preterm infants with PH. Therefore, investigating mechanisms that alter the nitric oxide-signaling pathway has been at the forefront of pulmonary vascular biology research. In this review, we will discuss the various mechanistic pathways that have been targets in neonatal PH, including NO precursors, soluble guanylate cyclase modulators, phosphodiesterase inhibitors and antioxidants. We will review their role in enhancing NO-signaling at the bench, in animal models, as well as highlight their role in the treatment of neonates with PH.
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Affiliation(s)
- Julie Dillard
- Pulmonary Hypertension Group, Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
| | - Marta Perez
- Division of Neonatology, Stanley Manne Children's Research Institute, Ann and Robert H Lurie Children's Hospital, Chicago, IL, USA; Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.
| | - Bernadette Chen
- Pulmonary Hypertension Group, Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Pediatrics, The Ohio State University, Columbus, OH, USA.
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15
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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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Simonsen U, Winther AK, Oliván-Viguera A, Comerma-Steffensen S, Köhler R, Bek T. Extracellular l-arginine Enhances Relaxations Induced by Opening of Calcium-Activated SKCa Channels in Porcine Retinal Arteriole. Int J Mol Sci 2019; 20:ijms20082032. [PMID: 31027156 PMCID: PMC6515554 DOI: 10.3390/ijms20082032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 04/22/2019] [Accepted: 04/23/2019] [Indexed: 01/27/2023] Open
Abstract
We investigated whether the substrate for nitric oxide (NO) production, extracellular l-arginine, contributes to relaxations induced by activating small (SKCa) conductance Ca2+-activated potassium channels. In endothelial cells, acetylcholine increased 3H-l-arginine uptake, while blocking the SKCa and the intermediate (IKCa) conductance Ca2+-activated potassium channels reduced l-arginine uptake. A blocker of the y+ transporter system, l-lysine also blocked 3H-l-arginine uptake. Immunostaining showed co-localization of endothelial NO synthase (eNOS), SKCa3, and the cationic amino acid transporter (CAT-1) protein of the y+ transporter system in the endothelium. An opener of SKCa channels, cyclohexyl-[2-(3,5-dimethyl-pyrazol-1-yl)-6-methyl-pyrimidin-4-yl]-amine (CyPPA) induced large currents in endothelial cells, and concentration-dependently relaxed porcine retinal arterioles. In the presence of l-arginine, concentration-response curves for CyPPA were leftward shifted, an effect unaltered in the presence of low sodium, but blocked by l-lysine in the retinal arterioles. Our findings suggest that SKCa channel activity regulates l-arginine uptake through the y+ transporter system, and we propose that in vasculature affected by endothelial dysfunction, l-arginine administration requires the targeting of additional mechanisms such as SKCa channels to restore endothelium-dependent vasodilatation.
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Affiliation(s)
- Ulf Simonsen
- Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Aarhus University, Wilhelm Meyers Allé 4, DK-8000 Aarhus C, Denmark.
| | - Anna K Winther
- Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Aarhus University, Wilhelm Meyers Allé 4, DK-8000 Aarhus C, Denmark.
| | - Aida Oliván-Viguera
- BESICoS group, Aragón Institute of Engineering Research, IIS-Aragón, University of Zaragoza, 50009 Zaragoza, Spain.
| | - Simon Comerma-Steffensen
- Department of Biomedicine, Pulmonary and Cardiovascular Pharmacology, Aarhus University, Wilhelm Meyers Allé 4, DK-8000 Aarhus C, Denmark.
| | - Ralf Köhler
- Aragón Agency for Research and Development (ARAID) at IACS and IIS Aragón, 50009 Zaragoza, Spain.
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, DK-8000 Aarhus C, Denmark.
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17
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Short-term l-arginine supplementation attenuates elevation of interleukin 6 level after resistance exercise in overweight men. Clin Nutr ESPEN 2018; 22:43-47. [PMID: 29415833 DOI: 10.1016/j.clnesp.2017.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 06/05/2017] [Accepted: 09/05/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND AIM l-Arginine (l-arg) supplementation and resistance exercise can induce changes in inflammatory and anti-inflammatory cytokines; however, it has not been investigated in obese hypertensive men. This study examines the effects of short-term l-arg supplementation and acute resistance exercise (AREX) on cytokine levels in obese hypertensive men. METHODS Eight obese hypertensive men aged 46 ± 6 yrs. with an average body weight of 92.56 ± 9.9 kg and a BMI of 31.68 ± 2.18 kg/m2 participated in a randomized, double-blinded, crossover study. The patients were distributed into exercise groups based on the type of supplementation (6 g/day of placebo or l-arg for 7 days). Supplementation periods were separated by a seven-day washout period. The AREX regimen consisted of eight exercises with an exercise intensity of 60% of 1 repetition maximum. The interleukins IL-1ra, IL-6, and IL-10 and the IL-6/IL10 ratio were determined at rest, immediately after exercise and 1 h after exercise sessions. RESULTS IL-1ra levels exhibited a significant difference both immediately and 1 h after exercise when the l-arg and placebo groups were compared (P < 0.05). IL-6 levels increased significantly after exercise in the placebo group compared with the l-arg group (P < 0.05). The placebo group showed a decrease in the IL-10 levels 1 h after exercise compared with resting levels (P < 0.05). The IL-6/IL-10 ratio showed a statistically significant increase in the placebo group after exercise compared to the l-arg group (P < 0.05). CONCLUSIONS LARG supplementation attenuates the cytokine increase after AREX, in particular peak IL-6 levels decrease and exercise induced decreases in IL-10 levels are attenuated.
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18
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Nguyen MC, Ryoo S. Intravenous administration of piceatannol, an arginase inhibitor, improves endothelial dysfunction in aged mice. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2016; 21:83-90. [PMID: 28066144 PMCID: PMC5214914 DOI: 10.4196/kjpp.2017.21.1.83] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 10/07/2016] [Accepted: 11/14/2016] [Indexed: 01/13/2023]
Abstract
Advanced age is one of the risk factors for vascular diseases that are mainly caused by impaired nitric oxide (NO) production. It has been demonstrated that endothelial arginase constrains the activity of endothelial nitric oxide synthase (eNOS) and limits NO generation. Hence, arginase inhibition is suggested to be vasoprotective in aging. In this study, we examined the effects of intravenous injection of Piceatannol, an arginase inhibitor, on aged mice. Our results show that Piceatannol administration reduced the blood pressure in aged mice by inhibiting arginase activity, which was associated with NO production and reactive oxygen species generation. In addition, Piceatannol administration recovered Ca2+/calmodulin-dependent protein kinase II phosphorylation, eNOS phosphorylation and eNOS dimer stability in the aged mice. The improved NO signaling was shown to be effective in attenuating the phenylephrine-dependent contractile response and in enhancing the acetylcholine-dependent vasorelaxation response in aortic rings from the aged mice. These data suggest Piceatannol as a potential treatment for vascular disease.
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Affiliation(s)
- Minh Cong Nguyen
- Department of Biology, College of Natural Sciences, Kangwon National University, Chuncheon 24341, Korea
| | - Sungwoo Ryoo
- Department of Biology, College of Natural Sciences, Kangwon National University, Chuncheon 24341, Korea
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19
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Nguyen MC, Park JT, Jeon YG, Jeon BH, Hoe KL, Kim YM, Lim HK, Ryoo S. Arginase Inhibition Restores Peroxynitrite-Induced Endothelial Dysfunction via L-Arginine-Dependent Endothelial Nitric Oxide Synthase Phosphorylation. Yonsei Med J 2016; 57:1329-38. [PMID: 27593859 PMCID: PMC5011263 DOI: 10.3349/ymj.2016.57.6.1329] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 04/01/2016] [Accepted: 04/07/2016] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Peroxynitrite plays a critical role in vascular pathophysiology by increasing arginase activity and decreasing endothelial nitric oxide synthase (eNOS) activity. Therefore, the aims of this study were to investigate whether arginase inhibition and L-arginine supplement could restore peroxynitrite-induced endothelial dysfunction and determine the involved mechanism. MATERIALS AND METHODS Human umbilical vein endothelial cells (HUVECs) were treated with SIN-1, a peroxynitrite generator, and arginase activity, nitrite/nitrate production, and expression levels of proteins were measured. eNOS activation was evaluated via Western blot and dimer blot analysis. We also tested nitric oxide (NO) and reactive oxygen species (ROS) production and performed a vascular tension assay. RESULTS SIN-1 treatment increased arginase activity in a time- and dose-dependent manner and reciprocally decreased nitrite/nitrate production that was prevented by peroxynitrite scavenger in HUVECs. Furthermore, SIN-1 induced an increase in the expression level of arginase I and II, though not in eNOS protein. The decreased eNOS phosphorylation at Ser1177 and the increased at Thr495 by SIN-1 were restored with arginase inhibitor and L-arginine. The changed eNOS phosphorylation was consistent in the stability of eNOS dimers. SIN-1 decreased NO production and increased ROS generation in the aortic endothelium, all of which was reversed by arginase inhibitor or L-arginine. N(G)-Nitro-L-arginine methyl ester (L-NAME) prevented SIN-1-induced ROS generation. In the vascular tension assay, SIN-1 enhanced vasoconstrictor responses to U46619 and attenuated vasorelaxant responses to acetylcholine that were reversed by arginase inhibition. CONCLUSION These findings may explain the beneficial effect of arginase inhibition and L-arginine supplement on endothelial dysfunction under redox imbalance-dependent pathophysiological conditions.
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Affiliation(s)
- Minh Cong Nguyen
- Department of Biology, College of Natural Sciences, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Jong Taek Park
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Yeong Gwan Jeon
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Byeong Hwa Jeon
- Infectious Signaling Network Research Center, Department of Physiology, School of Medicine, Chungnam National University, Daejeon, Korea
| | - Kwang Lae Hoe
- Department of New Drug Discovery and Development, Chungnam National University, Daejeon, Korea
| | - Young Myeong Kim
- Department of Molecular and Cellular Biochemistry, School of Medicine, Kangwon National University, Chuncheon, Korea
| | - Hyun Kyo Lim
- Department of Anesthesiology and Pain Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
| | - Sungwoo Ryoo
- Department of Biology, College of Natural Sciences, School of Medicine, Kangwon National University, Chuncheon, Korea.
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20
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Therapeutic Benefits of l-Arginine: An Umbrella Review of Meta-analyses. J Chiropr Med 2016; 15:184-9. [PMID: 27660594 DOI: 10.1016/j.jcm.2016.06.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/03/2016] [Accepted: 06/14/2016] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE l-Arginine is a semi-essential amino acid that is the substrate for nitric oxide production by vascular endothelial and immune cells. Nitric oxide production by these cells is essential for both blood pressure regulation and immune regulation. However, there is much discrepancy in the literature when it comes to randomized controlled studies, and so this umbrella review of published meta-analyses was performed to examine the efficacy of l-arginine's role as a therapeutic agent. METHODS There was an overall search of the literature from January 1, 1980 through December 31, 2015 of three separate databases-PubMed, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature-using the following search strategy: (arginine) AND (meta-analysis OR systematic review). Only English language publications were retrieved that provided quantitative statistical analysis of outcomes on blood pressure and immune function. RESULTS The 7 meta-analyses that were included in this umbrella review reported significant positive benefits for reducing systolic and diastolic blood pressure in hypertensive adults by 2.2 to 5.4 mm Hg and 2.7 to 3.1 mm Hg, respectively, reducing diastolic blood pressure in pregnant women with gestational hypertension by 4.9 mm Hg, and reducing the length of stay in the hospital for surgical patients; in addition, 2 of the 3 meta-analyses indicated a 40% reduction in the incidence of hospital-acquired infections. However, these positive results should be considered with caution because statistically significant heterogeneity was observed in 5 of the 7 meta-analyses. CONCLUSIONS Some evidence appears to support the benefit of l-arginine supplementation for reducing systolic and diastolic blood pressure in hypertensive adults and reducing the incidence of hospital-acquired infections and the length of stay in the hospital for surgical patients. Given the limitations of the included studies, interpretations should be made with caution.
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21
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Fike CD, Dikalova A, Kaplowitz MR, Cunningham G, Summar M, Aschner JL. Rescue Treatment with L-Citrulline Inhibits Hypoxia-Induced Pulmonary Hypertension in Newborn Pigs. Am J Respir Cell Mol Biol 2015; 53:255-64. [PMID: 25536367 DOI: 10.1165/rcmb.2014-0351oc] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Infants with cardiopulmonary disorders associated with hypoxia develop pulmonary hypertension. We previously showed that initiation of oral L-citrulline before and continued throughout hypoxic exposure improves nitric oxide (NO) production and ameliorates pulmonary hypertension in newborn piglets. Rescue treatments, initiated after the onset of pulmonary hypertension, better approximate clinical strategies. Mechanisms by which L-citrulline improves NO production merit elucidation. The objective of this study was to determine whether starting L-citrulline after the onset of pulmonary hypertension inhibits disease progression and improves NO production by recoupling endothelial NO synthase (eNOS). Hypoxic and normoxic (control) piglets were studied. Some hypoxic piglets received oral L-citrulline starting on Day 3 of hypoxia and continuing throughout the remaining 7 days of hypoxic exposure. Catheters were placed for hemodynamic measurements, and pulmonary arteries were dissected to assess NO production and eNOS dimer-to-monomer ratios (a measure of eNOS coupling). Pulmonary vascular resistance was lower in L-citrulline-treated hypoxic piglets than in untreated hypoxic piglets but was higher than in normoxic controls. NO production and eNOS dimer-to-monomer ratios were greater in pulmonary arteries from L-citrulline-treated than from untreated hypoxic animals but were lower than in normoxic controls. When started after disease onset, oral L-citrulline treatment improves NO production by recoupling eNOS and inhibits the further development of chronic hypoxia-induced pulmonary hypertension in newborn piglets. Oral L-citrulline may be a novel strategy to halt or reverse pulmonary hypertension in infants suffering from cardiopulmonary conditions associated with hypoxia.
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Affiliation(s)
- Candice D Fike
- 1 Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee.,2 Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee
| | - Anna Dikalova
- 1 Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mark R Kaplowitz
- 1 Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Gary Cunningham
- 3 Division of Genetics and Metabolism, Children's National Medical Center, Washington, District of Columbia; and
| | - Marshall Summar
- 3 Division of Genetics and Metabolism, Children's National Medical Center, Washington, District of Columbia; and
| | - Judy L Aschner
- 4 Department of Pediatrics, Albert Einstein College of Medicine and the Children's Hospital at Montefiore, New York, New York
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McCarty MF, DiNicolantonio JJ. An increased need for dietary cysteine in support of glutathione synthesis may underlie the increased risk for mortality associated with low protein intake in the elderly. AGE (DORDRECHT, NETHERLANDS) 2015; 37:96. [PMID: 26362762 PMCID: PMC5005830 DOI: 10.1007/s11357-015-9823-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/28/2015] [Indexed: 06/05/2023]
Abstract
Restricted dietary intakes of protein or essential amino acids tend to slow aging and boost lifespan in rodents, presumably because they downregulate IGF-I/Akt/mTORC1 signaling that acts as a pacesetter for aging and promotes cancer induction. A recent analysis of the National Health and Nutrition Examination Survey (NHANES) III cohort has revealed that relatively low protein intakes in mid-life (under 10 % of calories) are indeed associated with decreased subsequent risk for mortality. However, in those over 65 at baseline, such low protein intakes were associated with increased risk for mortality. This finding accords well with other epidemiology correlating relatively high protein intakes with lower risk for loss of lean mass and bone density in the elderly. Increased efficiency of protein translation reflecting increased leucine intake and consequent greater mTORC1 activity may play a role in this effect; however, at present there is little solid evidence that leucine supplementation provides important long-term benefits to the elderly. Aside from its potential pro-anabolic impact, higher dietary protein intakes may protect the elderly in another way-by providing increased amino acid substrate for synthesis of key protective factors. There is growing evidence, in both rodents and humans, that glutathione synthesis declines with increasing age, likely reflecting diminished function of Nrf2-dependent inductive mechanisms that boost expression of glutamate cysteine ligase (GCL), rate-limiting for glutathione synthesis. Intracellular glutathione blunts the negative impact of reactive oxygen species (ROS) on cell health and functions both by acting as an oxidant scavenger and by opposing the pro-inflammatory influence of hydrogen peroxide on cell signaling. Fortunately, since GCL's K m for cysteine is close to intracellular cysteine levels, increased intakes of cysteine-achieved from whole proteins or via supplementation with N-acetylcysteine (NAC)-can achieve a compensatory increase in glutathione synthesis, such that more youthful tissue levels of this compound can be restored. Supplementation with phase 2 inducers-such as lipoic acid-can likewise increase glutathione levels by promoting increased GCL expression. In aging humans and/or rodents, NAC supplementation has exerted favorable effects on vascular health, muscle strength, bone density, cell-mediated immunity, markers of systemic inflammation, preservation of cognitive function, progression of neurodegeneration, and the clinical course of influenza-effects which could be expected to lessen mortality and stave off frailty. Hence, greater cysteine availability may explain much of the favorable impact of higher protein intakes on mortality and frailty risk in the elderly, and joint supplementation with NAC and lipoic acid could be notably protective in the elderly, particularly in those who follow plant-based diets relatively low in protein. It is less clear whether the lower arginine intake associated with low-protein diets has an adverse impact on vascular health.
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Affiliation(s)
- Mark F McCarty
- Catalytic Longevity, 7831 Rush Rose Dr., Apt. 316, Carlsbad, CA, 92009, USA.
| | - James J DiNicolantonio
- Preventive Cardiology Department, St. Luke's Mid America Heart Institute, Kansas City, MO, USA.
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Hwang HM, Lee JH, Min BS, Jeon BH, Hoe KL, Kim YM, Ryoo S. A Novel Arginase Inhibitor Derived from Scutellavia indica Restored Endothelial Function in ApoE-Null Mice Fed a High-Cholesterol Diet. J Pharmacol Exp Ther 2015; 355:57-65. [PMID: 26265320 DOI: 10.1124/jpet.115.224592] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 08/07/2015] [Indexed: 11/22/2022] Open
Abstract
Elevated endothelial arginase activity decreases nitric oxide (NO) production by competing with the substrate l-arginine, previously reported, and reciprocally regulating endothelial nitric oxide synthase (eNOS) activity. Thus, arginase inhibitors may help treat vascular diseases associated with endothelial dysfunction. A screening of metabolites from medicinal plants revealed that (2S)-5,2',5'-trihydroxy-7,8-dimethoxy flavanone (TDF) was a noncompetitive inhibitor of arginase. We investigated whether TDF reciprocally regulated endothelial NO production and its possible mechanism. TDF noncompetitively inhibited arginase I and II activity in a dose-dependent manner. TDF incubation decreased arginase activity and increased NO production in human umbilical vein endothelial cells and isolated mouse aortic vessels and reduced reactive oxygen species (ROS) generation in the endothelium of the latter. These TDF-mediated effects were associated with increased eNOS phosphorylation and dimerization but not with changes in protein content. Endothelium-dependent vasorelaxant responses to acetylcholine (Ach) were significantly increased in TDF-incubated aortic rings and attenuated by incubation with soluble guanylyl cyclase inhibitor. Phenylephrine-induced vasoconstrictor responses were markedly attenuated in TDF-treated vessels from wild-type mice. In atherogenic-prone ApoE(-/-) mice, TDF attenuated the high-cholesterol diet (HCD)-induced increase in arginase activity, which was accompanied by restoration of NO production and reduction of ROS generation. TDF incubation induced eNOS dimerization and phosphorylation at Ser1177. In addition, TDF improved Ach-dependent vasorelaxation responses and attenuated U46619-dependent contractile responses but did not change sodium nitroprusside-induced vasorelaxation or N-NAME-induced vasoconstriction. The findings suggest that TDF may help treat cardiovascular diseases by reducing pathophysiology derived from HCD-mediated endothelial dysfunction.
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Affiliation(s)
- Hye Mi Hwang
- Departments of Biological Sciences (H.M.H., S.R.) and Biochemistry (J.H.L.), College of Natural Sciences, and Departments of Molecular and Cellular Biochemistry (Y.M.K.), School of Medicine, Kangwon National University, Chuncheon, Gangwon-do; College of Pharmacy, Catholic University, Daegu (B.S.M.); Infectious Signaling Network Research Center, Department of Physiology, School of Medicine, (B.H.J.) and Department of New Drug Discovery and Development (K.L.H.), Chungnam National University, Daejeon, South Korea
| | - Jeong Hyung Lee
- Departments of Biological Sciences (H.M.H., S.R.) and Biochemistry (J.H.L.), College of Natural Sciences, and Departments of Molecular and Cellular Biochemistry (Y.M.K.), School of Medicine, Kangwon National University, Chuncheon, Gangwon-do; College of Pharmacy, Catholic University, Daegu (B.S.M.); Infectious Signaling Network Research Center, Department of Physiology, School of Medicine, (B.H.J.) and Department of New Drug Discovery and Development (K.L.H.), Chungnam National University, Daejeon, South Korea
| | - Byung Sun Min
- Departments of Biological Sciences (H.M.H., S.R.) and Biochemistry (J.H.L.), College of Natural Sciences, and Departments of Molecular and Cellular Biochemistry (Y.M.K.), School of Medicine, Kangwon National University, Chuncheon, Gangwon-do; College of Pharmacy, Catholic University, Daegu (B.S.M.); Infectious Signaling Network Research Center, Department of Physiology, School of Medicine, (B.H.J.) and Department of New Drug Discovery and Development (K.L.H.), Chungnam National University, Daejeon, South Korea
| | - Byeong Hwa Jeon
- Departments of Biological Sciences (H.M.H., S.R.) and Biochemistry (J.H.L.), College of Natural Sciences, and Departments of Molecular and Cellular Biochemistry (Y.M.K.), School of Medicine, Kangwon National University, Chuncheon, Gangwon-do; College of Pharmacy, Catholic University, Daegu (B.S.M.); Infectious Signaling Network Research Center, Department of Physiology, School of Medicine, (B.H.J.) and Department of New Drug Discovery and Development (K.L.H.), Chungnam National University, Daejeon, South Korea
| | - Kwang Lae Hoe
- Departments of Biological Sciences (H.M.H., S.R.) and Biochemistry (J.H.L.), College of Natural Sciences, and Departments of Molecular and Cellular Biochemistry (Y.M.K.), School of Medicine, Kangwon National University, Chuncheon, Gangwon-do; College of Pharmacy, Catholic University, Daegu (B.S.M.); Infectious Signaling Network Research Center, Department of Physiology, School of Medicine, (B.H.J.) and Department of New Drug Discovery and Development (K.L.H.), Chungnam National University, Daejeon, South Korea
| | - Young Myeong Kim
- Departments of Biological Sciences (H.M.H., S.R.) and Biochemistry (J.H.L.), College of Natural Sciences, and Departments of Molecular and Cellular Biochemistry (Y.M.K.), School of Medicine, Kangwon National University, Chuncheon, Gangwon-do; College of Pharmacy, Catholic University, Daegu (B.S.M.); Infectious Signaling Network Research Center, Department of Physiology, School of Medicine, (B.H.J.) and Department of New Drug Discovery and Development (K.L.H.), Chungnam National University, Daejeon, South Korea
| | - Sungwoo Ryoo
- Departments of Biological Sciences (H.M.H., S.R.) and Biochemistry (J.H.L.), College of Natural Sciences, and Departments of Molecular and Cellular Biochemistry (Y.M.K.), School of Medicine, Kangwon National University, Chuncheon, Gangwon-do; College of Pharmacy, Catholic University, Daegu (B.S.M.); Infectious Signaling Network Research Center, Department of Physiology, School of Medicine, (B.H.J.) and Department of New Drug Discovery and Development (K.L.H.), Chungnam National University, Daejeon, South Korea
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Kotwal J, Kotwal A, Bhalla S, Singh PK, Nair V. Effectiveness of homocysteine lowering vitamins in prevention of thrombotic tendency at high altitude area: A randomized field trial. Thromb Res 2015; 136:758-62. [PMID: 26319423 DOI: 10.1016/j.thromres.2015.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 06/23/2015] [Accepted: 08/03/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION A higher risk of thrombosis has been reported on prolonged stay at high altitude (HAA). Lowering of homocysteine (Hcy) has been found to reduce the risk of venous thrombosis. A randomized field trial was conducted with primary question whether Hcy lowering agents have any effect on the incidence of thrombosis at HAA amongst Indian soldiers as compared to existing interventions. METHODS All units freshly inducted to HAA were randomized into intervention (Vit B12 1000 microgram/day, B6 3mg/day & folic acid 5mg/day) and control arms, with a sample size of 12,000 person-years in each arm. RESULTS At the end of one year stay at HAA, Folate and B 12 levels decreased significantly in control arm. The levels of Hcy, fibrinogen and plasminogen activator inhibitor (PAI 1) were lower and nitric oxide higher in intervention arm as compared to control arm (p<0.05). At the end of 2years, 5 thrombotic episodes occurred in the intervention arm and 17 in control arm with RR of 0.29 (95% CI 0.11-0.80), attributable fraction % (AFe) 70.59%, Population attributable risk percent 54.55% and Protective Fraction 240%. CONCLUSION Intervention with B12 and folic acid is effective in reducing Hcy, PAI 1, fibrinogen levels and increasing NO levels at 1yr as compared to control arm and reducing the incidence of thrombosis at 2years of stay at HAA. Thus, vitamin B 12, B6 and folic acid intervention is safe and effective method of reducing morbidity and mortality caused by HAA induced coagulopathy.
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Affiliation(s)
- Jyoti Kotwal
- Department of Hematology, Sir Gangaram Hospital & GRIPMER, Rajinder Nagar, New Delhi, 110060, India.
| | - Atul Kotwal
- Commandant Hospital, Leh and Consultant Comm Med & Epidemiologist.
| | - Sandeep Bhalla
- Director AFMS (Medical Research), O/o DGAFMS, New Delhi, India.
| | - P K Singh
- Addl DGMS (Army), O/o DGMS (Army), New Delhi, India.
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Staniszewska A, Rajagopalan S, Al-Shaheen A, Thies F, Brittenden J. Increased levels of symmetric dimethyl-arginine are associated with all-cause mortality in patients with symptomatic peripheral arterial disease. J Vasc Surg 2015; 61:1292-8. [DOI: 10.1016/j.jvs.2015.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 01/06/2015] [Indexed: 11/24/2022]
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Interaction of L-arginine with κ-casein and its effect on amyloid fibril formation by the protein: Multi-spectroscopic approaches. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2015; 143:130-8. [DOI: 10.1016/j.jphotobiol.2015.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Revised: 12/25/2014] [Accepted: 01/06/2015] [Indexed: 01/14/2023]
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Scheja L, Kluwe J. Arginine and NASH--do macrophages deliver the first hit? J Hepatol 2015; 62:260-1. [PMID: 25450197 DOI: 10.1016/j.jhep.2014.11.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 11/02/2014] [Accepted: 11/04/2014] [Indexed: 02/06/2023]
Affiliation(s)
- Ludger Scheja
- Department of Biochemistry and Molecular Cell Biology, Hamburg University Medical Center, Hamburg, Germany
| | - Johannes Kluwe
- Department of Gastroenterology and Hepatology, Hamburg University Medical Center, Hamburg, Germany.
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Pahlavani N, Jafari M, Sadeghi O, Rezaei M, Rasad H, Rahdar HA, Entezari MH. L-arginine supplementation and risk factors of cardiovascular diseases in healthy men: a double-blind randomized clinical trial. F1000Res 2014; 3:306. [PMID: 28751963 PMCID: PMC5510020 DOI: 10.12688/f1000research.5877.2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2017] [Indexed: 01/10/2023] Open
Abstract
Context: The effect of L-arginine on risk factors of cardiovascular diseases (CVD) has mostly focused on western countries. Since cardiovascular diseases is the second cause of death in Iran and, as far as we are aware, there have been no studies about the effect of L-arginine on CVD risk factors, the aim of this trial was to assess the effects of L-arginine supplementation on CVD risk factors in healthy men. Objective: The purpose of this study was to evaluate the effect of low-dose L-arginine supplementation on CVD risk factors (lipid profile, blood sugar and blood pressure) in Iranian healthy men. Design, setting, participants: We conducted a double-blind randomized controlled trial in 56 patients selected from sport clubs at the Isfahan University of Medical Science between November 2013 and December 2013. Interventions: Healthy men received L-arginine supplementation (2000 mg daily) in the intervention group or placebo (2000 mg maltodextrin daily) in the control group for 45 days. Main outcome measure: The primary outcome measures were we measured the levels of fasting blood sugar, blood pressure and lipid profile including triglyceride (TG), cholesterol, LDL and HDL in healthy subjects. It was hypothesized that these measures would be significantly improved in those receiving L–arginine supplementation. at the beginning and end of the study. Results: In this trial, we had complete data for 52 healthy participants with mean age of 20.85±4.29 years. At the end of study, fasting blood sugar (P=0.001) and lipid profile (triglycerideTG (P<0.001), cholesterol (P<0.001), LDL (P=0.04), HDL (P=0.015)) decreased in the L-arginine group but we found no significant change in the placebo group. In addition, the reduction of fasting blood sugar and lipid profile in L-arginine was significant compared with placebo group. No significant changes were found about systolic (P=0.81) and diastolic blood pressure either in L-arginine or placebo group. (P=0.532). Conclusion: The use of L-arginine significantly improved outcomes compared to placebo.
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Affiliation(s)
- Naseh Pahlavani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Jafari
- Student Research Committee, Arak University of Medical Science, Arak, Iran
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Rezaei
- Faculty of Nursing and Midwifery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Rasad
- Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Ali Rahdar
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hasan Entezari
- Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Pahlavani N, Jafari M, Sadeghi O, Rezaei M, Rasad H, Rahdar HA, Entezari MH. L-arginine supplementation and risk factors of cardiovascular diseases in healthy men: a double-blind randomized clinical trial. F1000Res 2014; 3:306. [PMID: 28751963 DOI: 10.12688/f1000research.5877.1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2014] [Indexed: 01/04/2023] Open
Abstract
Context: The effect of L-arginine on risk factors of cardiovascular diseases (CVD) has mostly focused on western countries. Since cardiovascular diseases is the second cause of death in Iran and, as far as we are aware, there have been no studies about the effect of L-arginine on CVD risk factors, the aim of this trial was to assess the effects of L-arginine supplementation on CVD risk factors in healthy men. Objective: The purpose of this study was to evaluate the effect of low-dose L-arginine supplementation on CVD risk factors (lipid profile, blood sugar and blood pressure) in Iranian healthy men. Design, setting, participants: We conducted a double-blind randomized controlled trial in 56 patients selected from sport clubs at the Isfahan University of Medical Science between November 2013 and December 2013. Interventions: Healthy men received L-arginine supplementation (2000 mg daily) in the intervention group or placebo (2000 mg maltodextrin daily) in the control group for 45 days. Main outcome measure: The primary outcome measures were we measured the levels of fasting blood sugar, blood pressure and lipid profile including triglyceride (TG), cholesterol, LDL and HDL in healthy subjects. It was hypothesized that these measures would be significantly improved in those receiving L-arginine supplementation. at the beginning and end of the study. Results: In this trial, we had complete data for 52 healthy participants with mean age of 20.85±4.29 years. At the end of study, fasting blood sugar (P=0.001) and lipid profile (triglycerideTG (P<0.001), cholesterol (P<0.001), LDL (P=0.04), HDL (P=0.015)) decreased in the L-arginine group but we found no significant change in the placebo group. In addition, the reduction of fasting blood sugar and lipid profile in L-arginine was significant compared with placebo group. No significant changes were found about systolic (P=0.81) and diastolic blood pressure either in L-arginine or placebo group. (P=0.532). Conclusion: The use of L-arginine significantly improved outcomes compared to placebo.
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Affiliation(s)
- Naseh Pahlavani
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.,Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Jafari
- Student Research Committee, Arak University of Medical Science, Arak, Iran
| | - Omid Sadeghi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Rezaei
- Faculty of Nursing and Midwifery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamid Rasad
- Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Ali Rahdar
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hasan Entezari
- Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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You H, Gao T, Cooper TK, Morris SM, Awad AS. Diabetic nephropathy is resistant to oral L-arginine or L-citrulline supplementation. Am J Physiol Renal Physiol 2014; 307:F1292-301. [PMID: 25320354 DOI: 10.1152/ajprenal.00176.2014] [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] [Indexed: 11/22/2022] Open
Abstract
Our recent publication showed that pharmacological blockade of arginases confers kidney protection in diabetic nephropathy via a nitric oxide (NO) synthase (NOS)3-dependent mechanism. Arginase competes with endothelial NOS (eNOS) for the common substrate L-arginine. Lack of L-arginine results in reduced NO production and eNOS uncoupling, which lead to endothelial dysfunction. Therefore, we hypothesized that L-arginine or L-citrulline supplementation would ameliorate diabetic nephropathy. DBA mice injected with multiple low doses of vehicle or streptozotocin (50 mg/kg ip for 5 days) were provided drinking water with or without L-arginine (1.5%, 6.05 g·kg(-1)·day(-1)) or L-citrulline (1.66%, 5.73 g·kg(-1)·day(-1)) for 9 wk. Nonsupplemented diabetic mice showed significant increases in albuminuria, blood urea nitrogen, glomerular histopathological changes, kidney macrophage recruitment, kidney TNF-α and fibronectin mRNA expression, kidney arginase activity, kidney arginase-2 protein expression, and urinary oxidative stress along with a significant reduction of nephrin and eNOS protein expression and kidney nitrite + nitrate compared with normal mice after 9 wk of diabetes. Surprisingly, L-arginine or L-citrulline supplementation in diabetic mice did not affect any of these parameters despite greatly increasing kidney and plasma arginine levels. These findings demonstrate that chronic L-arginine or L-citrulline supplementation does not prevent or reduce renal injury in a model of type 1 diabetes.
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Affiliation(s)
- Hanning You
- Division of Nephrology, Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Ting Gao
- Division of Nephrology, Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania
| | - Timothy K Cooper
- Department of Comparative Medicine, Penn State University College of Medicine, Hershey, Pennsylvania; and
| | - Sidney M Morris
- Department of Microbiology and Molecular Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alaa S Awad
- Division of Nephrology, Department of Medicine, Penn State University College of Medicine, Hershey, Pennsylvania;
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Fike CD, Summar M, Aschner JL. L-citrulline provides a novel strategy for treating chronic pulmonary hypertension in newborn infants. Acta Paediatr 2014; 103:1019-26. [PMID: 24862864 DOI: 10.1111/apa.12707] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 03/23/2014] [Accepted: 05/23/2014] [Indexed: 02/05/2023]
Abstract
UNLABELLED Effective therapies are urgently needed for infants with forms of pulmonary hypertension that develop or persist beyond the first week of life. The L-arginine nitric oxide (NO) precursor, L-citrulline, improves NO signalling and ameliorates pulmonary hypertension in newborn animals. In vitro studies demonstrate that manipulating L-citrulline transport alters NO production. CONCLUSION Strategies that increase the supply and transport of L-citrulline merit pursuit as novel approaches to managing infants with chronic, progressive pulmonary hypertension.
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Affiliation(s)
- Candice D. Fike
- Department of Pediatrics; Vanderbilt University Medical Center; Nashville TN USA
- Monroe Carell Jr. Children's Hospital at Vanderbilt; Nashville TN USA
| | - Marshall Summar
- Division of Genetics and Metabolism; Children's National Medical Center; Washington DC USA
| | - Judy L. Aschner
- Department of Pediatrics; Albert Einstein College of Medicine and the Children's Hospital at Montefiore; New York NY USA
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Bähr M, Fechner A, Kiehntopf M, Jahreis G. Consuming a mixed diet enriched with lupin protein beneficially affects plasma lipids in hypercholesterolemic subjects: a randomized controlled trial. Clin Nutr 2014; 34:7-14. [PMID: 24746974 DOI: 10.1016/j.clnu.2014.03.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 03/19/2014] [Accepted: 03/24/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND & AIMS The objectives of this study were to assess whether 25 g/d lupin protein, integrated into a mixed diet, might affect cardiovascular risk factors and whether l-arginine was responsible for these effects. METHODS Seventy-two hypercholesterolemic subjects participated in the randomized, controlled, double-blind three-phase crossover study. They were assigned to three diets with 25 g/d lupin protein (LP), milk protein (MP) or milk protein plus 1.6 g/d arginine (MPA) each for 28 d in a random order interrupted by 6-week washout periods. Lupin protein and the comparator milk protein were incorporated into complex food products (bread, roll, sausage, and vegetarian spread). Arginine was administered via capsules. Sixty-eight subjects were included in final analyses. RESULTS Compared with MP, LDL cholesterol was significantly lower after LP. Compared with MP and MPA, homocysteine was significantly lower after LP. Compared with baseline, concentrations of total, LDL, and HDL cholesterol significantly decreased after LP and MPA. Triacylglycerols and uric acid significantly decreased after LP. The relative changes in total and LDL cholesterol were significantly greater for subjects with severe hypercholesterolemia (>6.6 mmol/L) than those with moderate hypercholesterolemia (5.2-6.6 mmol/L). CONCLUSIONS The present study showed for the first time that incorporation of 25 g/d of lupin protein into a variety of complex food products lowers total and LDL cholesterol, triacylglycerols, homocysteine, and uric acid in hypercholesterolemic subjects. The hypocholesterolemic effect is stronger in subjects with severe hypercholesterolemia. Arginine might be responsible for some, but not all of the beneficial effects of lupin protein. This trial was registered at http://clinicaltrials.gov (study ID number NCT01598649).
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Affiliation(s)
- Melanie Bähr
- Friedrich Schiller University Jena, Institute of Nutrition, Department of Nutritional Physiology, Dornburger Str. 24, 07743 Jena, Germany.
| | - Anita Fechner
- Friedrich Schiller University Jena, Institute of Nutrition, Department of Nutritional Physiology, Dornburger Str. 24, 07743 Jena, Germany.
| | - Michael Kiehntopf
- Jena University Hospital, Institute of Clinical Chemistry and Laboratory Medicine, Erlanger Allee 101, 07747 Jena, Germany.
| | - Gerhard Jahreis
- Friedrich Schiller University Jena, Institute of Nutrition, Department of Nutritional Physiology, Dornburger Str. 24, 07743 Jena, Germany.
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Sodium-coupled neutral amino acid transporter 1 (SNAT1) modulates L-citrulline transport and nitric oxide (NO) signaling in piglet pulmonary arterial endothelial cells. PLoS One 2014; 9:e85730. [PMID: 24454923 PMCID: PMC3893279 DOI: 10.1371/journal.pone.0085730] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Accepted: 11/30/2013] [Indexed: 01/22/2023] Open
Abstract
RATIONALE There is evidence that impairments in nitric oxide (NO) signaling contribute to chronic hypoxia-induced pulmonary hypertension. The L-arginine-NO precursor, L-citrulline, has been shown to ameliorate pulmonary hypertension. Sodium-coupled neutral amino acid transporters (SNATs) are involved in the transport of L-citrulline into pulmonary arterial endothelial cells (PAECs). The functional link between the SNATs, L-citrulline, and NO signaling has not yet been explored. OBJECTIVE We tested the hypothesis that changes in SNAT1 expression and transport function regulate NO production by modulating eNOS coupling in newborn piglet PAECs. METHODS AND RESULTS A silencing RNA (siRNA) technique was used to assess the contribution of SNAT1 to NO production and eNOS coupling (eNOS dimer-to-monomer ratios) in PAECs from newborn piglets cultured under normoxic and hypoxic conditions in the presence and absence of L-citrulline. SNAT1 siRNA reduced basal NO production in normoxic PAECs and prevented L-citrulline-induced elevations in NO production in both normoxic and hypoxic PAECs. SNAT1 siRNA reduced basal eNOS dimer-to-monomer ratios in normoxic PAECs and prevented L-citrulline-induced increases in eNOS dimer-to-monomer ratios in hypoxic PAECs. CONCLUSIONS SNAT1 mediated L-citrulline transport modulates eNOS coupling and thus regulates NO production in hypoxic PAECs from newborn piglets. Strategies that increase SNAT1-mediated transport and supply of L-citrulline may serve as novel therapeutic approaches to enhance NO production in patients with pulmonary vascular disease.
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Romero MJ, Yao L, Sridhar S, Bhatta A, Dou H, Ramesh G, Brands MW, Pollock DM, Caldwell RB, Cederbaum SD, Head CA, Bagi Z, Lucas R, Caldwell RW. l-Citrulline Protects from Kidney Damage in Type 1 Diabetic Mice. Front Immunol 2013; 4:480. [PMID: 24400007 PMCID: PMC3871963 DOI: 10.3389/fimmu.2013.00480] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 12/09/2013] [Indexed: 01/01/2023] Open
Abstract
RATIONALE Diabetic nephropathy (DN) is a major cause of end-stage renal disease, associated with endothelial dysfunction. Chronic supplementation of l-arginine (l-arg), the substrate for endothelial nitric oxide synthase (eNOS), failed to improve vascular function. l-Citrulline (l-cit) supplementation not only increases l-arg synthesis, but also inhibits cytosolic arginase I, a competitor of eNOS for the use of l-arg, in the vasculature. AIMS To investigate whether l-cit treatment reduces DN in streptozotocin (STZ)-induced type 1 diabetes (T1D) in mice and rats and to study its effects on arginase II (ArgII) function, the main renal isoform. METHODS STZ-C57BL6 mice received l-cit or vehicle supplemented in the drinking water. For comparative analysis, diabetic ArgII knock out mice and l-cit-treated STZ-rats were evaluated. RESULTS l-Citrulline exerted protective effects in kidneys of STZ-rats, and markedly reduced urinary albumin excretion, tubulo-interstitial fibrosis, and kidney hypertrophy, observed in untreated diabetic mice. Intriguingly, l-cit treatment was accompanied by a sustained elevation of tubular ArgII at 16 weeks and significantly enhanced plasma levels of the anti-inflammatory cytokine IL-10. Diabetic ArgII knock out mice showed greater blood urea nitrogen levels, hypertrophy, and dilated tubules than diabetic wild type (WT) mice. Despite a marked reduction in collagen deposition in ArgII knock out mice, their albuminuria was not significantly different from diabetic WT animals. l-Cit also restored nitric oxide/reactive oxygen species balance and barrier function in high glucose-treated monolayers of human glomerular endothelial cells. Moreover, l-cit also has the ability to establish an anti-inflammatory profile, characterized by increased IL-10 and reduced IL-1β and IL-12(p70) generation in the human proximal tubular cells. CONCLUSION l-Citrulline supplementation established an anti-inflammatory profile and significantly preserved the nephron function during T1D.
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Affiliation(s)
- Maritza J Romero
- Department of Pharmacology and Toxicology, Georgia Regents University , Augusta, GA , USA ; Department of Anesthesiology and Perioperative Medicine, Georgia Regents University , Augusta, GA , USA ; Vascular Biology Center, Georgia Regents University , Augusta, GA , USA
| | - Lin Yao
- Department of Pharmacology and Toxicology, Georgia Regents University , Augusta, GA , USA
| | - Supriya Sridhar
- Vascular Biology Center, Georgia Regents University , Augusta, GA , USA
| | - Anil Bhatta
- Department of Pharmacology and Toxicology, Georgia Regents University , Augusta, GA , USA
| | - Huijuan Dou
- Vascular Biology Center, Georgia Regents University , Augusta, GA , USA
| | - Ganesan Ramesh
- Vascular Biology Center, Georgia Regents University , Augusta, GA , USA ; Department of Medicine, Georgia Regents University , Augusta, GA , USA
| | - Michael W Brands
- Department of Physiology, Georgia Regents University , Augusta, GA , USA
| | - David M Pollock
- Department of Pharmacology and Toxicology, Georgia Regents University , Augusta, GA , USA ; Department of Medicine, Georgia Regents University , Augusta, GA , USA
| | - Ruth B Caldwell
- Vascular Biology Center, Georgia Regents University , Augusta, GA , USA ; Department of Cell Biology and Anatomy, Georgia Regents University , Augusta, GA , USA ; Department of Ophthalmology, Georgia Regents University , Augusta, GA , USA ; VA Medical Center, Georgia Regents University , Augusta, GA , USA
| | - Stephen D Cederbaum
- Intellectual and Developmental Disabilities Research Center/Neuropsychiatric Institute (IDDRC/NPI), University of California Los Angeles School of Medicine , Los Angeles, CA , USA
| | - C Alvin Head
- Department of Anesthesiology and Perioperative Medicine, Georgia Regents University , Augusta, GA , USA
| | - Zsolt Bagi
- Vascular Biology Center, Georgia Regents University , Augusta, GA , USA
| | - Rudolf Lucas
- Department of Pharmacology and Toxicology, Georgia Regents University , Augusta, GA , USA ; Vascular Biology Center, Georgia Regents University , Augusta, GA , USA ; Division of Pulmonary Medicine, Georgia Regents University , Augusta, GA , USA
| | - Robert W Caldwell
- Department of Pharmacology and Toxicology, Georgia Regents University , Augusta, GA , USA ; Department of Physiology, Georgia Regents University , Augusta, GA , USA
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Suliburska J, Bogdanski P, Szulinska M, Pupek-Musialik D, Jablecka A. Changes in mineral status are associated with improvements in insulin sensitivity in obese patients following L-arginine supplementation. Eur J Nutr 2013; 53:387-93. [PMID: 23708056 PMCID: PMC3925292 DOI: 10.1007/s00394-013-0533-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 05/14/2013] [Indexed: 01/19/2023]
Abstract
PURPOSE The aim of this study is to evaluate the long-term influence of L-arginine intake on mineral concentration in patients with obesity and to assess the changes in lipid serum levels, fat content, and insulin resistance that result. METHODS A randomized double-blind placebo-controlled study was conducted. 88 obese patients were randomly assigned to receive either 9 g of L-arginine or placebo daily, for 6 months. At baseline and after 6 months, selected anthropometrical measurements and blood biochemical analyses were performed and mineral levels were assessed. To assess insulin sensitivity, the gold-standard euglycemic clamp methodology was used. RESULTS We found that 6 months of L-arginine supplementation resulted in significant increases in insulin sensitivity (Δ1.1 mg/kg/min, P < 0.01) and zinc levels (Δ1.5 μmol/L, P < 0.001). Moreover, a positive correlation between the change in zinc concentration in serum and the change in insulin sensitivity was observed (R = 0.80, P < 0.01). In the group of patients treated with L-arginine, a negative correlation between the change in zinc concentration in serum and the change in body fat content was noted (R = -0.38, P < 0.05). CONCLUSIONS L-Arginine supplementation affects zinc status in obese patients. One beneficial influence is related to the improvements in insulin sensitivity.
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Affiliation(s)
- Joanna Suliburska
- Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, Wojska Polskiego 31, 60-624, Poznan, Poland,
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Bogdanski P, Szulinska M, Suliburska J, Pupek-Musialik D, Jablecka A, Witmanowski H. Supplementation with L-arginine favorably influences plasminogen activator inhibitor type 1 concentration in obese patients. A randomized, double blind trial. J Endocrinol Invest 2013; 36:221-6. [PMID: 22732180 DOI: 10.3275/8467] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Elevated plasminogen activator inhibitor type 1 (PAI 1) plays an important role in the pathogenesis of excess blood coagulability in obese patients. L-arginine supplementation has shown to be associated with enhanced cardiovascular and metabolic health. The aim of the study was to assess the effect of L-arginine supplementation on PAI 1 concentration and to evaluate the relation to changes in nitric oxide (NO) plasma level, insulin sensitivity (M value), and total antioxidant status (TAS) in obese patients. MATERIAL/SUBJECTS AND METHODS A randomized, double-blind, placebo-controlled study was conducted from March 2010 to June 2011. Eightyeight obese patients were randomly assigned to receive either 9 g of L-arginine or placebo daily for 6 months. At baseline and after 6 months, selected anthropometrical measurements and blood biochemical analyses were performed, and PAI 1, NO, TAS levels were assessed. Insulin sensitivity was evaluated using the hyperinsulinemic euglycemic clamp technique. RESULTS We found that 6-month L-arginine supplementation resulted in significant decrease of PAI 1. Significant increase of NO, TAS, and insulin sensitivity level were noticed. In a group of patients treated with L-arginine, negative correlation between a change of insulin sensitivity value and a change of PAI 1 concentration was found. CONCLUSIONS The present findings demonstrate favorable influence of L-arginine supplementation on PAI 1 concentration in obese patients. Beneficial influence is related to insulin sensitivity improvement. The potential therapeutic role of L-arginine administration in patients with obesity needs further investigation.
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Affiliation(s)
- P Bogdanski
- Department of Internal Medicine, Metabolic Disorders and Hypertension, Poznan University of Medical Sciences, Szamarzewskiego 84 Str., 60-569 Poznan, Poland.
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Sanchez-Gonzalez MA, Koutnik AP, Ramirez K, Wong A, Figueroa A. The effects of short term L-citrulline supplementation on wave reflection responses to cold exposure with concurrent isometric exercise. Am J Hypertens 2013; 26:518-26. [PMID: 23467207 DOI: 10.1093/ajh/hps052] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Supplementation with L-citrulline (L-cit) has shown attenuating effects on blood pressure (BP) and pulse-wave-reflection responses (augmentation index (AIx)) to local exposure to cold, but the potential cardioprotective effects of L-cit during whole-body cold exposure with concurrent exercise are poorly understood. We hypothesized that L-cit would attenuate the BP and AIx responses to cold exposure and isometric handgrip (IHG) exercise. METHODS Sixteen healthy males with a mean age of 23±3 years volunteered for a study of the effect of L-cit on the BP and AIx responses to cold exposure and IHG exercise. Experiments were conducted inside an environmental chamber in cold conditions (4 ºC). Radial waveforms were obtained in duplicates and averaged through applanation tonometry. After 5 minutes of measurements made at rest in the supine position (RES), after the finalization of the exercise about the subjects were evaluated in non exercise condition that were basically the same as the RES. After initial measurements in cold conditions, subjects were randomized to receive either a placebo (Maltodextrin, PL) or L-cit (100mg/kg) for 14 days, followed by a 14-day washout period and then a 14-day regimen of the other agent. Subjects were re-evaluated after each treatment period. RESULTS At RES, there was a significant treatment-by-time interaction for brachial systolic BP (BSBP; P < 0.01), aortic systolic BP (ASBP; P < 0.01), and AIx (P < 0.05), such that L-cit decreased BSBP (-11±2mm Hg; P < 0.01), ASBP (-10±2mm Hg; P < 0.05), and AIx (-2±2%; P < 0.05) as compared with their respective values before the intervention. During IHG, BSBP, ASBP, and AIx were increased (P < 0.05) as compared with their values at RES, but these responses were unaffected by either of the study treatments. CONCLUSIONS L-citrulline may be a feasible adjuvant treatment for decrease the BP and AIx responses induced by cold. Further research is warranted to evaluate the impact of cold exposure and exercise on cardiovascular risk in clinical populations.
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[Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): cardiac patient]. Med Intensiva 2012; 35 Suppl 1:81-5. [PMID: 22309760 DOI: 10.1016/s0210-5691(11)70017-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patients with cardiac disease can develop two types of malnutrition: cardiac cachexia, which appears in chronic congestive heart failure, and malnutrition due to the complications of cardiac surgery or any other type of surgery in patients with heart disease. Early enteral nutrition should be attempted if the oral route cannot be used. When cardiac function is severely compromised, enteral nutrition is feasible, but supplementation with parenteral nutrition is sometimes required. Sustained hyperglycemia in the first 24 hours in patients admitted for acute coronary syndrome, whether diabetic or not, is a poor prognostic factor for 30-day mortality. In critically-ill cardiac patients with stable hemodynamic failure, nutritional support of 20-25 kcal/kg/day is effective in maintaining adequate nutritional status. Protein intake should be 1.2*-1.5 g/kg/day. Routine polymeric or high protein formulae should be used, according to the patient's prior nutritional status, with sodium and volume restriction according to the patient's clinical situation. The major energy source for myocytes is glutamine, through conversion to glutamate, which also protects the myocardial cell from ischemia in critical situations. Administration of 1 g/ day of omega-3 (EPA+DHA) in the form of fish oil can prevent sudden death in the treatment of acute coronary syndrome and can also help to reduce hospital admission for cardiovascular events in patients with chronic heart failure.
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Bescós R, Sureda A, Tur JA, Pons A. The effect of nitric-oxide-related supplements on human performance. Sports Med 2012; 42:99-117. [PMID: 22260513 DOI: 10.2165/11596860-000000000-00000] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Nitric oxide (NO) has led a revolution in physiology and pharmacology research during the last two decades. This labile molecule plays an important role in many functions in the body regulating vasodilatation, blood flow, mitochondrial respiration and platelet function. Currently, it is known that NO synthesis occurs via at least two physiological pathways: NO synthase (NOS) dependent and NOS independent. In the former, L-arginine is the main precursor. It is widely recognized that this amino acid is oxidized to NO by the action of the NOS enzymes. Additionally, L-citrulline has been indicated to be a secondary NO donor in the NOS-dependent pathway, since it can be converted to L-arginine. Nitrate and nitrite are the main substrates to produce NO via the NOS-independent pathway. These anions can be reduced in vivo to NO and other bioactive nitrogen oxides. Other molecules, such as the dietary supplement glycine propionyl-L-carnitine (GPLC), have also been suggested to increase levels of NO, although the physiological mechanisms remain to be elucidated. The interest in all these molecules has increased in many fields of research. In relation with exercise physiology, it has been suggested that an increase in NO production may enhance oxygen and nutrient delivery to active muscles, thus improving tolerance to physical exercise and recovery mechanisms. Several studies using NO donors have assessed this hypothesis in a healthy, trained population. However, the conclusions from these studies showed several discrepancies. While some reported that dietary supplementation with NO donors induced benefits in exercise performance, others did not find any positive effect. In this regard, training status of the subjects seems to be an important factor linked to the ergogenic effect of NO supplementation. Studies involving untrained or moderately trained healthy subjects showed that NO donors could improve tolerance to aerobic and anaerobic exercise. However, when highly trained subjects were supplemented, no positive effect on performance was indicated. In addition, all this evidence is mainly based on a young male population. Further research in elderly and female subjects is needed to determine whether NO supplements can induce benefit in exercise capacity when the NO metabolism is impaired by age and/or estrogen status.
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Affiliation(s)
- Raúl Bescós
- National Institute of Physical Education INEFC-Barcelona, Physiology Laboratory, University of Barcelona, Barcelona, Spain.
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Alef MJ, Tzeng E, Zuckerbraun BS. Nitric oxide and nitrite-based therapeutic opportunities in intimal hyperplasia. Nitric Oxide 2012; 26:285-94. [PMID: 22504069 DOI: 10.1016/j.niox.2012.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2012] [Revised: 03/27/2012] [Accepted: 03/30/2012] [Indexed: 12/22/2022]
Abstract
Vascular intimal hyperplasia (IH) limits the long term efficacy of current surgical and percutaneous therapies for atherosclerotic disease. There are extensive changes in gene expression and cell signaling in response to vascular therapies, including changes in nitric oxide (NO) signaling. NO is well recognized for its vasoregulatory properties and has been investigated as a therapeutic treatment for its vasoprotective abilities. The circulating molecules nitrite (NO(2)(-)) and nitrate (NO(3)(-)), once thought to be stable products of NO metabolism, are now recognized as important circulating reservoirs of NO and represent a complementary source of NO in contrast to the classic L-arginine-NO-synthase pathway. Here we review the background of IH, its relationship with the NO and nitrite/nitrate pathways, and current and future therapeutic opportunities for these molecules.
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Affiliation(s)
- Matthew J Alef
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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Abstract
PURPOSE OF REVIEW Many physiologic and pathophysiologic processes are modulated by arginine availability, which can be regulated by arginase. An understanding of the conditions that result in elevated arginase activity as well as the consequences of arginine deficiency is essential for design of effective nutritional support for disease. This review will emphasize recent findings regarding effects of plasma arginase and arginine deficiencies in disease. RECENT FINDINGS Elevations in plasma arginase, derived primarily from hemolysis of red blood cells or liver damage, that are associated with arginine deficiency have been identified in an increasing number of diseases and conditions. Arginine insufficiency not only can activate a stress kinase pathway that impairs function of T lymphocytes but it also can inhibit the mitogen-activated protein kinase signaling pathway required for macrophage production of cytokines in response to bacterial endotoxin/lipopolysaccharide. SUMMARY There are at least two broad categories of arginine deficiency syndromes, involving either T-cell dysfunction or endothelial dysfunction, depending on the disease context in which arginine deficiency occurs. There is limited information regarding the safety and efficacy of supplementation with arginine or its precursor citrulline in ameliorating arginine deficiency in specific diseases, indicating the need for further studies.
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Affiliation(s)
- Sidney M Morris
- Department of Microbiology and Molecular Genetics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
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Lüneburg N, Xanthakis V, Schwedhelm E, Sullivan LM, Maas R, Anderssohn M, Riederer U, Glazer NL, Vasan RS, Böger RH. Reference intervals for plasma L-arginine and the L-arginine:asymmetric dimethylarginine ratio in the Framingham Offspring Cohort. J Nutr 2011; 141:2186-90. [PMID: 22031661 PMCID: PMC3223876 DOI: 10.3945/jn.111.148197] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
L-arginine, as a precursor of NO synthesis, has attracted much scientific attention in recent years. Experimental mouse models suggest that L-arginine supplementation can retard, halt, or even reverse atherogenesis. In human studies, supplementation with L-arginine improved endothelium-dependent vasodilation. However, L-arginine levels are best interpreted in the context of levels of asymmetric dimethylarginine (ADMA), a competitive inhibitor of NO synthase. Thus, reference limits for circulating L-arginine and the L-arginine:ADMA ratio may help to determine the nutritional state of individuals at high cardiovascular risk in light of increased ADMA levels. We defined reference limits for plasma L-arginine in 1141 people and for the L-arginine:ADMA ratio in 1138 relatively healthy individuals from the Framingham Offspring Cohort. Plasma L-arginine and ADMA concentrations were determined by using a stable isotope-based LC-MS/MS method. The reference limits (2.5th and 97.5th percentiles) for plasma L-arginine were 41.0 μmol/L (95% CI = 39.5-42.5 μmol/L) and 114 μmol/L (95% CI = 112-115 μmol/L), whereas corresponding reference limits (2.5th and 97.5th percentiles) for the L-arginine:ADMA ratio were 74.3 μmol/L (95% CI = 71.1-77.3 μmol/L) and 225 μmol/L (95% CI = 222-228 μmol/L). Plasma L-arginine was positively associated with the estimated glomerular filtration rate (eGFR) and blood glucose levels, whereas the L-arginine:ADMA ratio was positively associated with eGFR and diastolic blood pressure but inversely associated with homocysteine and (log)C-reactive protein. We report reference levels for plasma L-arginine and for the L-arginine:ADMA ratio that may be helpful for evaluation of the effects of L-arginine supplementation in participants with an impaired L-arginine/NO pathway.
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Affiliation(s)
- Nicole Lüneburg
- Institute of Clinical Pharmacology and Toxicology, University Medical Center, Hamburg-Eppendorf, Germany.
| | - Vanessa Xanthakis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA,Framingham Heart Study, Boston University School of Medicine, Framingham, MA; and,Preventive Medicine and Cardiology Sections, and
| | - Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center, Hamburg-Eppendorf, Germany
| | - Lisa M. Sullivan
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Renke Maas
- Institute of Clinical Pharmacology and Toxicology, Friedrich-Alexander University, Erlangen, Germany
| | - Maike Anderssohn
- Institute of Clinical Pharmacology and Toxicology, University Medical Center, Hamburg-Eppendorf, Germany
| | - Ulrich Riederer
- Institute of Pharmacy, University of Hamburg, Hamburg, Germany
| | | | - Ramachandran S. Vasan
- Framingham Heart Study, Boston University School of Medicine, Framingham, MA; and,Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Rainer H. Böger
- Institute of Clinical Pharmacology and Toxicology, University Medical Center, Hamburg-Eppendorf, Germany
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Does l-arginine supplementation play a role in cerebral small vessels disease? Implication in the treatment of leukoaraiosis. Med Hypotheses 2011; 77:671-3. [DOI: 10.1016/j.mehy.2011.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 07/04/2011] [Indexed: 11/17/2022]
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Alef MJ, Vallabhaneni R, Carchman E, Morris SM, Shiva S, Wang Y, Kelley EE, Tarpey MM, Gladwin MT, Tzeng E, Zuckerbraun BS. Nitrite-generated NO circumvents dysregulated arginine/NOS signaling to protect against intimal hyperplasia in Sprague-Dawley rats. J Clin Invest 2011; 121:1646-56. [PMID: 21436585 DOI: 10.1172/jci44079] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Accepted: 01/26/2011] [Indexed: 12/30/2022] Open
Abstract
Vascular disease, a significant cause of morbidity and mortality in the developed world, results from vascular injury. Following vascular injury, damaged or dysfunctional endothelial cells and activated SMCs engage in vasoproliferative remodeling and the formation of flow-limiting intimal hyperplasia (IH). We hypothesized that vascular injury results in decreased bioavailability of NO secondary to dysregulated arginine-dependent NO generation. Furthermore, we postulated that nitrite-dependent NO generation is augmented as an adaptive response to limit vascular injury/proliferation and can be harnessed for its protective effects. Here we report that sodium nitrite (intraperitoneal, inhaled, or oral) limited the development of IH in a rat model of vascular injury. Additionally, nitrite led to the generation of NO in vessels and SMCs, as well as limited SMC proliferation via p21Waf1/Cip1 signaling. These data demonstrate that IH is associated with increased arginase-1 levels, which leads to decreased NO production and bioavailability. Vascular injury also was associated with increased levels of xanthine oxidoreductase (XOR), a known nitrite reductase. Chronic inhibition of XOR and a diet deficient in nitrate/nitrite each exacerbated vascular injury. Moreover, established IH was reversed by dietary supplementation of nitrite. The vasoprotective effects of nitrite were counteracted by inhibition of XOR. These data illustrate the importance of nitrite-generated NO as an endogenous adaptive response and as a pathway that can be harnessed for therapeutic benefit.
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Affiliation(s)
- Matthew J Alef
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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Vadivel A, Aschner JL, Rey-Parra GJ, Magarik J, Zeng H, Summar M, Eaton F, Thébaud B. L-citrulline attenuates arrested alveolar growth and pulmonary hypertension in oxygen-induced lung injury in newborn rats. Pediatr Res 2010; 68:519-25. [PMID: 20805789 PMCID: PMC3132222 DOI: 10.1203/pdr.0b013e3181f90278] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Bronchopulmonary dysplasia (BPD) is characterized by arrested alveolar development and complicated by pulmonary hypertension (PH). NO promotes alveolar growth. Inhaled NO (iNO) ameliorates the BPD phenotype in experimental models and in some premature infants. Arginosuccinate synthetase (ASS) and arginosuccinate lyase (ASL) convert L-citrulline to L-arginine; L-citrulline is regenerated during NO synthesis from L-arginine. Plasma levels of these NO precursors are low in PH. We hypothesized that L-citrulline prevents experimental O2-induced BPD in newborn rats. Rat pups were assigned from birth through postnatal day (P) 14 to room air (RA), RA + L-citrulline, 95% hyperoxia (BPD model), and 95%O2 + L-citrulline. Rat pups exposed to hyperoxia had fewer and enlarged air spaces and decreased capillary density, mimicking human BPD. This was associated with decreased plasma L-arginine and L-citrulline concentrations on P7. L-citrulline treatment significantly increased plasma L-arginine and L-citrulline concentrations and increased ASL protein expression in hyperoxia. L-citrulline preserved alveolar and vascular growth in O2-exposed pups and decreased pulmonary arterial medial wall thickness (MWT) and right ventricular hypertrophy (RVH). Increased lung arginase (ARG) activity in O2-exposed pups was reversed by L-citrulline treatment. L-citrulline supplementation prevents hyperoxia-induced lung injury and PH in newborn rats. L-citrulline may represent a novel therapeutic alternative to iNO for prevention of BPD.
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Affiliation(s)
- Arul Vadivel
- Department of Pediatrics, Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta T6G 2S2, Canada
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Dalsgaard T, Kroigaard C, Simonsen U. Calcium-activated potassium channels - a therapeutic target for modulating nitric oxide in cardiovascular disease? Expert Opin Ther Targets 2010; 14:825-37. [PMID: 20560781 DOI: 10.1517/14728222.2010.500616] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
IMPORTANCE OF THE FIELD Cardiovascular risk factors are often associated with endothelial dysfunction, which is also prognostic for occurrence of cardiovascular events. Endothelial dysfunction is reflected by blunted vasodilatation and reduced nitric oxide (NO) bioavailability. Endothelium-dependent vasodilatation is mediated by NO, prostacyclin, and an endothelium-derived hyperpolarising factor (EDHF), and involves small (SK) and intermediate (IK) conductance Ca(2+)-activated K(+) channels. Therefore, SK and IK channels may be drug targets for the treatment of endothelial dysfunction in cardiovascular disease. AREAS COVERED IN THIS REVIEW SK and IK channels are involved in EDHF-type vasodilatation, but recent studies suggest that these channels are also involved in the regulation of NO bioavailability. Here we review how SK and IK channels may regulate NO bioavailability. WHAT THE READER WILL GAIN Opening of SK and IK channels is associated with EDHF-type vasodilatation, but, through increased endothelial cell Ca(2+) influx, L-arginine uptake, and decreased ROS production, it may also lead to increased NO bioavailability and endothelium-dependent vasodilatation. TAKE HOME MESSAGE Opening of SK and IK channels can increase both EDHF and NO-mediated vasodilatation. Therefore, openers of SK and IK channels may have the potential of improving endothelial cell function in cardiovascular disease.
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Affiliation(s)
- Thomas Dalsgaard
- Department of Pharmacology, Aarhus University, DK-8000 Aarhus C, Denmark.
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Vignini A, D'Angelo M, Nanetti L, Camilloni MA, Cester AM, Faloia E, Salvolini E, Mazzanti L. Anorexia nervosa: a role for L-arginine supplementation in cardiovascular risk factors? Int J Eat Disord 2010; 43:464-71. [PMID: 19544555 DOI: 10.1002/eat.20709] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE The aim of the present study was to evaluate the effects of a short-term oral L-arginine treatment on platelet NO production, intracellular calcium concentration, iNOS and eNOS expression, in AN patients. METHOD Forty outpatients belonging to restricting subtype and 40 normal participants age and sex matched were enrolled in the study. RESULTS NO production was significantly elevated in the platelets from AN patients compared with controls while [Ca(2+)](i) was significantly decreased in patients with respect to controls. Western blot analysis demonstrated that iNOS isoform was more pronounced in the cell lysates from AN patients than controls. After supplementation with L-arginine, both NO production and [Ca(2+)](i) seem to return to control levels, suggesting a probable recovery of their metabolisms. The same was found after western blot analysis of NOS expression. DISCUSSION The results here proposed can be considered highly indicative of a positive effect of L-arginine supplementation on platelet NO production in AN patients.
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Affiliation(s)
- Arianna Vignini
- Department of Biochemistry, Biology and Genetics, School of Medicine, Polytechnic University of Marche, Ancona, Italy.
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Marques MJ, Barbin ICC, Taniguti APT, Oggian DS, Ferretti R, Santo Neto H. Myocardial fibrosis is unaltered by long-term administration of L-arginine in dystrophin deficient mdx mice: a histomorphometric analysis. ACTA BIOLOGICA HUNGARICA 2010; 61:168-74. [PMID: 20519171 DOI: 10.1556/abiol.61.2010.2.5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Cardiac failure secondary to myocardial fibrosis (MF) significantly contributes to death in Duchenne muscular dystrophy (DMD), a fatal form of muscle disease. In aging, the mdx mice, an animal model of DMD, MF is similar to that observed in humans. Nitric oxide-based therapy has been proposed to retard MF in DMD and a candidate is L-arginine (L-arg). In this study we evaluated the effects of long-term therapy with L-arg in the MF of mdx mice. mdx mice (6 months old) were treated with L-arg in drinking water. Control mdx mice received water only. After 15 months of treatment, hearts were stained with Masson's trichrome for analysis of MF and with hematoxilyn and eosin for analysis of inflammation and cardiomyocyte damage. We observed that MF was not affected (29.5 +/- 2.5% of MF area for control vs 31.4 +/- 2% for L-arginine-treated animals; P > 0.05). The density of inflammatory cells was reduced (169 +/- 12 cells/mm 2 in control vs 102 +/- 9 cells/mm 2 in L-arg-treated; P < 0.05). The present study shows that long-term administration of L-arg is not effective in retarding MF in mdx dystrophinopathy.
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Affiliation(s)
- Maria Julia Marques
- Universidade Estadual de Campinas (UNICAMP) Departamento de Anatomia, Instituto de Biologia Celular, Fisiologia e Biofisica CP 6109 13083-970 Campinas, SP Brazil
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Schade D, Kotthaus J, Clement B. Modulating the NO generating system from a medicinal chemistry perspective: Current trends and therapeutic options in cardiovascular disease. Pharmacol Ther 2010; 126:279-300. [DOI: 10.1016/j.pharmthera.2010.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2010] [Accepted: 02/10/2010] [Indexed: 01/05/2023]
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Doutreleau S, Rouyer O, Di Marco P, Lonsdorfer E, Richard R, Piquard F, Geny B. L-arginine supplementation improves exercise capacity after a heart transplant. Am J Clin Nutr 2010; 91:1261-7. [PMID: 20200265 DOI: 10.3945/ajcn.2009.27881] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Endothelial dysfunction is associated with the decreased exercise capacity observed in heart-transplant (HTx) recipients. L-arginine supplementation (LAS) stimulates the nitric oxide (NO) pathway and restores endothelial function. OBJECTIVE We compared exercise capacity in healthy subjects and HTx patients and investigated whether chronic LAS might improve exercise capacity and NO/endothelin balance after an HTx. DESIGN Clinical, echocardiographic, and exercise characteristics were measured in 11 control subjects and 22 HTx recipients. In a prospective, double-blind study, the 22 HTx recipients performed a 6-min exercise [6-min-walk test (6MWT)] and a maximal bicycle exercise test before and after a 6-wk period of placebo intake or LAS. Endothelial function was measured by analyzing blood NO metabolites, endothelin, and the resulting NO/endothelin balance. RESULTS Exercise capacity decreased after transplantation. Unlike with the placebo intake, 6 wk of LAS improved quality of life in HTx recipients (mean +/- SEM Minnesota Score: from 15.3 +/- 1.3 to 10.6 +/- 1.1; P < 0.001) and their submaximal exercise capacity. The distance walked during the 6MWT increased (from 525 +/- 20 to 580 +/- 20 m; P = 0.002), and the ventilatory threshold during the incremental test was delayed by 1.2 min (P = 0.01). Central factors such as resting stroke volume, systolic pulmonary arterial pressure, cardiac systolodiastolic functions, and heart-rate reserve were not modified, but LAS significantly increased the NO:endothelin ratio (from 2.49 +/- 0.38 to 3.31 +/- 0.39; P = 0.03). CONCLUSION Oral LAS may be a useful adjuvant therapeutic to improve quality of life and exercise tolerance in HTx recipients.
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