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Sydow K, Boger RH. Reloaded: ADMA and oxidative stress are responsible for endothelial dysfunction in hyperhomocyst(e)inaemia: effects of L-arginine and B vitamins: AUTHORS' RETROSPECTIVE. Cardiovasc Res 2012. [DOI: 10.1093/cvr/cvs205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Dimethylarginine dimethylaminohydrolase1 is an organ-specific mediator of end organ damage in a murine model of hypertension. PLoS One 2012; 7:e48150. [PMID: 23110194 PMCID: PMC3482201 DOI: 10.1371/journal.pone.0048150] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 09/21/2012] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA) is an independent predictor of cardiovascular and overall mortality. Moreover, elevated ADMA plasma concentrations are associated with the extent of hypertension. However, data from small-sized clinical trials and experimental approaches using murine transgenic models have revealed conflicting results regarding the impact of ADMA and its metabolizing enzyme dimethylarginine dimethylaminohydrolase (DDAH) in the pathogenesis of hypertension. METHODOLOGY/PRINCIPAL FINDINGS Therefore, we investigated the role of ADMA and DDAH1 in hypertension-induced end organ damage using the uninephrectomized, deoxycorticosterone actetate salt, and angiotensin II-induced hypertension model in human DDAH1 (hDDAH1) overexpressing and wild-type (WT) mice. ADMA plasma concentrations differed significantly between hDDAH1 and WT mice at baseline, but did not significantly change during the induction of hypertension. hDDAH1 overexpression did not protect against hypertension-induced cardiac fibrosis and hypertrophy. In addition, the hypertension-induced impairment of the endothelium-dependent vasorelaxation of aortic segments ex vivo was not significantly attenuated by hDDAH1 overexpression. However, hDDAH1 mice displayed an attenuated hypertensive inflammatory response in renal tissue, resulting in less hypertensive renal injury. CONCLUSION/SIGNIFICANCE Our data reveal that hDDAH1 organ-specifically modulates the inflammatory response in this murine model of hypertension. The lack of protection in cardiac and aortic tissues may be due to DDAH1 tissue selectivity and/or the extent of hypertension by the used combined model. However, our study underlines the potency of hDDAH1 overexpression in modulating inflammatory processes as a crucial step in the pathogenesis of hypertension, which needs further experimental and clinical investigation.
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203
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Siegerink B, Maas R, Vossen CY, Schwedhelm E, Koenig W, Böger R, Rothenbacher D, Brenner H, Breitling LP. Asymmetric and symmetric dimethylarginine and risk of secondary cardiovascular disease events and mortality in patients with stable coronary heart disease: the KAROLA follow-up study. Clin Res Cardiol 2012; 102:193-202. [PMID: 23073705 DOI: 10.1007/s00392-012-0515-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2012] [Accepted: 09/24/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND Asymmetric dimethylarginine (ADMA) is an endogenous nitric oxide synthase inhibitor, which has been associated with total and cardiovascular mortality in various clinical settings. Studies on its structural isomer, symmetric dimethylarginine (SDMA), are scarce. This study aimed to determine the associations of both ADMA and SDMA levels with secondary cardiovascular disease events and all-cause mortality in patients with stable coronary heart disease (CHD). METHODS In the observational prospective cohort study KAROLA, 1,148 CHD patients were followed for a median of 8.1 years. ADMA and SDMA were determined by liquid chromatography-tandem mass spectrometry. Baseline ADMA and SDMA levels were categorized in quartiles or standardized by their respective standard deviation, and appropriate hazard ratios and 95 % confidence intervals (HR [95 % CI]) were estimated in Cox proportional hazards models. RESULTS 150 patients experienced secondary cardiovascular disease events (CVD) and 121 patients died. After adjustment for confounders, ADMA was not associated with the risk of secondary CVD events (HR per standard deviation increase: 1.02 [95 %CI: 0.86-1.21]), whereas an association was suggested for SDMA (HR 1.17 [1.00-1.37]). Higher hazard ratios were observed in all-cause mortality models (ADMA: HR 1.15 [0.95-1.37]; SDMA: HR 1.29 [1.09-1.52]). CONCLUSIONS Our results suggest that especially SDMA might possibly have potential as a risk marker for all-cause mortality and to a lesser extent for secondary cardiovascular events. Future studies are needed to quantify these associations more precisely and should, in particular, further address the possibility of residual confounding by impaired kidney function.
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Affiliation(s)
- Bob Siegerink
- German Cancer Research Center (DKFZ), Division of Clinical Epidemiology and Aging Research C070, Heidelberg, Germany
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204
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Abstract
Metabolomics is the systematic study of the unique chemical fingerprints of small molecules or metabolite profiles that are related to a variety of cellular metabolic processes in a cell, organ, or organism. Although messenger RNA gene expression data and proteomic analyses do not tell the whole story of what might be happening in a cell, metabolic profiling provides direct and indirect physiologic insights that can potentially be detectable in a wide range of biospecimens. Although not specific to cardiac conditions, translating metabolomics to cardiovascular biomarkers has followed the traditional path of biomarker discovery from identification and confirmation to clinical validation and bedside testing. With technological advances in metabolomic tools (such as nuclear magnetic resonance spectroscopy and mass spectrometry) and more sophisticated bioinformatics and analytical techniques, the ability to measure low-molecular-weight metabolites in biospecimens provides a unique insight into established and novel metabolic pathways. Systemic metabolomics may provide physiologic understanding of cardiovascular disease states beyond traditional profiling and may involve descriptions of metabolic responses of an individual or population to therapeutic interventions or environmental exposures.
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Affiliation(s)
- Todd Senn
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA
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205
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Asymmetric and symmetric dimethylarginine in patients presenting with risk factors for coronary heart disease. Open Med (Wars) 2012. [DOI: 10.2478/s11536-012-0031-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractThe aim of the present study was to investigate asymmetric (ADMA) and symmetric dimethylarginine (SDMA) production in patients presenting with one or more risk factor (RF) for coronary heart disease (CHD). Patients and methods: Overall, 113 participants were enrolled in the study, including 45 patients presenting with risk for CHD (27 male and 18 female; aged 55.9 ± 6.4 years), 30 sex and age-matched middle-aged healthy controls (16 male and 14 female; aged 56.3 ± 8.4 years), and 38 young healthy controls (38 male; aged 24.6 ± 3.9 years). Results: No significant differences for ADMA and SDMA were recorded between patients groups presenting with risk for CHD. However, ADMA and SDMA were significantly higher in all examined patient groups (≥3 and 1–2 RF, hypertensive and non-hypertensive, obese and non-obese, diabetics and non-diabetics) compared with both control groups (middle-aged and young controls) (p<0.001). ADMA significantly correlated with SDMA in ≥3 RF (p<0.05), hypertensive (p<0.05), non-obese (p<0.05), non-diabetics (p<0.01), as well in middle-aged (p<0.05) and young controls (p<0.001). Conclusion: Significantly higher ADMA and SDMA were found between patients presenting with risk for CHD (≥3 and 1–2 RF, hypertensive and nonhypertensive, obese and non-obese, diabetics and non-diabetics) and healthy, middle-aged and young controls. ADMA significantly correlated with SDMA in ≥3 RF, hypertensive, non-obese and non-diabetic patients, as well as in middle-aged and young controls.
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206
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Chen XM, Hu CP, Li YJ, Jiang JL. Cardiovascular risk in autoimmune disorders: role of asymmetric dimethylarginine. Eur J Pharmacol 2012; 696:5-11. [PMID: 23026371 DOI: 10.1016/j.ejphar.2012.09.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 09/04/2012] [Accepted: 09/17/2012] [Indexed: 02/08/2023]
Abstract
Mounting evidence indicates that cardiovascular events are a main cause of excessive mortality of autoimmune disorders like type I diabetes mellitus and rheumatic diseases. Inflammation and endothelial dysfunction, independent predictors to cardiovascular disease, are hallmarks of autoimmunity. Asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, can cause or contribute to the inflammatory syndrome and endothelial dysfunction. Recently, elevated ADMA levels have been demonstrated in many autoimmune diseases, suggesting that ADMA might play an important role for the associated manifestations of cardiovascular disease. In the review, we discuss the role of ADMA in the excessive cardiovascular morbidity and mortality associated with autoimmune diseases.
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Affiliation(s)
- Xu-Meng Chen
- Department of Pharmacology, School of Pharmaceutical Sciences, Central South University, Xiang-Ya Road #110, Changsha 410078, China
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207
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Caplin B, Wang Z, Slaviero A, Tomlinson J, Dowsett L, Delahaye M, Salama A, Wheeler DC, Leiper J. Alanine-glyoxylate aminotransferase-2 metabolizes endogenous methylarginines, regulates NO, and controls blood pressure. Arterioscler Thromb Vasc Biol 2012; 32:2892-900. [PMID: 23023372 DOI: 10.1161/atvbaha.112.254078] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Asymmetric dimethylarginine is an endogenous inhibitor of NO synthesis that may mediate cardiovascular disease. Alanine-glyoxylate aminotransferase-2 (AGXT2) has been proposed to degrade asymmetric dimethylarginine. We investigated the significance of AGXT2 in methylarginine metabolism in vivo and examined the effect of this enzyme on blood pressure. METHODS AND RESULTS In isolated mouse kidney mitochondria, we show asymmetric dimethylarginine deamination under physiological conditions. We demonstrate increased asymmetric dimethylarginine, reduced NO, and hypertension in an AGXT2 knockout mouse. We provide evidence for a role of AGXT2 in methylarginine metabolism in humans by demonstrating an inverse relationship between renal (allograft) gene expression and circulating substrate levels and an association between expression and urinary concentrations of the product. Finally, we examined data from a meta-analysis of blood pressure genome-wide association studies. No genome-wide significance was observed, but taking a hypothesis-driven approach, there was a suggestive association between the T allele at rs37369 (which causes a valine-isoleucine substitution and altered levels of AGXT2 substrate) and a modest increase in diastolic blood pressure (P=0.0052). CONCLUSIONS Although the effect of variation at rs37369 needs further study, these findings suggest that AGXT2 is an important regulator of methylarginines and represents a novel mechanism through which the kidney regulates blood pressure.
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Affiliation(s)
- Ben Caplin
- Nitric Oxide Signalling Group, Medical Research Council Clinical Sciences Center, Imperial College London, London, United Kingdom.
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208
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Dimitroulas T, Sandoo A, Kitas GD. Asymmetric dimethylarginine as a surrogate marker of endothelial dysfunction and cardiovascular risk in patients with systemic rheumatic diseases. Int J Mol Sci 2012. [PMID: 23202900 PMCID: PMC3497274 DOI: 10.3390/ijms131012315] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The last few decades have witnessed an increased life expectancy of patients suffering with systemic rheumatic diseases, mainly due to improved management, advanced therapies and preventative measures. However, autoimmune disorders are associated with significantly enhanced cardiovascular morbidity and mortality not fully explained by traditional cardiovascular disease (CVD) risk factors. It has been suggested that interactions between high-grade systemic inflammation and the vasculature lead to endothelial dysfunction and atherosclerosis, which may account for the excess risk for CVD events in this population. Diminished nitric oxide synthesis—due to down regulation of endothelial nitric oxide synthase—appears to play a prominent role in the imbalance between vasoactive factors, the consequent impairment of the endothelial hemostasis and the early development of atherosclerosis. Asymmetric dimethylarginine (ADMA) is one of the most potent endogenous inhibitors of the three isoforms of nitric oxide synthase and it is a newly discovered risk factor in the setting of diseases associated with endothelial dysfunction and adverse cardiovascular events. In the context of systemic inflammatory disorders there is increasing evidence that ADMA contributes to the vascular changes and to endothelial cell abnormalities, as several studies have revealed derangement of nitric oxide/ADMA pathway in different disease subsets. In this article we discuss the role of endothelial dysfunction in patients with rheumatic diseases, with a specific focus on the nitric oxide/ADMA system and we provide an overview on the literature pertaining to ADMA as a surrogate marker of subclinical vascular disease.
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Affiliation(s)
- Theodoros Dimitroulas
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, West Midlands DY1 2HQ, UK; E-Mails: (A.S.); (G.D.K.)
- Author to whom correspondence should be addressed; E-Mail: or ; Tel.: +44-1384-244842; Fax: +44-1283-244272
| | - Aamer Sandoo
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, West Midlands DY1 2HQ, UK; E-Mails: (A.S.); (G.D.K.)
| | - George D. Kitas
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Russells Hall Hospital, Dudley, West Midlands DY1 2HQ, UK; E-Mails: (A.S.); (G.D.K.)
- Arthritis Research UK Epidemiology Unit, University of Manchester, Manchester M15 6SZ, UK
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209
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Interaction of the cardiovascular risk marker asymmetric dimethylarginine (ADMA) with the human cationic amino acid transporter 1 (CAT1). J Mol Cell Cardiol 2012; 53:392-400. [DOI: 10.1016/j.yjmcc.2012.06.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 06/04/2012] [Accepted: 06/05/2012] [Indexed: 12/12/2022]
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210
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HIV replication, inflammation, and the effect of starting antiretroviral therapy on plasma asymmetric dimethylarginine, a novel marker of endothelial dysfunction. J Acquir Immune Defic Syndr 2012; 60:128-34. [PMID: 22421746 DOI: 10.1097/qai.0b013e318252f99f] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND HIV infection is associated with premature development of cardiovascular disease. Understanding the effects of HIV replication on endothelial dysfunction and platelet activation may identify treatment targets to reduce cardiovascular disease risk. METHODS A subgroup of HIV-infected participants in the Strategies for Management of Antiretroviral Therapy study off antiretroviral therapy (ART) at entry enabled a randomized comparison of immediate versus deferred ART initiation of changes in asymmetric dimethylarginine (ADMA), soluble CD40 ligand (sCD40L), and P-selectin levels. RESULTS At study entry, median (interquartile range) levels of ADMA, sCD40L, and P-selectin were 0.57 (0.49-0.66) μg/mL, 251 (135-696) μmol/L, and 34 (28-44) pg/mL. Compared to those randomized to deferral of ART (n = 114), participants randomized to immediate ART (n = 134) had 10.3% lower ADMA levels (P = 0.003) at 12 months; treatment differences in sCD40L (95% confidence interval: -17% to 44%; P = 0.53) and P-selectin (95% confidence interval: -10% to 10%; P = 0.95) were not significant. The difference in ADMA for those assigned immediate ART compared with those assigned ART deferral was greater among younger patients and those with higher levels of high-sensitivity C-reactive protein and D-dimer (P ≤ 0.05 for interaction for both) but not HIV RNA level at baseline (P = 0.51). DISCUSSION ART initiation leads to declines in ADMA levels, a marker of nitric oxide-mediated endothelial dysfunction. Improvement in ADMA levels was related to the degree of inflammation and coagulation, suggesting that upregulation of these pathways contributes to premature vascular disease among individuals with HIV infection. Whether declines in ADMA levels impact risk of disease requires further research.
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211
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Förstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J 2012; 33:829-37, 837a-837d. [PMID: 21890489 PMCID: PMC3345541 DOI: 10.1093/eurheartj/ehr304] [Citation(s) in RCA: 2620] [Impact Index Per Article: 218.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Revised: 07/14/2011] [Accepted: 07/28/2011] [Indexed: 02/06/2023] Open
Abstract
Nitric oxide (NO), the smallest signalling molecule known, is produced by three isoforms of NO synthase (NOS; EC 1.14.13.39). They all utilize l-arginine and molecular oxygen as substrates and require the cofactors reduced nicotinamide-adenine-dinucleotide phosphate (NADPH), flavin adenine dinucleotide (FAD), flavin mononucleotide (FMN), and (6R-)5,6,7,8-tetrahydrobiopterin (BH(4)). All NOS bind calmodulin and contain haem. Neuronal NOS (nNOS, NOS I) is constitutively expressed in central and peripheral neurons and some other cell types. Its functions include synaptic plasticity in the central nervous system (CNS), central regulation of blood pressure, smooth muscle relaxation, and vasodilatation via peripheral nitrergic nerves. Nitrergic nerves are of particular importance in the relaxation of corpus cavernosum and penile erection. Phosphodiesterase 5 inhibitors (sildenafil, vardenafil, and tadalafil) require at least a residual nNOS activity for their action. Inducible NOS (NOS II) can be expressed in many cell types in response to lipopolysaccharide, cytokines, or other agents. Inducible NOS generates large amounts of NO that have cytostatic effects on parasitic target cells. Inducible NOS contributes to the pathophysiology of inflammatory diseases and septic shock. Endothelial NOS (eNOS, NOS III) is mostly expressed in endothelial cells. It keeps blood vessels dilated, controls blood pressure, and has numerous other vasoprotective and anti-atherosclerotic effects. Many cardiovascular risk factors lead to oxidative stress, eNOS uncoupling, and endothelial dysfunction in the vasculature. Pharmacologically, vascular oxidative stress can be reduced and eNOS functionality restored with renin- and angiotensin-converting enzyme-inhibitors, with angiotensin receptor blockers, and with statins.
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Affiliation(s)
- Ulrich Förstermann
- Department of Pharmacology, Johannes Gutenberg University Medical Center, 55101 Mainz, Germany.
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212
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Caplin B, Leiper J. Endogenous nitric oxide synthase inhibitors in the biology of disease: markers, mediators, and regulators? Arterioscler Thromb Vasc Biol 2012; 32:1343-53. [PMID: 22460557 DOI: 10.1161/atvbaha.112.247726] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The asymmetric methylarginines inhibit nitric oxide synthesis in vivo by competing with L-arginine at the active site of nitric oxide synthase. High circulating levels of asymmetric dimethylarginine predict adverse outcomes, specifically vascular events but there is now increasing experimental and epidemiological evidence that these molecules, and the enzymes that regulate this pathway, play a mechanistic role in cardiovascular diseases. Recent data have provided insight into the impact of altered levels of these amino acids in both humans and rodents, however these reports also suggest a simplistic approach based on measuring, and modulating circulating asymmetric dimethylarginine alone is inadequate. This review outlines the basic biochemistry and physiology of endogenous methylarginines, examines both the experimental and observational evidence for a role in disease pathogenesis, and examines the potential for therapeutic regulation of these molecules.
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Affiliation(s)
- Ben Caplin
- Centre for Nephrology, UCL Medical School, Royal Free Campus 2nd Floor, Rowland Hill St, London NW3 2PF.
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213
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Li X, Wang X, Guo Y, Deng N, Zheng P, Xu Q, Wu Y, Dai G. Regulation of endothelial nitric oxide synthase and asymmetric dimethylarginine by matrine attenuates isoproterenol-induced acute myocardial injury in rats. ACTA ACUST UNITED AC 2012; 64:1107-18. [PMID: 22775214 DOI: 10.1111/j.2042-7158.2012.01502.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study was designed to investigate the cardioprotective effects of matrine on regulation of endothelial nitric oxide synthase (eNOS) and asymmetric dimethylarginine (ADMA) in isoproterenol-induced acute myocardial ischaemic rats. METHODS Male Sprague-Dawley rats were pretreated with matrine (200, 100 and 50 mg/kg) orally for 10 days. Acute myocardial injury was induced in rats by subcutaneous injection of isoproterenol. Serum and haemodynamic parameters, histopathological variables and expression of protein levels were analysed. KEY FINDINGS Oral administration of matrine (200, 100 and 50 mg/kg) significantly attenuated isoproterenol-induced cardiac necrosis and left ventricular dysfunction. Matrine treatment restored impaired ventricular Akt and eNOS protein expression with concomitant increased phosphorylation of Akt (Ser473) and eNOS (Ser1177), and also restored glycogen synthase kinase 3β activity, as indicated by increased phosphorylation at Ser 9. Moreover, treatment with matrine had no effect on the isoproterenol-induced elevated protein arginine methyltransferase 1 protein expression, but could significantly normalize the reduced dimethylarginine dimethylaminohydrolase 2 expression and attenuate the increased serum level of ADMA. The expression of catechol-o-methyltransferase and monoamine oxidase did not differ among all groups (all P > 0.05). CONCLUSIONS Our results suggested that matrine protects against isoproterenol-induced myocardial ischaemia via eNOS and ADMA pathway.
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Affiliation(s)
- Xiaobing Li
- Department of Pharmacology, School of Pharmacy, Ningxia Medical University, Ningxia, China
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214
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Lekakis J, Abraham P, Balbarini A, Blann A, Boulanger CM, Cockcroft J, Cosentino F, Deanfield J, Gallino A, Ikonomidis I, Kremastinos D, Landmesser U, Protogerou A, Stefanadis C, Tousoulis D, Vassalli G, Vink H, Werner N, Wilkinson I, Vlachopoulos C. Methods for evaluating endothelial function: a position statement from the European Society of Cardiology Working Group on Peripheral Circulation. ACTA ACUST UNITED AC 2012; 18:775-89. [PMID: 21450600 DOI: 10.1177/1741826711398179] [Citation(s) in RCA: 213] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The endothelium holds a pivotal role in cardiovascular health and disease. Assessment of its function was until recently limited to experimental designs due to its location. The advent of novel techniques has facilitated testing on a more detailed basis, with focus on distinct pathways. This review presents available in-vivo and ex-vivo methods for evaluating endothelial function with special focus on more recent ones. The diagnostic modalities covered include assessment of epicardial and microvascular coronary endothelial function, local vasodilation by venous occlusion plethysmography and flow-mediated dilatation, arterial pulse wave analysis and pulse amplitude tonometry, microvascular blood flow by laser Doppler flowmetry, biochemical markers and bioassays, measurement of endothelial-derived microparticles and progenitor cells, and glycocalyx measurements. Insights and practical information on the theoretical basis, methodological aspects, and clinical application in various disease states are discussed. The ability of these methods to detect endothelial dysfunction before overt cardiovascular disease manifests make them attractive clinical tools for prevention and rehabilitation.
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Affiliation(s)
- John Lekakis
- 2nd Cardiology Department, Attikon Hospital, University of Athens, Greece
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215
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Can A, Bekpinar S, Gurdol F, Tutuncu Y, Unlucerci Y, Dinccag N. Dimethylarginines in patients with type 2 diabetes mellitus: relation with the glycaemic control. Diabetes Res Clin Pract 2011; 94:e61-4. [PMID: 21889812 DOI: 10.1016/j.diabres.2011.08.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Accepted: 08/08/2011] [Indexed: 10/17/2022]
Abstract
We tested the relationship between plasma levels of dimethylarginines (ADMA and SDMA) and glycaemic control in 43 type 2 diabetic patients. Type 2 diabetics with poor glycaemic control (HbA1c>6.5) had significantly lower SDMA and higher ADMA concentrations than those with well-controlled glycaemia (HbA1c<6.5).
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Affiliation(s)
- Ayten Can
- Department of Biochemistry, Istanbul Faculty of Medicine, Istanbul University, Capa 34093, Istanbul, Turkey
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216
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Lu TM, Chung MY, Lin MW, Hsu CP, Lin SJ. Plasma asymmetric dimethylarginine predicts death and major adverse cardiovascular events in individuals referred for coronary angiography. Int J Cardiol 2011; 153:135-40. [DOI: 10.1016/j.ijcard.2011.06.120] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 05/27/2011] [Accepted: 06/25/2011] [Indexed: 11/28/2022]
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217
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Affiliation(s)
- Joseph A. Vita
- From the Evans Department of Medicine and the Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA
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218
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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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von Leitner EC, Klinke A, Atzler D, Slocum JL, Lund N, Kielstein JT, Maas R, Schmidt-Haupt R, Pekarova M, Hellwinkel O, Tsikas D, D'Alecy LG, Lau D, Willems S, Kubala L, Ehmke H, Meinertz T, Blankenberg S, Schwedhelm E, Gadegbeku CA, Böger RH, Baldus S, Sydow K. Pathogenic cycle between the endogenous nitric oxide synthase inhibitor asymmetrical dimethylarginine and the leukocyte-derived hemoprotein myeloperoxidase. Circulation 2011; 124:2735-45. [PMID: 22082678 DOI: 10.1161/circulationaha.111.060541] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The nitric oxide synthase inhibitor asymmetrical dimethylarginine (ADMA) and the leukocyte-derived hemoprotein myeloperoxidase (MPO) are associated with cardiovascular diseases. Activation of monocytes and polymorphonuclear neutrophils (PMNs) with concomitant release of MPO is regulated in a nitric oxide-dependent fashion. The aim of the study was to investigate a potential 2-way interaction between ADMA and MPO. METHODS AND RESULTS Ex vivo, ADMA uptake by isolated human PMNs, the principal source of MPO in humans, significantly impaired nitric oxide synthase activity determined by gas chromatography-mass spectrometry. In humans, short-term ADMA infusion (0.0125 mg · kg(-1) · min(-1)) significantly increased MPO plasma concentrations. Functionally, PMN exposure to ADMA enhanced leukocyte adhesion to endothelial cells, augmented NADPH oxidase activity, and stimulated PMN degranulation, resulting in release of MPO. In vivo, a 28-day ADMA infusion (250 μmol · kg(-1) · d(-1)) in C57Bl/6 mice significantly increased plasma MPO concentrations, whereas this ADMA effect on MPO was attenuated by human dimethylarginine dimethylaminohydrolase1 (hDDAH1) overexpression. Moreover, the MPO-derived reactive molecule hypochlorous acid impaired recombinant hDDAH1 activity in vitro. In MPO(-/-) mice, the lipopolysaccharide-induced increase in systemic ADMA concentrations was abrogated. CONCLUSIONS ADMA profoundly impairs nitric oxide synthesis of PMNs, resulting in increased PMN adhesion to endothelial cells, superoxide generation, and release of MPO. In addition, MPO impairs DDAH1 activity. Our data reveal an ADMA-induced cycle of PMN activation, enhanced MPO release, and subsequent impairment of DDAH1 activity. These findings not only highlight so far unrecognized cytokine-like properties of ADMA but also identify MPO as a regulatory switch for ADMA bioavailability under inflammatory conditions.
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Wang H, Liu J. Plasma asymmetric dimethylarginine and L-arginine levels in Chinese patients with essential hypertension without coronary artery disease. J Cardiovasc Dis Res 2011; 2:177-80. [PMID: 22022146 PMCID: PMC3195197 DOI: 10.4103/0975-3583.85265] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To investigate the plasma asymmetric dimethylarginine (ADMA) levels and L-arginine in the essential hypertension (EH) patients without coronary artery disease. Patients and Methods: A total of 86 Chinese patients were enrolled in this study. All patients received coronary multidetector-row computed tomography to exclude distinct coronary stenosis and treadmill exercise testing to exclude microvascular angina pectoris. The patients with normal blood pressure (n = 26) were set as the control group. The EH patients were divided into three subgroups: the prehypertension group (n = 26), the stage 1 hypertension group (n = 26) and the stage 2 hypertension group (n = 8). The plasma ADMA and L-arginine concentrations were measured by a validated high-throughput liquid chromatographic tandem mass spectrometric assay. Results: There was a significantly higher ADMA level [0.028 (0.016) mmol/L vs. 0.021 (0.010) mmol/L, P = 0.002] and lower L-arginine to ADMA ratio [1.42 (0.58) vs. 2.01 (0.99), P < 0.001] in the EH group compared with the control group. Among the EH patients, the ADMA levels were increased by grades of hypertension [0.028 (0.011) mmol/L, 0.027 (0.014) mmol/L, 0.035 (0.024) mmol/L, respectively, P < 0.001]. The ADMA level was independently related to the systolic blood pressure (r = 1.047, P = 0.001). Conclusion: The plasma ADMA levels were significantly elevated with grades of hypertension in EH patients and were positively related to the systolic blood pressure levels.
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Affiliation(s)
- Hongju Wang
- The First affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui Province, China
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Abstract
Prognosis, risk stratification and monitoring the effects of treatment are fundamental elements in the decision-making process when implementing prevention strategies for chronic kidney disease. The use of biomarkers is increasingly proposed as a method to refine risk stratification and guide therapy. In this Review, we present basic concepts regarding the validation of biomarkers and highlight difficulties inherent to the identification of useful new biomarkers in patients on hemodialysis. We focus on prognostic biomarkers that have been consistently linked to survival in this group of patients. To date, no biomarker has had sufficient full-scale testing to qualify as a useful addition to standard prognostic factors or to guide the prescription of specific treatments in this population. Furthermore, little information exists on the relative strength of various biomarkers for their prediction of mortality. A multimarker approach might refine prognosis in patients on hemodialysis, but this concept needs to be properly evaluated in large longitudinal studies and clinical trials. The potential of proteomics for the identification and study of new biomarkers in the pathophysiology of cardiovascular disease in patients with end-stage renal disease is also discussed.
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Tousoulis D, Siasos G, Oikonomou E, Stougianos P, Papageorgiou N, Papavassiliou AG, Stefanadis C. Asymmetric dimethylarginine (ADMA): is really a biomarker for cardiovascular prognosis? Int J Cardiol 2011; 153:123-5. [PMID: 21937129 DOI: 10.1016/j.ijcard.2011.08.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 08/20/2011] [Indexed: 11/24/2022]
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Bekpinar S, Gurdol F, Unlucerci Y, Develi S, Yilmaz A. Serum levels of arginase I are associated with left ventricular function after myocardial infarction. Clin Biochem 2011; 44:1090-1093. [DOI: 10.1016/j.clinbiochem.2011.06.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 06/03/2011] [Accepted: 06/05/2011] [Indexed: 02/05/2023]
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Türkçüoğlu I, Engin-Üstün Y, Turan F, Kali Z, Karabulut AB, Meydanli M, Kafkasli A. Evaluation of asymmetric dimethylarginine, nitric oxide levels and associated independent variables in obese and lean patients with polycystic ovarian syndrome. Gynecol Endocrinol 2011; 27:609-14. [PMID: 20695761 DOI: 10.3109/09513590.2010.507291] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To evaluate the asymmetric dimethylarginine (ADMA) and nitric oxide (NO) levels in obese and lean patients with polycystic ovarian syndrome (PCOS) and find out their relation with hormonal and metabolic parameters. METHODS Twenty-two obese, 18 lean patients with PCOS and 11 obese, 24 lean healthy control patients were enrolled prospectively. Plasma ADMA and NO levels and arginine/ADMA ratio were evaluated on 3rd day of menstrual cycle after at least 10 h overnight fasting. RESULTS Plasma ADMA, NO levels and arginine/ADMA ratio were similar in the groups. ADMA level did not correlate with the hormonal and metabolic parameters in patients with PCOS. However, NO correlated inversely with fasting insulin (r = -0.353, p = 0.041) and homeostasis model of insulin resistance (HOMA-IR) (r = -0.379, p = 0.027). Arginine/ADMA ratio also correlated inversely with fasting insulin (r = -0.339, p = 0.050). In multinomial regression analysis the risk of low NO was associated independently with high fasting insulin (OR = 1.19, 95% CI 1.001-1.42, p = 0.049) and high HOMA-IR in patients with PCOS (OR = 2.26, 95% CI 1.03-4.98, p = 0.042). CONCLUSIONS Insulin resistance may be the underlying mechanism of endothelial dysfunction through NO pathway in PCOS.
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Affiliation(s)
- Ilgin Türkçüoğlu
- Department of Obstetrics and Gynaecology, İnönü University School of Medicine, Malatya, Turkey.
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Quintavalle M, Condorelli G, Elia L. Arterial remodeling and atherosclerosis: miRNAs involvement. Vascul Pharmacol 2011; 55:106-10. [PMID: 21864716 DOI: 10.1016/j.vph.2011.08.216] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 07/23/2011] [Accepted: 08/08/2011] [Indexed: 12/20/2022]
Abstract
Cardiometabolic diseases (CMD) (such as atherosclerosis, diabetes, and hypertension) are the primary cause of death and disability in the Western world. Although lifestyle programs and therapeutic approaches have significantly reduced the socio-economic burden of CMD, a large number of events still cannot be avoided (the so called residual risk). Recent developments in genetics and genomics provide a platform for investigating further this area with the aim of deepening our understanding of the atherosclerotic phenomena underlying CMD, for instance by providing better information on the type of subjects who would benefit the most from therapeutic interventions, or by discovering new genetic and metabolic derangements that may be targeted for the development of new interventions. MicroRNAs (miRNA) are short, non-coding RNAs that negatively regulate the expression of proteins by binding to specific sequences on the 3' region of target mRNAs. Bioinformatics analysis predicts that each miRNA may regulate hundreds of targets, suggesting that miRNAs may play roles in almost every biological pathway and process, including those of the cardiovascular system. Studies are beginning to unravel their fundamental importance in vessel biology. Here, we review recent advance regarding the involvement of miRNAs in arterial remodeling and atherosclerosis.
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Kielstein JT, Veldink H, Martens-Lobenhoffer J, Haller H, Perthel R, Lovric S, Lichtinghagen R, Kliem V, Bode-Böger SM. Unilateral nephrectomy causes an abrupt increase in inflammatory mediators and a simultaneous decrease in plasma ADMA: a study in living kidney donors. Am J Physiol Renal Physiol 2011; 301:F1042-6. [PMID: 21835767 DOI: 10.1152/ajprenal.00640.2010] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthases (NOS). Reducing inducible NOS activity in acute inflammation seems to be desirable. In vitro data show that ADMA increases in response to inflammatory mediators, yet the effect of acute inflammation in vivo is scarcely studied. The aim of the study was to evaluate ADMA plasma levels before, during, and after the acute (nonbacterial) inflammatory-like state. Plasma ADMA, l-arginine, C-reactive protein, and IL-6 were determined in 24 healthy subjects undergoing living related kidney donation before as well as 1, 6, 12, 24, 72, and 168 h thereafter. Six hours after nephrectomy, ADMA levels decreased compared with baseline (0.488 ± 0.075 vs. 0.560 ± 0.060 μmol/l, P < 0.05). This difference became even more marked 24 h after the operation (0.478 ± 0.083 μmol/l, P < 0.01 vs. baseline), when the proinflammatory cytokine IL-6 peaked. Seven days after unilateral nephrectomy, ADMA levels were elevated above baseline (0.63 ± 0.05 μmol/l, P < 0.001 vs. baseline). l-Arginine levels decreased already 1 h after nephrectomy (97.5 ± 22.5 μmol/l, P < 0.01 vs. baseline) and paralleled the change in ADMA thereafter. At the end of the observation period when inflammation markers were regressing, l-arginine levels were significantly elevated above baseline (160.6 ± 25.1 μmol/l, P < 0.001 vs. baseline). In summary, this is the first study showing that both ADMA and l-arginine decrease temporarily after unilateral nephrectomy coinciding with the increase in inflammatory mediators. The l-arginine/ADMA ratio, a surrogate for NO production capacity, was only altered for <24 h.
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Affiliation(s)
- Jan T Kielstein
- Dept. of Nephrology and Hypertension, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
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Lehmann HI, Goette A, Martens-Lobenhoffer J, Hammwohner M, Rohl FW, Bukowska A, Ghanem A, Klein HU, Bode-Boger SM. Asymmetric dimethylarginine predicts appropriate implantable cardioverter-defibrillator intervention in patients with left ventricular dysfunction. Europace 2011; 13:1428-35. [DOI: 10.1093/europace/eur171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Zhang Q, Chen N, Qiu W, Xu X, Wang D, Tsao PS, Jin H. Asymmetric dimethylarginine impairs fibrinolytic activity in human umbilical vein endothelial cells via p38 MAPK and NF-κB pathways. Thromb Res 2011; 128:42-6. [PMID: 21429569 DOI: 10.1016/j.thromres.2011.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Revised: 02/18/2011] [Accepted: 02/20/2011] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Asymmetric dimethylarginine (ADMA) is a potent endogenous inhibitor of nitric oxide (NO) synthase. An increased synthesis and/or a reduced catabolism of ADMA might contribute to the onset and progression of thrombosis. The present study was designed to evaluate the effect of ADMA on fibrinolytic factors in endothelial cells, and to investigate the cellular mechanisms. MATERIALS AND METHODS Human umbilical vein endothelial cells (HUVECs) were treated with different concentrations of ADMA for various periods; Then HUVECs were preincubated with NO precursor (L-arginine), MAPK inhibitors, or NF-κB inhibitor (PDTC) before ADMA treatment to repeat the experiment. Protein levels of tissue plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1), and NF-κB activity were measured by ELISA; mRNA levels of tPA and PAI-1 were assayed by qRT-PCR; The activation of MAPK was characterized by western blot analysis. RESULTS (1) ADMA decreased tPA antigen levels in time- and concentration-dependent manners, with the maximum effect of 30 μmol/L ADMA for 48h (control 109.01 ± 4.15 ng/ml vs ADMA 86.76 ± 5.95 ng/ml, p<0.01); (2) 30 μmol/L ADMA elevated antigen levels of PAI-1 in a time-dependent manner, with the maximum effect of 30 μmol/L ADMA for 48 h (control 2721.12 ± 278.02 ng/ml vs. ADMA 3435.78 ± 22.33ng/ml, p<0.05); (3) ADMA reduced tPA mRNA levels and increased PAI-1 mRNA levels; (4) L-arginine, SB203580 (p38 MAPK inhibitor) and PDTC attenuated the effects of ADMA on tPA and PAI-1 significantly. (5) ADMA induced a rapid phosphorylation of p38 MAPK, and stimulated NF-κB activity greatly. CONCLUSIONS ADMA may accelerate thrombosis development by impairing fibrinolytic activity in vascular via inhibiting nitric oxide production and then activating its downstream p38 MAPK and NF-κB pathways.
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Affiliation(s)
- Qin Zhang
- The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
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Lu TM, Chung MY, Lin CC, Hsu CP, Lin SJ. Asymmetric dimethylarginine and clinical outcomes in chronic kidney disease. Clin J Am Soc Nephrol 2011; 6:1566-72. [PMID: 21642363 DOI: 10.2215/cjn.08490910] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Elevated plasma level of asymmetric dimethylarginine (ADMA) have been reported to be associated with endothelial dysfunction and atherosclerosis risk factors, and may predict cardiovascular events in patients with ESRD. In this study, we aimed to assess the association between plasma ADMA and long-term outcome in a cohort of patients with stage 3 to 4 chronic kidney disease (CKD). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS From July 2006 to June 2009, 298 consecutive patients with stage 3 to 4 CKD scheduled to undergo coronary angiography were recruited. Plasma ADMA levels were determined using HPLC. RESULTS The mean age was 73 ± 10 years. Approximately half of the patients had diabetes and 88 patients had proteinuria. The baseline estimated GFR (eGFR) was 44 ± 13 ml/min per 1.73 m². The plasma ADMA levels of the patients with proteinuria were significantly higher than those without. The plasma ADMA levels correlated significantly with eGFR. During the median follow-up period of 2.7 years, we observed 26 all-cause deaths, 12 nonfatal myocardial infarctions, and 2 strokes. Multivariate Cox analysis revealed that an increase of 0.1 μmol/L in plasma ADMA level was associated with a 37% increased risk of the composite outcomes of all-cause deaths, nonfatal myocardial infarctions, and strokes. CONCLUSIONS In this elder and high-risk population with stage 3 to 4 CKD, high plasma ADMA level was associated with low eGFR and macroalbuminuria. Furthermore, high plasma ADMA level appeared to be an independent predictor of long-term outcome.
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Affiliation(s)
- Tse-Min Lu
- Division of Cardiology, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
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Tripepi G, Mattace Raso F, Sijbrands E, Seck MS, Maas R, Boger R, Witteman J, Rapisarda F, Malatino L, Mallamaci F, Zoccali C. Inflammation and asymmetric dimethylarginine for predicting death and cardiovascular events in ESRD patients. Clin J Am Soc Nephrol 2011; 6:1714-21. [PMID: 21642364 DOI: 10.2215/cjn.11291210] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Endothelial dysfunction as assessed by asymmetric dimethylarginine (ADMA) and inflammation has been consistently linked to atherosclerosis, death, and cardiovascular (CV) events in ESRD patients. Inflammation amplifies the effect of ADMA on the severity of atherosclerosis in ESRD patients, but it is still unknown whether inflammation and ADMA interact in the high risk of death and CV events in this population. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In a cohort of 225 hemodialysis patients, we investigated the interaction between inflammatory biomarkers (C-reactive protein and IL-6) and ADMA as predictors of death and CV events over an extended follow-up (13 years). RESULTS During follow-up, 160 patients died, and 123 had CV events. With crude and multiple Cox regression analyses, an interaction was found between inflammation biomarkers and ADMA for explaining death and CV events in ESRD patients. The adjusted hazard ratios (HRs) for death (HR, 2.18; 95% confidence interval [CI], 1.34 to 3.54) and CV outcomes (HR, 2.59; 95% CI, 1.47 to 4.55) of patients with C-reactive protein and ADMA above the median were higher than expected in the absence of interaction under the additive model (1.15 and 1.97, respectively) and significantly higher than in patients with only one biomarker above the median. Data analyses carried out by stratifying patients according to IL-6 provided similar results. CONCLUSIONS These data support the hypothesis that inflammation amplifies the risk of death and CV events associated with high ADMA levels in ESRD. These analyses further emphasize the need for intervention studies to attenuate inflammation and high ADMA levels in this population.
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Affiliation(s)
- Giovanni Tripepi
- CNR-IBIM, Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension, Reggio Calabria, Italy
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Blackwell S, O'Reilly DSJ, Reid D, Talwar D. Plasma dimethylarginines during the acute inflammatory response. Eur J Clin Invest 2011; 41:635-41. [PMID: 21175611 DOI: 10.1111/j.1365-2362.2010.02451.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Asymmetric dimethylarginine (ADMA) concentrations are increased in critically ill patients and may play a role in multiple organ failure. However, plasma ADMA concentrations during the development of the inflammatory response have not been documented. We measured plasma ADMA, as well as urinary excretion of its major metabolite dimethylamine, and nitrate as a marker of nitric oxide synthase (NOS) activity, in a cohort of patients undergoing elective knee arthroplasty that is known to provoke a significant inflammatory response. METHODS Thirty-eight patients were recruited. Fasting venous blood samples were obtained pre-operatively and at 12h and daily until the fifth post-operative day. ADMA and symmetric dimethylarginine (SDMA) were measured by high-performance liquid chromatography (HPLC). Urinary dimethylamine and nitrate were measured pre-operatively and on each of the post-operative mornings using HPLC and expressed as a ratio to creatinine. RESULTS Plasma ADMA fell by a median of 31% during the post-operative period, reaching a nadir on day 2, and recovering to baseline by the end of the study. SDMA showed no significant changes. No increase in urinary dimethylamine excretion was noted until day 5 post-op, whereupon it doubled. Urinary nitrate showed a small, but nonsignificant decrease on day 2, suggesting no major activation of NOS activity. CONCLUSIONS Plasma ADMA concentration decreases rapidly and transiently during the first 48h of acute inflammation. This appears not be caused by increased catabolism and may reflect increased cellular partitioning. This may serve to regulate NOS activity and prevent harmful increases in inducible NOS in situations where it is not appropriate.
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Affiliation(s)
- Scott Blackwell
- Department of Clinical Biochemistry, Royal Infirmary, Glasgow, UK
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Gu LQ, Zhao L, Zhu W, Li FY, Zhang MJ, Liu Y, Liu JM, Ning G, Zhao YJ. Relationships between serum levels of thyroid hormones and serum concentrations of asymmetric dimethylarginine (ADMA) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) in patients with Graves' disease. Endocrine 2011; 39:266-71. [PMID: 21387129 DOI: 10.1007/s12020-011-9436-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2011] [Accepted: 02/04/2011] [Indexed: 12/17/2022]
Abstract
Endothelial dysfunction as well as abnormal thyroid hormone levels may be responsible for increased cardiovascular risk in Graves' disease (GD). Asymmetric dimethylarginine (ADMA) and N-terminal-pro-B-type natriuretic peptide (NT-proBNP) are new markers of endothelial and myocardial dysfunction, respectively. The purpose of this study was to investigate the relationship among the serum levels of ADMA, NT-proBNP, and thyroid hormones in GD patients. This was a cross-sectional investigation conducted in a university teaching hospital. Two hundred and thirty-nine GD (Female: 182, Male: 57) patients and 81 normal controls were enrolled in this study. Serum levels of ADMA were positively related with FT3 (r = 0.584, P < 0.001), FT4 (r = 0.551, P < 0.001), and TRAb levels (r = 0.502, P < 0.001). Serum NT-proBNP levels were positively associated with FT3 (r = 0.243, P < 0.001) and FT4 levels (r = 0.274, P < 0.001), as well as heart rate (r = 0.271, P < 0.03). The elevation of serum ADMA and NT-proBNP levels were also observed in patients with controlled hyperthyroidism. It is thus concluded that serum ADMA and NT-proBNP levels were increased in GD patients. Future studies may determine the usefulness of these two biomarkers to detect early signs of endothelial dysfunction, vascular stiffness, and fluid volume in GD patients.
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Affiliation(s)
- Li-Qun Gu
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-tong University School of Medicine, Shanghai Institute of Endocrine and Metabolic Diseases, Shanghai Clinical Center For Endocrine and Metabolic Diseases, 197 Rui-jin Er Road, Shanghai, 200025, People's Republic of China
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Ioakeimidis N, Vlachopoulos C, Rokkas K, Aggelis A, Terentes-Printzios D, Samentzas A, Alexopoulos N, Stefanadis C. Relationship of Asymmetric Dimethylarginine With Penile Doppler Ultrasound Parameters in Men with Vasculogenic Erectile Dysfunction. Eur Urol 2011; 59:948-55. [DOI: 10.1016/j.eururo.2011.02.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 02/02/2011] [Indexed: 10/18/2022]
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Robotic treadmill training improves cardiovascular function in spinal cord injury patients. Int J Cardiol 2011; 149:323-9. [DOI: 10.1016/j.ijcard.2010.02.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Revised: 01/05/2010] [Accepted: 02/06/2010] [Indexed: 11/18/2022]
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Kandavar R, Higashi Y, Chen W, Blackstock C, Vaughn C, Sukhanov S, Sander GE, Roffidal LE, Delafontaine P, Giles TD. The effect of nebivolol versus metoprolol succinate extended release on asymmetric dimethylarginine in hypertension. JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION : JASH 2011; 5:161-5. [PMID: 21251896 PMCID: PMC3141281 DOI: 10.1016/j.jash.2010.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 11/11/2010] [Accepted: 11/15/2010] [Indexed: 11/29/2022]
Abstract
This study sought to determine if metoprolol succinate ER (MET), and nebivolol (NEB), a β1-AR with increased bioavailability of nitric oxide (NO), would have differing effects on plasma asymmetric dimethylarginine concentration in hypertensives. It was hypothesized that NEB, a β1-AR antagonist and β3-AR agonist with NO-releasing properties, and MET, only a β1-AR antagonist, would have different effects on plasma asymmetric dimethylarginine (ADMA) concentration. Forty-one hypertensive subjects randomly received either 50 mg of MET (n = 19) or 5 mg of NEB (n = 22) for 4 weeks followed by 100 mg MET and 10 mg NEB for 4 weeks. ADMA and insulin-like growth factor-1 (IGF-1) were measured by enzyme-linked immunosorbent assay kit; endothelial progenitor cells were estimated using fluorescein-labeled monoclonal antibody to KDR and CD133 receptors; arterial augmentation index was measured by radial tonometry. Baseline systolic/diastolic blood pressure was 155.1 ± 18.7/85.3 ± 12.5 mm Hg for MET subjects and 157.6 ± 20.7/87.1 ± 14.0 mm Hg for NEB subjects. Baseline ADMA was 0.32 ± 0.123 μmol/L in the MET group and 0.4035 ± 0.1378 in the NEB group. ADMA increased 44.78% and 72% in the MET group at weeks 4 and 8 (P < .05 for both), respectively, without increase in the NEB group. At week 8, augmentation index was increased in the MET group (P < .05). IGF-1 and endothelial progenitor cells were unchanged by treatment. Plasma ADMA and augmentation index are increased in a dose-dependent fashion by MET but not with NEB.
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Affiliation(s)
- Ramprasad Kandavar
- Heart and Vascular Institute, Tulane University School of Medicine, New Orleans, LA 70005, USA
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Hu X, Atzler D, Xu X, Zhang P, Guo H, Lu Z, Fassett J, Schwedhelm E, Böger RH, Bache RJ, Chen Y. Dimethylarginine dimethylaminohydrolase-1 is the critical enzyme for degrading the cardiovascular risk factor asymmetrical dimethylarginine. Arterioscler Thromb Vasc Biol 2011; 31:1540-6. [PMID: 21493890 DOI: 10.1161/atvbaha.110.222638] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The objective of this study was to identify the role of dimethylarginine dimethylaminohydrolase-1 (DDAH1) in degrading the endogenous nitric oxide synthase inhibitors asymmetrical dimethylarginine (ADMA) and N(g)-monomethyl-L-arginine (L-NMMA). METHODS AND RESULTS We generated a global-DDAH1 gene-deficient (DDAH1(-/-)) mouse strain to examine the role of DDAH1 in ADMA and l-NMMA degradation and the physiological consequences of loss of DDAH1. Plasma and tissue ADMA and L-NMMA levels in DDAH1(-/-) mice were several folds higher than in wild-type mice, but growth and development of these DDAH1(-/-) mice were similar to those of their wild-type littermates. Although the expression of DDAH2 was unaffected, DDAH activity was undetectable in all tissues tested. These findings indicate that DDAH1 is the critical enzyme for ADMA and L-NMMA degradation. Blood pressure was ≈ 20 mm Hg higher in the DDAH1(-/-) mice than in wild-type mice, but no other cardiovascular phenotype was found under unstressed conditions. Crossing DDAH1(+/-) male with DDAH1(+/-) female mice yielded DDAH1(+/+), DDAH1(+/-), and DDAH1(-/-) mice at the anticipated ratio of 1:2:1, indicating that DDAH1 is not required for embryonic development in this strain. CONCLUSIONS Our findings indicate that DDAH1 is required for metabolizing ADMA and L-NMMA in vivo, whereas DDAH2 had no detectable role for degrading ADMA and l-NMMA.
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Affiliation(s)
- Xinli Hu
- Cardiovascular Division, Lillehei Heart Institute, University of Minnesota, Minneapolis, MN 55455, USA
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238
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Peng ZY, Zhang SD, Liu S, He BM. Protective effect of neferine on endothelial cell nitric oxide production induced by lysophosphatidylcholine: the role of the DDAH–ADMA pathway. Can J Physiol Pharmacol 2011; 89:289-94. [PMID: 21526974 DOI: 10.1139/y11-021] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Neferine, extracted from the seed embryo of Nelumbo nucifera Gaertn., has multiple cardiovascular pharmacological effects. The dimethylarginine dimethylaminohydrolase (DDAH) – asymmetric dimethylarginine (ADMA) system is a novel pathway for modulating nitric oxide (NO) production. The aim of this study was to investigate whether the protective effect of neferine on endothelial NO production was related to the DDAH–ADMA pathway. Human umbilical vein endothelial cells (HUVECs) were first exposed to neferine (0.1, 1.0, or 10.0 μmol/L) for 1 h, and then incubated with lysophosphatidylcholine (LPC; 10 μg/mL) in the presence of neferine for 24 h. The medium was collected for measuring the levels of NO, maleic dialdehyde (MDA), as well as ADMA. The endothelial cells were collected for measuring DDAH activity and the level of reactive oxygen species (ROS). LPC significantly decreased NO concentration and DDAH activity and increased the levels of ADMA, ROS, and MDA. Neferine could partially counteract the changes induced by LPC. These findings suggested that neferine could modulate the DDAH–ADMA pathway via its antioxidant properties, which was involved in its beneficial effect on endothelial NO production.
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Affiliation(s)
- Zhen-Yu Peng
- Department of Cardiology, Xiangya Hospital, Central South University, Xiangya Road No. 88, Changsha, P.R. China
- Department of Emergency, Second Xiangya Hospital, Central South University, Middle Ren-Min Road No. 139, Changsha, P.R. China
| | - Sai-Dan Zhang
- Department of Cardiology, Xiangya Hospital, Central South University, Xiangya Road No. 88, Changsha, P.R. China
| | - Shao Liu
- Department of Pharmacy, Xiangya Hospital, Central South University, Xiangya Road No. 88, Changsha, P.R. China
| | - Bai-Mei He
- Department of Respiratory Medicine, Xiangya Hospital, Central South University, Xiangya Road No. 88, Changsha, P.R. China
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239
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Kanazawa I, Yano S, Notsu Y, Yamaguchi T, Nabika T, Sugimoto T. Asymmetric dimethylarginine as a risk factor for cardiovascular disease in Japanese patients with type 2 diabetes mellitus. Clin Endocrinol (Oxf) 2011; 74:467-72. [PMID: 21128993 DOI: 10.1111/j.1365-2265.2010.03946.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIMS Although asymmetric dimethylarginine (ADMA) is known to be involved in the developing process of cardiovascular diseases (CVD), little is known about the effects of ADMA on atherosclerosis in Asian patients with diabetes, who have the racial feature of lower body mass index (BMI) and decreased capacity of insulin secretion and sensitivity. METHODS We employed 55 Japanese patients with type 2 diabetes mellitus (mean age, 64·2 years; 56% men) in a 6-month-longitudinal study and 450 patients (mean age, 62·7 years; 56% men) in a cross-sectional study and examined the association of serum ADMA with atherosclerosis parameters [intima-media thickness (IMT) and brachial-ankle pulse wave velocity (baPWV)] as well as with the presence of CVD. RESULTS In the longitudinal study, multiple regression analysis showed that basal serum ADMA level had a significantly positive association with changes in IMT (β=0·35, P=0·03) independently of age, duration of diabetes, BMI, blood pressure, low-density lipoprotein and high-density lipoprotein (LDL and HDL) cholesterol, HbA(1c) , and renal function. In the cross-sectional study, the serum ADMA level was significantly and positively associated with the presence of CVD (odds ratio=7·22, 95% confidence interval 1·29-40·40, P=0·02, by logistic analysis) and with baPWV (β=0·14, P <0·01, by multiple regression analysis). In contrast, serum symmetric dimethylarginine level, a structural isomer of ADMA, was associated neither with parameters for atherosclerosis nor with the presence of CVD in both studies. CONCLUSIONS Serum ADMA is a predictor of atherosclerosis and associated with the presence of CVD in Japanese patients with type 2 diabetes mellitus.
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Affiliation(s)
- Ippei Kanazawa
- Department of Internal Medicine 1, The Center for Community-based Health Research and Education (COHRE), Shimane University Faculty of Medicine, 89-1 Enya-cho, Izumo, Japan.
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Schwedhelm E, Böger RH. The role of asymmetric and symmetric dimethylarginines in renal disease. Nat Rev Nephrol 2011; 7:275-85. [PMID: 21445101 DOI: 10.1038/nrneph.2011.31] [Citation(s) in RCA: 180] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthases. By inhibiting nitric oxide formation, ADMA causes endothelial dysfunction, vasoconstriction, elevation of blood pressure, and aggravation of experimental atherosclerosis. Levels of ADMA and its isomer symmetric dimethylarginine (SDMA), which does not inhibit nitric oxide synthesis, are both elevated in patients with kidney disease. Currently available data from prospective clinical trials in patients with chronic kidney disease suggest that ADMA is an independent marker of progression of renal dysfunction, vascular complications and death. High SDMA levels also negatively affect survival in populations at increased cardiovascular risk, but the mechanisms underlying this effect are currently only partly understood. Beyond glomerular filtration, other factors influence the plasma concentrations of ADMA and SDMA. Elevated plasma concentrations of these dimethylarginines might also indirectly influence the activity of nitric oxide synthases by inhibiting the uptake of cellular L-arginine. Other mechanisms may exist by which SDMA exerts its biological activity. The biochemical pathways that regulate ADMA and SDMA, and the pathways that transduce their biological function, could be targeted to treat renal disease in the future.
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Affiliation(s)
- Edzard Schwedhelm
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Martinistrasse 52, 20246 Hamburg, Germany
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241
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Palomo I, Contreras A, Alarcón LM, Leiva E, Guzmán L, Mujica V, Icaza G, Díaz N, González DR, Moore-Carrasco R. Elevated concentration of asymmetric dimethylarginine (ADMA) in individuals with metabolic syndrome. Nitric Oxide 2011; 24:224-8. [PMID: 21419857 DOI: 10.1016/j.niox.2011.03.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 02/03/2011] [Accepted: 03/13/2011] [Indexed: 01/28/2023]
Abstract
The metabolic syndrome (MS) is a cluster of pathophysiological alterations that includes the presence of hypertension, insulin resistance, dyslipidemia, and abdominal obesity. MS is associated with increased risk of developing diabetes and cardiovascular diseases. Endothelial dysfunction with impaired nitric oxide (NO) bioavailability has been implicated in insulin resistance and hypertension. NO is synthesized by nitric oxide synthase (NOS) using l-arginine as substrate. Asymmetric dimethyl arginine (ADMA) is a major and potent endogenous NOS inhibitor, associated with cardiovascular and renal diseases. We tested the hypothesis that plasmatic ADMA levels are increased in patients with MS. We studied 85 adult individuals from Talca, Chile, separated in two groups, 48 individuals with MS (according to modified ATP III criteria), and 37 individuals without MS as controls. ADMA levels were significantly increased in the MS group (mean±standard deviation 0.71±0.38 vs. 0.48±0.28μmol/L, p=0.0009). Furthermore, the levels of ADMA were modestly but significantly correlated with waist circumference (p=0.01) but not with the other components of MS (blood pressure, glycemia, triglycerides and high density lipoprotein cholesterol HDL-c). These results suggest a possible link between increased ADMA levels and the MS.
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Affiliation(s)
- Iván Palomo
- Departamento de Bioquímica Clínica e Inmunohematología, Facultad de Ciencias de la Salud, Universidad de Talca, Talca, Chile.
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242
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Böger RH, Endres HG, Schwedhelm E, Darius H, Atzler D, Lüneburg N, von Stritzky B, Maas R, Thiem U, Benndorf RA, Diehm C. Asymmetric dimethylarginine as an independent risk marker for mortality in ambulatory patients with peripheral arterial disease. J Intern Med 2011; 269:349-61. [PMID: 21175900 DOI: 10.1111/j.1365-2796.2010.02322.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide (NO) synthesis causing endothelial dysfunction, an early sign of atherogenesis. Symmetric dimethylarginine (SDMA) does not inhibit NO synthases. Peripheral arterial disease (PAD) is a systemic indication of atherosclerosis. METHODS We assessed the associations between both ADMA and SDMA blood levels and major cardiovascular and cerebrovascular events or death from any cause within a 5-year follow-up in the multicentre getABI trial. From a cohort of 6821 primary care patients, aged ≥65 years, all 1260 patients with prevalent PAD were compared with a random sample of 1187 non-PAD controls. A total of 11,544 patient-years were documented. Multivariate risks were calculated by Cox proportional hazard models, adjusting for PAD, renal dysfunction and other important cardiovascular risk factors. RESULTS We documented 390 deaths, 296 cardiovascular events and 98 cerebrovascular events. Increased ADMA levels in the 4th quartile were significantly associated with total mortality [hazard ratio (HR) 1.41; 95% CI 1.14-1.74] and with cardiovascular events (HR 1.32; 95% CI 1.03-1.69), but there was a nonsignificant association with cerebrovascular events (HR 1.50; 95% CI 0.98-2.29). Increased SDMA was only just significantly associated with mortality (HR 1.27; 95% CI 1.01-1.59). In PAD patients compared with non-PAD controls, only mean SDMA concentration was considerably increased (0.52 μmol L(-1) vs. 0.48 μmol L(-1); P < 0.001) mainly because of a highly significant association with impaired renal function. CONCLUSION These data suggest that ADMA but not SDMA is an independent risk marker for death from any cause or from cardiovascular events. The association between SDMA and mortality is in part explained by a close link between SDMA and renal function.
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Affiliation(s)
- R H Böger
- Institute of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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243
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Lu TM, Lin SJ, Lin MW, Hsu CP, Chung MY. The association of dimethylarginine dimethylaminohydrolase 1 gene polymorphism with type 2 diabetes: a cohort study. Cardiovasc Diabetol 2011; 10:16. [PMID: 21303562 PMCID: PMC3050685 DOI: 10.1186/1475-2840-10-16] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Accepted: 02/09/2011] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Elevated plasma levels of asymmetric dimethylarginine (ADMA) has been reported to be associated with insulin resistance and micro/macrovascular diabetic complications, and may predict cardiovascular events in type 2 diabetic patients. Dimethylarginine dimethylaminohydrolase 1 (DDAH1) is the major enzyme eliminating ADMA in humans, but the effect of genetic variations in DDAH1 on type 2 diabetes and its long-term outcome are unknown. METHODS From July 2006 to June 2009, we assessed the association between polymorphisms in DDAH1 and type 2 diabetes in 814 consecutive unrelated subjects, including 309 type 2 diabetic patients and 505 non-diabetic individuals. Six single nucleotide polymorphisms (SNPs) in DDAH1, rs233112, rs1498373, rs1498374, rs587843, rs1403956, and rs1241321 were analyzed. Plasma ADMA levels were determined by high performance liquid chromatography. Insulin sensitivity was assessed by the homeostasis model assessment of insulin resistance (HOMA-IR). RESULTS Among the 6 SNPs, only rs1241321 was significantly associated with a decreased risk of type 2 diabetes (AA vs GG+AG, OR = 0.64, 95% CI 0.47-0.86, p = 0.004). The association remained unchanged after adjustment for plasma ADMA level. The fasting plasma glucose and log HOMA-IR tended to be lower in subjects carrying the homozygous AA genotype of rs1241321 compared with the GG+AG genotypes. Over a median follow-up period of 28.2 months, there were 44 all-cause mortality and 50 major adverse cardiovascular events (MACE, including cardiovascular death, non-fatal myocardial infarction and stroke). Compared with the GG and AG genotypes, the AA genotype of rs1241321 was associated with reduced risk of MACE (HR = 0.31, 95% CI: 0.11-0.90, p = 0.03) and all-cause mortality (HR = 0.18, 95% CI: 0.04-0.80, p = 0.02) only in subgroup with type 2 diabetes. One common haplotype (GGCAGC) was found to be significantly associated with a decreased risk of type 2 diabetes (OR = 0.67, 95% CI = 0.46-0.98, p = 0.04). CONCLUSIONS Our results provide the first evidence that SNP rs1241321 in DDAH1 is associated with type 2 diabetes and its long-term outcome.
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Affiliation(s)
- Tse-Min Lu
- Division of Cardiology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R,O,C
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244
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Tain YL, Huang LT. Asymmetric Dimethylarginine: Clinical Applications in Pediatric Medicine. J Formos Med Assoc 2011; 110:70-7. [DOI: 10.1016/s0929-6646(11)60012-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 05/31/2010] [Accepted: 06/17/2010] [Indexed: 10/18/2022] Open
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245
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Peng ZY, Zhao SP, He BM, Peng DQ, Hu M. Protective effect of HDL on endothelial NO production: the role of DDAH/ADMA pathway. Mol Cell Biochem 2011; 351:243-9. [PMID: 21264497 DOI: 10.1007/s11010-011-0731-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 01/10/2011] [Indexed: 12/01/2022]
Abstract
Accumulating studies have demonstrated that the dimethylarginine dimethylaminohydrolase/asymmetric dimethylarginine (DDAH/ADMA) system is a novel pathway for modulating nitric oxide (NO) production. The aim of this study was to investigate whether the protective effect of high density lipoprotein (HDL) on endothelial NO production was related to its effect on DDAH/ADMA pathway. Human umbilical vein endothelial cells (HUVECs) were prior exposed to HDL (10, 50, or 100 μg/ml) for 1 h, and then incubated with oxidized low density lipoprotein (ox-LDL) (100 μg/ml) for 24 h. The cultured medium was collected for measuring the concentration of NO and ADMA. The cells were collected for measuring the mRNA and protein expression of DDAH-II as well as DDAH activity. HUVECs treated with ox-LDL (100 μg/ml) for 24 h significantly decreased the concentration of NO, the mRNA and protein expression of DDAH-II as well as DDAH activity and increased the level of ADMA. Pretreatment with HDL (10, 50, or 100 μg/ml) could counteract these changes induced by ox-LDL (100 μg/ml). HDL significantly increased the attenuated endothelial cell NO production induced by ox-LDL, which was attributed to its effect on DDAH/ADMA pathway.
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Affiliation(s)
- Zhen-Yu Peng
- Department of Cardiology, Second Xiangya Hospital, Central South University, Middle Ren-Min Road 139, Changsha 410011, China
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Serg M, Kampus P, Kals J, Zagura M, Muda P, Tuomainen TP, Zilmer K, Salum E, Zilmer M, Eha J. Association between asymmetric dimethylarginine and indices of vascular function in patients with essential hypertension. Blood Press 2010; 20:111-6. [DOI: 10.3109/08037051.2010.533821] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Martin Serg
- Department of Cardiology, University of Tartu, Tartu, Estonia
- Endothelial Centre, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
| | - Priit Kampus
- Department of Cardiology, University of Tartu, Tartu, Estonia
- Endothelial Centre, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
| | - Jaak Kals
- Endothelial Centre, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
- Department of Vascular Surgery, Tartu University Hospital, Tartu, Estonia
| | - Maksim Zagura
- Department of Cardiology, University of Tartu, Tartu, Estonia
- Endothelial Centre, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
| | - Piibe Muda
- Department of Cardiology, University of Tartu, Tartu, Estonia
| | - Tomi-Pekka Tuomainen
- Research Institute of Public Health, School of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Kersti Zilmer
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
| | - Erik Salum
- Department of Cardiology, University of Tartu, Tartu, Estonia
- Endothelial Centre, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
| | - Mihkel Zilmer
- Endothelial Centre, University of Tartu, Tartu, Estonia
- Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia
| | - Jaan Eha
- Department of Cardiology, University of Tartu, Tartu, Estonia
- Endothelial Centre, University of Tartu, Tartu, Estonia
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Vardar SA, Gunduz O, Altun GD, Aydogdu N, Karadag H, Torun N, Kaya O. The alteration of asymmetric dimetilarginine (ADMA) levels in cardiac and gastrocnemius muscles following radioactive iodine application in guinea pigs and the effect of L-carnitine on this alteration. Int J Radiat Biol 2010. [DOI: 10.3109/09553002.2011.518209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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248
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Li XH, Peng J, Tan N, Wu WH, Li TT, Shi RZ, Li YJ. Involvement of asymmetric dimethylarginine and Rho kinase in the vascular remodeling in monocrotaline-induced pulmonary hypertension. Vascul Pharmacol 2010; 53:223-9. [DOI: 10.1016/j.vph.2010.09.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2010] [Revised: 08/16/2010] [Accepted: 09/08/2010] [Indexed: 10/19/2022]
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249
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Vardar SA, Gunduz O, Altun GD, Aydogdu N, Karadag H, Torun N, Kaya O. The alteration of asymmetric dimetilarginine (ADMA) levels in cardiac and gastrocnemius muscles following radioactive iodine application in guinea pigs and the effect of L-carnitine on this alteration. Int J Radiat Biol 2010; 87:2-7. [DOI: 10.3109/09553002.2010.518209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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250
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Visser M, Paulus WJ, Vermeulen MAR, Richir MC, Davids M, Wisselink W, de Mol BAJM, van Leeuwen PAM. The role of asymmetric dimethylarginine and arginine in the failing heart and its vasculature. Eur J Heart Fail 2010; 12:1274-81. [PMID: 20923854 DOI: 10.1093/eurjhf/hfq158] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Nitric oxide (NO) is formed from arginine by the enzyme nitric oxide synthase (NOS). Asymmetric dimethylarginine (ADMA) can inhibit NO production by competing with arginine for NOS binding. Therefore, the net amount of NO might be indicated by the arginine/ADMA ratio. In turn, arginine can be metabolized by the enzyme arginase, and ADMA by the enzyme dimethylarginine dimethylaminohydrolase (DDAH). While ADMA has been implicated as a cardiovascular risk factor, arginine supplementation has been indicated as a treatment in cardiac diseases. This review discusses the roles of ADMA and arginine in the failing heart and its vasculature. Furthermore, it proposes nutritional therapies to improve NO availability.
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Affiliation(s)
- Marlieke Visser
- Department of Surgery, VU University Medical Center, Amsterdam, The Netherlands
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