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Bima C, Parasiliti-Caprino M, Rumbolo F, Ponzetto F, Gesmundo I, Nonnato A, Fornengo P, Vaula G, Ghigo E, Mengozzi G, Settanni F. Asymmetric and symmetric dimethylarginine as markers of endothelial dysfunction in cerebrovascular disease: A prospective study. Nutr Metab Cardiovasc Dis 2024; 34:1639-1648. [PMID: 38570234 DOI: 10.1016/j.numecd.2024.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/07/2024] [Accepted: 03/11/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND AND AIM Asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) have been proposed as mediators of endothelial dysfunction. In this study, we aimed to investigate the diagnostic and prognostic role of ADMA and SDMA in acute cerebrovascular disease. METHODS AND RESULTS A prospective case-control study was performed, enrolling 48 patients affected by ischemic stroke with no cardioembolic origin, 20 patients affected by TIA, 40 subjects at high cardiovascular risk and 68 healthy subjects. ADMA levels were significantly lower in high-risk subjects (18.85 [11.78-22.83] μmol/L) than in patients with brain ischemic event, both transient (25.70 [13.15-40.20] μmol/L; p = 0.032) and permanent (24.50 [18.0-41.33] μmol/L; p = 0.001). SDMA levels were different not only between high-risk subjects and ischemic patients, but also between TIA and stroke patients, reaching higher levels in TIA group and lower levels in stroke group (1.15 [0.90-2.0] vs 0.68 [0.30-1.07] μmol/L; p < 0.001). SDMA was also correlated with short-term prognosis, with lower levels in case of adverse clinical course, evaluated by type of discharge (p = 0.009) and need of prolonged rehabilitation (p = 0.042). CONCLUSIONS The present study highlights the relationship between l-arginine, ADMA, SDMA and acute cerebrovascular events. Therefore, our results suggested a potential role of SDMA as a specific marker of transient ischemic damage and as a short-term positive prognostic marker.
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Affiliation(s)
- Chiara Bima
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mirko Parasiliti-Caprino
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy.
| | - Francesca Rumbolo
- Clinical Biochemistry Laboratory, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Federico Ponzetto
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Iacopo Gesmundo
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Antonello Nonnato
- Clinical Biochemistry Laboratory, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo Fornengo
- Internal Medicine 3, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giovanna Vaula
- Stroke Unit, Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Ezio Ghigo
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Giulio Mengozzi
- Clinical Biochemistry Laboratory, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Fabio Settanni
- Clinical Biochemistry Laboratory, Department of Medical Sciences, University of Turin, Turin, Italy
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Onmaz M, Demirbas N, Eryavuz Onmaz D, Kutlu R, Unlu A. Effect of cigarette smoking on serum methylarginine and α-klotho levels. Nutr Metab Cardiovasc Dis 2023; 33:602-609. [PMID: 36710115 DOI: 10.1016/j.numecd.2022.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/19/2022] [Accepted: 12/24/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND AIMS Smoking causes many diseases such as cardiovascular, lung diseases, stroke and premature aging. However, the role of smoking in the pathogenesis of these diseases is unclear. Increasing evidence suggests that methylarginine pathway metabolites and α-klotho may be strong markers for pathologies such as premature aging, endothelial dysfunction, and oxidant damage. Therefore, the study aimed to measure the serum levels of arginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), N-monomethyl-l-arginine (L-NMMA), and α-klotho levels in smokers. METHODS AND RESULTS This case-control analytical study included 65 smokers and 71 non-smokers. Sociodemographic characteristics, routine biochemistry parameters, Framingham risk scores and Fagerström Nicotine Dependence Test (FTND) were recorded. Serum methylarginine and α-klotho levels were analyzed by tandem mass spectrometry and enzyme-linked immunosorbent assay (ELISA), respectively. Serum ADMA (p < 0.001), L-NMMA (p = 0.024), SDMA (p < 0.001) levels of smokers were higher than non-smokers, and serum α-klotho (p < 0.001) and arginine levels (p < 0.001) were lower. There was a positive correlation between serum ADMA levels with FNDT, age and pack/year in smokers, while there was a negative correlation between klotho levels and age. A positive correlation was found between serum ADMA levels, Framingham risk score and age in non-smokers. CONCLUSION Smoking is related to premature aging and is a strong risk factor for various diseases such as cardiovascular, inflammatory, and renal diseases. Elevated serum methylarginine and decreased serum klotho levels were found in smokers. Therefore, our findings suggest that smoking may be involved in the pathogenesis of these diseases by affecting α-klotho and methylarginine-related pathways.
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Affiliation(s)
- Mustafa Onmaz
- Necmettin Erbakan University Faculty of Medicine, Department of Family Medicine, Konya, Turkey.
| | - Nur Demirbas
- Necmettin Erbakan University Faculty of Medicine, Department of Family Medicine, Konya, Turkey
| | - Duygu Eryavuz Onmaz
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Ruhusen Kutlu
- Necmettin Erbakan University Faculty of Medicine, Department of Family Medicine, Konya, Turkey
| | - Ali Unlu
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
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Alsagaff MY, Thaha M, Pikir BS, Susilo H, Wungu CDK, Suryantoro SD, Haryati MR, Ramadhani R, Agustin ED, Putra MRA, Maiguma M, Suzuki Y. The role of oxidative stress markers in Indonesian chronic kidney disease patients: a cross sectional study. F1000Res 2022. [DOI: 10.12688/f1000research.74985.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Background: Several aspects of chronic kidney disease (CKD) such as the incidence rate and mortality rate are concerning. Oxidative stress contributes to progression and mortality in patients with CKD; however, a specific correlation between several markers of oxidative stress and the estimated glomerular filtration rate (eGFR) and albumin-creatinine ratio (ACR) in the Indonesian population has not been sufficiently described yet. Methods: This study was an analytic observational study with a sample of 56 patients with CKD in Universitas Airlangga Hospital, Surabaya, Indonesia, from December 2019 – March 2020. The markers for oxidative stress investigated were urinary 8-hydroxy-2 deoxyguanosine (8-OHdG), serum symmetric dimethylarginine (SDMA) and asymmetric dimethylarginine (ADMA). The correlations between each variable of oxidative stress and CKD were analyzed using Pearson analysis. Results: There was a positive correlation between 8-OHdG and eGFR (p=0.00, r=0.51); however, there was a negative correlation between 8-OHdG and ACR (p=0.025, r=-0.30). SDMA and eGFR showed a negative correlation (p=0.00, r=-0.648), while SDMA and ACR showed a positive correlation (p=0.03, r=0.349). ADMA showed a negative correlation with eGFR (p=0.00, r=-0.476). There were significantly decreased 8-OHdG but increased ADMA and SDMA as the CKD stage progressed (p=0.001, p=0.00, and p = 0.00, respectively). Higher urine 8-OHdG was detected in patients without history of hemodialysis, whereas ADMA and SDMA showed higher value in patients with hemodialysis (p=0.00, p=0.00, and p=0.004, respectively), patients with history of diabetes mellitus (DM) had higher mean 8-OHdG (p 0.000) yet lower serum ADMA and SDMA (p=0.004 and p=0.003, respectively). Conclusions: In patients with CKD in Indonesia, the markers for oxidative stress 8-OHdG, SDMA, and ADMA are correlated with eGFR and ACR levels. There were also significant difference in 8-OHdG, SDMA, and ADMA levels among CKD stages, between dialysis vs non dialysis, and DM vs non DM patients.
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Karahan I, Durmaz Ceylan S, Gungunes A, Cifci A, Eker F, Kisa U. Non-functioning adrenal incidentalomas may increase toxic metabolites. Wien Klin Wochenschr 2021; 134:125-129. [PMID: 34255169 DOI: 10.1007/s00508-021-01909-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/15/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Non-functioning adrenal incidentaloma (NFAI) is a frequent diagnosis with increasing radiological tests. The emerging shreds of evidence showed that they might have negative cardiometabolic effects. The study aimed to investigate whether the toxic metabolites, asymmetric dimethylarginine (ADMA) levels, were altered in NFAI patients. METHODS We included 43 NFAI patients and 41 controls with similar ages and body mass indices in the study. We compared plasma ADMA levels of both groups and noted the radiological features of NFAIs. RESULTS The ADMA levels were significantly higher in NFAI patients than in the control group (307.04 ng/ml, range 81.89-577.7 ng/ml vs 192.54 ng/ml, range 70.61-440.26 ng/ml, p = 0.001). Nevertheless, we could not reach a significant correlation between ADMA levels and mass size. CONCLUSION The ADMA is known as a toxin and is increased in NFAI patients. NFAIs may not be innocent and may be considered a potential risk for the body. Further investigations were needed for more explanations.
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Affiliation(s)
- Irfan Karahan
- School of Medicine, Department of Internal Medicine, Kırıkkale University, Yahsihan, 71450, Kırıkkale, Turkey.
| | - Senay Durmaz Ceylan
- School of Medicine, Department of Endocrinology & Metabolism, Kırıkkale University, Yahsihan, 71450, Kırıkkale, Turkey
| | - Askin Gungunes
- School of Medicine, Department of Endocrinology & Metabolism, Kırıkkale University, Yahsihan, 71450, Kırıkkale, Turkey
| | - Aydın Cifci
- School of Medicine, Department of Internal Medicine, Kırıkkale University, Yahsihan, 71450, Kırıkkale, Turkey
| | - Fatih Eker
- Çanakkale Yenice Government Hospital, Canakkale, Turkey
| | - Ucler Kisa
- School of Medicine, Department of Biochemistry, Kırıkkale University, Yahsihan, 71450, Kırıkkale, Turkey
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Hsu CN, Tain YL. Preventing Developmental Origins of Cardiovascular Disease: Hydrogen Sulfide as a Potential Target? Antioxidants (Basel) 2021; 10:antiox10020247. [PMID: 33562763 PMCID: PMC7914659 DOI: 10.3390/antiox10020247] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/15/2022] Open
Abstract
The cardiovascular system can be programmed by a diversity of early-life insults, leading to cardiovascular disease (CVD) in adulthood. This notion is now termed developmental origins of health and disease (DOHaD). Emerging evidence indicates hydrogen sulfide (H2S), a crucial regulator of cardiovascular homeostasis, plays a pathogenetic role in CVD of developmental origins. Conversely, early H2S-based interventions have proved beneficial in preventing adult-onset CVD in animal studies via reversing programming processes by so-called reprogramming. The focus of this review will first summarize the current knowledge on H2S implicated in cardiovascular programming. This will be followed by supporting evidence for the links between H2S signaling and underlying mechanisms of cardiovascular programming, such as oxidative stress, nitric oxide deficiency, dysregulated nutrient-sensing signals, activation of the renin–angiotensin system, and gut microbiota dysbiosis. It will also provide an overview from animal models regarding how H2S-based reprogramming interventions, such as precursors of H2S and H2S donors, may prevent CVD of developmental origins. A better understanding of cardiovascular programming and recent advances in H2S-based interventions might provide the answers to bring down the global burden of CVD.
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Affiliation(s)
- Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan;
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - You-Lin Tain
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
- Correspondence: ; Tel.: +886-975-056-995; Fax: +886-7733-8009
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New Oxidative Stress Markers Useful in the Diagnosis of Acute Appendicitis in Children: Thiol/Disulfide Homeostasis and the Asymmetric Dimethylarginine Level. Pediatr Emerg Care 2020; 36:362-367. [PMID: 29135899 DOI: 10.1097/pec.0000000000001339] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate 2 new oxidative stress markers, thiol/disulfide homeostasis status and the asymmetric dimethylarginine (ADMA) level, in children with acute appendicitis (AA) and to evaluate their diagnostic utility. METHODS This case-control study included 45 patients with AA and 35 healthy children. Age, sex, white blood cell count, neutrophil-to-lymphocyte ratio, high-sensitivity C-reactive protein (hs-CRP) level, ultrasonographic findings, thiol/disulfide homeostasis parameters (native and total thiol levels, native thiol/total thiol ratios [antioxidant parameters], and disulfide, disulfide/native thiol, and disulfide/total thiol ratios [oxidant parameters]), and the ADMA level were compared between the 2 groups. RESULTS The native and total thiol levels, and the native thiol/total thiol ratio, were significantly lower, and the disulfide level and disulfide/native thiol and disulfide/total thiol ratios significantly higher, in the AA compared with the control group (all P < 0.001). The ADMA level was significantly higher in a perforated versus nonperforated subgroup of AA patients, but the thiol/disulfide homeostasis parameters did not differ significantly between the two subgroups. In addition, the hs-CRP level and appendiceal wall thickness were higher in the perforated subgroup. The thiol/disulfide antioxidant parameters and ADMA level correlated negatively with the white blood cell count, the neutrophil-to-lymphocyte ratio, and the hs-CRP level, in the AA group, but correlated positively with oxidant parameters. The sensitivity and specificity of the disulfide/native thiol and disulfide/total thiol ratios were high when used to diagnose AA, whereas the sensitivity of the ADMA level was high when used to diagnose perforated appendicitis. CONCLUSIONS Thiol/disulfide homeostasis and the ADMA level, together with certain other parameters, may be useful biomarkers of AA in children.
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Ismaeel A, Papoutsi E, Miserlis D, Lavado R, Haynatzki G, Casale GP, Bohannon WT, Smith RS, Eidson JL, Brumberg R, Hayson A, Kirk JS, Castro C, Sawicki I, Konstantinou C, Brewster LP, Pipinos II, Koutakis P. The Nitric Oxide System in Peripheral Artery Disease: Connection with Oxidative Stress and Biopterins. Antioxidants (Basel) 2020; 9:E590. [PMID: 32640613 PMCID: PMC7402092 DOI: 10.3390/antiox9070590] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/15/2020] [Accepted: 07/01/2020] [Indexed: 02/06/2023] Open
Abstract
Peripheral artery disease (PAD) pathophysiology extends beyond hemodynamics to include other operating mechanisms, including endothelial dysfunction. Oxidative stress may be linked to endothelial dysfunction by reducing nitric oxide (NO) bioavailability. We aimed to investigate whether the NO system and its regulators are altered in the setting of PAD and to assess the relationship between NO bioavailability and oxidative stress. Sera from 35 patients with intermittent claudication (IC), 26 patients with critical limb ischemia (CLI), and 35 non-PAD controls were analyzed to determine levels of tetrahydrobiopterin (BH4), dihydrobiopterin (BH2), nitrate/nitrite (nitric oxides, or NOx), arginine, citrulline, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and the oxidative stress markers 8-Oxo-2'-deoxyguanosine (8-OHdG), 4-hydroxynonenal (4-HNE), advanced glycation end products (AGEs), and protein carbonyls. NOx was significantly lower in IC and CLI patients compared to controls in association with elevated oxidative stress, with the greatest NOx reductions observed in CLI. Compared with controls, IC and CLI patients had reduced BH4, elevated BH2, and a reduced BH4/BH2 ratio. SDMA, the arginine/SDMA ratio, and the arginine/ADMA ratio were significantly higher in CLI patients. The NO system and its regulators are significantly compromised in PAD. This dysregulation appears to be driven by increased oxidative stress and worsens as the disease progresses from claudication to CLI.
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Affiliation(s)
- Ahmed Ismaeel
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (A.I.); (E.P.)
| | - Evlampia Papoutsi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (A.I.); (E.P.)
| | - Dimitrios Miserlis
- Department of Surgery, University of Texas Health Science Center San Antonio, San Antonio, TX 78229, USA;
| | - Ramon Lavado
- Department of Environmental Science, Baylor University, Waco, TX 76798, USA;
| | - Gleb Haynatzki
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE 68198, USA;
| | - George P. Casale
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA; (G.P.C.); (I.I.P.)
| | - William T. Bohannon
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX 76508, USA; (W.T.B.); (R.S.S.); (J.L.E.); (I.S.)
| | - Robert S. Smith
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX 76508, USA; (W.T.B.); (R.S.S.); (J.L.E.); (I.S.)
| | - Jack Leigh Eidson
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX 76508, USA; (W.T.B.); (R.S.S.); (J.L.E.); (I.S.)
| | - Robert Brumberg
- Vascular Surgery Associates, Tallahassee, FL 32308, USA; (R.B.); (A.H.)
| | - Aaron Hayson
- Vascular Surgery Associates, Tallahassee, FL 32308, USA; (R.B.); (A.H.)
| | - Jeffrey S. Kirk
- Department of Vascular Surgery, Capital Regional Medical Center, Tallahassee, FL 32308, USA; (J.S.K.); (C.C.)
| | - Carlos Castro
- Department of Vascular Surgery, Capital Regional Medical Center, Tallahassee, FL 32308, USA; (J.S.K.); (C.C.)
| | - Ian Sawicki
- Department of Surgery, Baylor Scott & White Medical Center, Temple, TX 76508, USA; (W.T.B.); (R.S.S.); (J.L.E.); (I.S.)
| | - Charalambos Konstantinou
- Department of Electrical & Computer Engineering, Florida State University, Tallahassee, FL 32310, USA;
| | - Luke P. Brewster
- Department of Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA;
| | - Iraklis I. Pipinos
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198, USA; (G.P.C.); (I.I.P.)
- Department of Surgery and Research Service, Veterans Affairs-Western Iowa Medical Center, Omaha, NE 68105, USA
| | - Panagiotis Koutakis
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL 32304, USA; (A.I.); (E.P.)
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Association between estimated glomerular filtration rate (eGFR) and asymmetric dimethylarginine (ADMA) concentrations among the elderly in a rural community: a cross-sectional study. BMC Geriatr 2019; 19:370. [PMID: 31870320 PMCID: PMC6929420 DOI: 10.1186/s12877-019-1388-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 12/16/2019] [Indexed: 11/10/2022] Open
Abstract
Background Reduced glomerular filtration rate and increased asymmetric dimethylarginine (ADMA) are prevalent in elderly people. However, most of the studies that have examined the association between the two conditions were performed in patients with renal dysfunction, but not in the general elderly population. Thus, we investigated an association between estimated glomerular filtration rate (eGFR) and ADMA concentration among community-dwelling older Koreans. Methods A cross-sectional study was conducted on 269 men and 382 women (mean age, 71.6 years) enrolled in the Korean Social Life, Health, and Aging Project (KSHAP), a population-based cohort study of health determinants in elderly Koreans. We calculated eGFR using chronic kidney disease- Epidemiology Collaboration Group (CKD-EPI) equation. ADMA concentration was measured by an enzyme-linked immunosorbent assay. The association between eGFR and ADMA concentrations was analyzed by multiple linear regression models. Results The mean ADMA was significantly higher in people with eGFR< 60 mL/min/1.73m2 (0.691 μmol/L) than in those with eGFR≥60 mL/min/1.73m2 (0.667 μmol/L, p = 0.013). The negative correlations between eGFR level and ADMA concentrations were significant in men and women after adjusted age. After adjusting for potential confounders which were sex, age, body surface, blood pressure, total and HDL cholesterol, diabetes, smoking, and drinking, eGFR levels were inversely associated with ADMA concentrations both in men (β = − 0.0015, p = 0.005) and women (β = − 0.001, p = 0.039). Conclusion Our findings suggest that an inverse association exists between eGFR and ADMA concentrations among the Korean elderly in a rural community.
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Atalar MN, Abuşoğlu S, Ünlü A, Tok O, İpekçi SH, Baldane S, Kebapcılar L. Assessment of serum galectin-3, methylated arginine and Hs-CRP levels in type 2 diabetes and prediabetes. Life Sci 2019; 231:116577. [PMID: 31211997 DOI: 10.1016/j.lfs.2019.116577] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/01/2019] [Accepted: 06/14/2019] [Indexed: 01/16/2023]
Abstract
PURPOSE Galectin-3 is associated with the process of inflammation and fibrosis. The aim of this study was both to evaluate of galectin-3, methylated arginines and hs-CRP in subjects with type 2 diabetes and prediabetes and to investigate a relation between serum galectin-3, methylated arginines and hs-CRP levels. METHODS In this study, all subjects were defined as the control group, type 2 diabetes (n = 84) by fasting plasma glucose and prediabetes (n = 34) by 75-g oral glucose tolerance test. Also, participants with type 2 diabetes were divided into as group I (HbA1c ≤7%, n = 40) and group II (HbA1c ≥7%, n = 44). The analysis of serum methylated arginines levels was analyzed by tandem mass spectrometry. Galectin-3 levels were determined via chemiluminescent microparticle immunoassay (CMIA). RESULTS Serum galectin-3, ADMA, L-NMMA and SDMA levels were significantly lower in the control group (13.3 ± 3.42; 0.630 (0.13-1.36); 0.176 (0.02-0.53); 0.115 (0.04-0.26), respectively) compared to diabetic subjects (15.71 ± 4.22; 0.825 (0.23-2.80); 0.366 (0.08-1.41); 0.1645 (0.06-0.47), p = 0.002, p = 0.01, p = 0.001 and p = 0.006, respectively). Galectin-3 was positively correlated with hs-CRP (r = 0.295 p = 0.001), L-NMMA (r = 0.181 p = 0.022), HbA1c (r = 0.247 p = 0.002), neopterin (r = 0.160 p = 0.045) and FPG (r = 0.207 p = 0.001) respectively. Also, there was positively correlated ADMA with FPG (r = 0.192 p = 0.016) and eAG (r = 0.235 p = 0.003). CONCLUSIONS Thus, galectin-3 might be a useful prognostic marker in the population with prediabetes and diabetes. Moreover, it can be a marker showing the condition of developing complications in diabetic patients.
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Affiliation(s)
- Mehmet Nuri Atalar
- Iğdır University, Department of Biochemistry, Faculty of Arts and Science, Iğdır, Turkey.
| | - Sedat Abuşoğlu
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Ali Ünlü
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Oğuzhan Tok
- Department of Biochemistry, Selcuk University Faculty of Medicine, Konya, Turkey
| | | | - Süleyman Baldane
- Department of Endocrinology, Selcuk University Faculty of Medicine, Konya, Turkey
| | - Levent Kebapcılar
- Department of Endocrinology, Selcuk University Faculty of Medicine, Konya, Turkey
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Wieczór AM, Wieczór R, Kulwas A, Rość D. Asymmetric dimethylarginine and angiogenesis: biological significance. INT ANGIOL 2018; 37:431-436. [DOI: 10.23736/s0392-9590.18.04017-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Ghayour-Mobarhan M, Ayati N, Sahebkar A, Moohebati M, Ayati N, Elyasi S, Mohammadpour AH. Evaluation of serum Asymmetric Dimethyl Arginine concentrations in coronary artery disease patients without traditional cardiovascular risk factors. ACTA BIO-MEDICA : ATENEI PARMENSIS 2018; 89:203-208. [PMID: 29957752 PMCID: PMC6179032 DOI: 10.23750/abm.v89i2.5335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 04/18/2016] [Indexed: 11/24/2022]
Abstract
Background: Previous studies have shown that Asymmetric Dimethyl Arginine (ADMA) is increased significantly during coronary artery diseases (CAD). However it is not clear either this increase is due to cardiovascular disease (CVD) risk factors or ADMA is increased independently in CAD. The aim of this study is to evaluate ADMA’s plasma level as an independent biomarker in CADs. Patients and methods: In current study a total of 165 subjects with no traditional CVD’s RFs, who fulfilled the inclusion and exclusion criteria, were recruited; 55 CAD+ patients which had more than 50% stenosis (CAD+); 55 CAD- patients which had less than 50% stenosis in their coronary arteries (CAD-), based on their angiography record and 55 healthy individuals as controls. CAD+ patients were divided into three groups: single (SVD), double (2VD), and triple vessel (3VD) disease. Plasma level of soluble ADMA was measured with an enzyme-linked immono sorbent assay (ELISA) kit. Results: No significant difference between ADMA’s plasma levels was found between CAD+, CAD- and healthy groups. In addition ADMA’s plasma levels was not significantly different between CAD+’s subgroups. Conclusions: The result of this study indicates no significant relation between ADMA’s plasma levels and either presence or severity of coronary artery stenosis. Therefore, it is presumed that ADMA may not be an independent biomarker for CADs. (www.actabiomedica.it)
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Toxic Dimethylarginines: Asymmetric Dimethylarginine (ADMA) and Symmetric Dimethylarginine (SDMA). Toxins (Basel) 2017; 9:toxins9030092. [PMID: 28272322 PMCID: PMC5371847 DOI: 10.3390/toxins9030092] [Citation(s) in RCA: 164] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Accepted: 03/04/2017] [Indexed: 02/07/2023] Open
Abstract
Asymmetric and symmetric dimethylarginine (ADMA and SDMA, respectively) are toxic, non-proteinogenic amino acids formed by post-translational modification and are uremic toxins that inhibit nitric oxide (NO) production and play multifunctional roles in many human diseases. Both ADMA and SDMA have emerged as strong predictors of cardiovascular events and death in a range of illnesses. Major progress has been made in research on ADMA-lowering therapies in animal studies; however, further studies are required to fill the translational gap between animal models and clinical trials in order to treat human diseases related to elevated ADMA/SDMA levels. Here, we review the reported impacts of ADMA and SDMA on human health and disease, focusing on the synthesis and metabolism of ADMA and SDMA; the pathophysiological roles of these dimethylarginines; clinical conditions and animal models associated with elevated ADMA and SDMA levels; and potential therapies against ADMA and SDMA. There is currently no specific pharmacological therapy for lowering the levels and counteracting the deleterious effects of ADMA and SDMA. A better understanding of the mechanisms underlying the impact of ADMA and SDMA on a wide range of human diseases is essential to the development of specific therapies against diseases related to ADMA and SDMA.
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Lluch P, Segarra G, Medina P. Asymmetric dimethylarginine as a mediator of vascular dysfunction in cirrhosis. World J Gastroenterol 2015; 21:9466-9475. [PMID: 26327755 PMCID: PMC4548108 DOI: 10.3748/wjg.v21.i32.9466] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 06/05/2015] [Accepted: 07/18/2015] [Indexed: 02/06/2023] Open
Abstract
Cirrhosis is associated with marked abnormalities in the circulatory function that involve a reduction in systemic vascular resistance. An important cause of this vasodilatation is the increased production or activity of nitric oxide (NO) in the splanchnic circulation. During portal hypertension and cirrhosis an increased endothelial NO synthase (eNOS) activity is demonstrated in splanchnic vessels. In contrast, the activity of eNOS in the cirrhotic liver is decreased, which suggests a different regulation of eNOS in the liver and in the splanchnic vessels. Asymmetric dimethylarginine (ADMA) is an endogenous NO inhibitor and higher plasma levels of ADMA are related to increased cardiovascular risk in both the general population and among patients with cirrhosis. It has been demonstrated that the liver is a key player in the metabolism of ADMA. This observation was further supported by investigations in human patients, showing a close correlation between ADMA plasma levels and the degree of hepatic dysfunction. ADMA is degraded to citrulline and dimethylamine by dimethylarginine dimethylaminohydrolases (DDAHs). DDAHs are expressed as type 1 and 2 isoforms and are widely distributed in various organs and tissues, including the liver. In this review, we discuss experimental and clinical data that document the effects of dimethylarginines on vascular function in cirrhosis. Our increasing understanding of the routes of synthesis and metabolism of methylarginines is beginning to provide insights into novel mechanisms of liver disease and allowing us to identify potential therapeutic opportunities.
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Ghebremariam YT, Cooke JP, Khan F, Thakker RN, Chang P, Shah NH, Nead KT, Leeper NJ. Proton pump inhibitors and vascular function: A prospective cross-over pilot study. Vasc Med 2015; 20:309-16. [PMID: 25835348 DOI: 10.1177/1358863x14568444] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Proton pump inhibitors (PPIs) are commonly used drugs for the treatment of gastric reflux. Recent retrospective cohorts and large database studies have raised concern that the use of PPIs is associated with increased cardiovascular (CV) risk. However, there is no prospective clinical study evaluating whether the use of PPIs directly causes CV harm. We conducted a controlled, open-label, cross-over pilot study among 21 adults aged 18 and older who are healthy (n=11) or have established clinical cardiovascular disease (n=10). Study subjects were assigned to receive a PPI (Prevacid; 30 mg) or a placebo pill once daily for 4 weeks. After a 2-week washout period, participants were crossed over to receive the alternate treatment for the ensuing 4 weeks. Subjects underwent evaluation of vascular function (by the EndoPAT technique) and had plasma levels of asymmetric dimethylarginine (ADMA, an endogenous inhibitor of endothelial function previously implicated in PPI-mediated risk) measured prior to and after each treatment interval. We observed a marginal inverse correlation between the EndoPAT score and plasma levels of ADMA (r = -0.364). Subjects experienced a greater worsening in plasma ADMA levels while on PPI than on placebo, and this trend was more pronounced amongst those subjects with a history of vascular disease. However, these trends did not reach statistical significance, and PPI use was also not associated with an impairment in flow-mediated vasodilation during the course of this study. In conclusion, in this open-label, cross-over pilot study conducted among healthy subjects and coronary disease patients, PPI use did not significantly influence vascular endothelial function. Larger, long-term and blinded trials are needed to mechanistically explain the correlation between PPI use and adverse clinical outcomes, which has recently been reported in retrospective cohort studies.
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Affiliation(s)
- Yohannes T Ghebremariam
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - John P Cooke
- Department of Cardiovascular Sciences, Houston Methodist Research Institute, Houston, TX, USA
| | - Fouzia Khan
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Rahul N Thakker
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Peter Chang
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nigam H Shah
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Kevin T Nead
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nicholas J Leeper
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Mokhtari Z, Hosseini S, Miri R, Baghestani AR, Zahedirad M, Rismanchi M, Nasrollahzadeh J. Relationship between Dietary Approaches to Stop Hypertension score and Alternative Healthy Eating Index score with plasma asymmetrical dimethylarginine levels in patients referring for coronary angiography. J Hum Nutr Diet 2015; 28:350-6. [DOI: 10.1111/jhn.12311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Z. Mokhtari
- Department of Clinical Nutrition & Dietetics; Faculty of Nutrtiton Sciences and Food Technology; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - S. Hosseini
- Endocrinology and Metabolism Research Institute; Tehran University of Medical Sciences; Tehran Iran
| | - R. Miri
- Department of Cardiology; School of Medicine; Imam Hossein Hospital; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - A. R. Baghestani
- Department of Biostatistics; Faculty of Paramedical Sciences; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - M. Zahedirad
- Department of Nutrition Research; National Nutrition and Food Technology Research Institute; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - M. Rismanchi
- Faculty of Nutrition Sciences and Food Technology; Shahid Beheshti University of Medical Sciences; Tehran Iran
| | - J. Nasrollahzadeh
- Department of Clinical Nutrition & Dietetics; Faculty of Nutrition Sciences and Food Technology; National Nutrition and Food Technology Research Institute; Shahid Beheshti University of Medical Sciences; Tehran Iran
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16
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Kayacelebi AA, Willers J, Pham VV, Hahn A, Schneider JY, Rothmann S, Frölich JC, Tsikas D. Plasma homoarginine, arginine, asymmetric dimethylarginine and total homocysteine interrelationships in rheumatoid arthritis, coronary artery disease and peripheral artery occlusion disease. Amino Acids 2015; 47:1885-91. [PMID: 25618752 DOI: 10.1007/s00726-015-1915-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 01/04/2015] [Indexed: 01/10/2023]
Abstract
Elevated circulating concentrations of total L-homocysteine (thCys) and free asymmetric dimethylarginine (ADMA) are long-established cardiovascular risk factors. Low circulating L-homoarginine (hArg) concentrations were recently found to be associated with increased cardiovascular morbidity and mortality. The biochemical pathways of these amino acids overlap and share the same cofactor S-adenosylmethionine (SAM). In the present study, we investigated potential associations between hArg, L-arginine (Arg), ADMA and thCys in plasma of patients suffering from rheumatoid arthritis (RA), coronary artery disease (CAD) or peripheral artery occlusive disease (PAOD). In RA, we did not find any correlation between ADMA or hArg and thCys at baseline (n = 100) and after (n = 83) combined add-on supplementation of omega-3 fatty acids, vitamin E, vitamin A, copper, and selenium, or placebo (soy oil). ADMA correlated with Arg at baseline (r = 0.446, P < 0.001) and after treatment (r = 0.246, P = 0.03). hArg did not correlate with ADMA, but correlated with Arg before (r = 0.240, P = 0.02) and after treatment (r = 0.233, P = 0.03). These results suggest that hArg, ADMA and Arg are biochemically familiar with each other, but unrelated to hCys in RA. In PAOD and CAD, ADMA and thCys did not correlate.
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Affiliation(s)
- Arslan Arinc Kayacelebi
- Centre of Pharmacology and Toxicology, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany
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Shao Y, Fan Y, Li J, Cao H, Liu B, Wang J, Yang J, Zhang Q, Hu X. Does elevated asymmetrical dimethylarginine predict major adverse cardiac events and mortality in patients after percutaneous coronary intervention? Int J Cardiol 2015; 178:188-90. [DOI: 10.1016/j.ijcard.2014.10.121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
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Staab EB, Weigel J, Xiao F, Madayiputhiya N, Wyatt TA, Wells SM. Asymmetric dimethyl-arginine metabolism in a murine model of cigarette smoke-mediated lung inflammation. J Immunotoxicol 2014; 12:273-82. [PMID: 25913572 DOI: 10.3109/1547691x.2014.961619] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
There is increasing evidence that the endogenous nitric oxide synthase (NOS) inhibitor asymmetric dimethyl-arginine (ADMA) is involved in the pathogenesis of chronic lung diseases. One important regulator of this molecule is the ADMA-metabolizing enzyme dimethyl-arginine dimethyl-aminohydrolase (DDAH). The objective of this study was to determine whether perturbation of the ADMA-DDAH pathway contributes to lung inflammation following exposure to cigarette smoke (CS). For these studies, wild-type and DDAH transgenic mice were sham or CS-exposed. Serum ADMA levels were determined by mass spectrometry. ADMA content and DDAH expression were also visualized in mouse lung tissue by immunohistochemistry. DDAH expression was determined by real-time quantitative PCR (qPCR). Inflammation was assessed by H&E staining and analyses of total cell counts and fluid tumor necrosis factor (TNF)-α levels (using ELISA) in lung lavage fluid. NF-κB binding activity in mouse lung epithelial (LA-4) cells was assessed by a transcription factor-binding assay. The results indicated that the concentration of serum ADMA was increased following exposure to CS, and this corresponded with increased ADMA content in bronchial epithelial cells in lung tissue. Total lung DDAH expression was significantly decreased in lung tissue and cultured LA-4 cells following CS exposure. Addition of exogenous ADMA increased CSE-mediated NF-κB binding activity and TNFα production in LA-4 cells more than 2-fold compared to that in CSE-exposed controls. CS-mediated lung inflammation was significantly attenuated in DDAH transgenic mice compared to in wild-type controls. These findings demonstrated that lung ADMA metabolism was altered in mice following CS exposure and suggested that ADMA played a role in CS-mediated inflammation through increasing the presence of inflammatory mediators in lung epithelial cells.
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Affiliation(s)
- Elizabeth B Staab
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center , Omaha, NE , USA
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Harman SM. Menopausal hormone treatment cardiovascular disease: another look at an unresolved conundrum. Fertil Steril 2014; 101:887-97. [PMID: 24680648 DOI: 10.1016/j.fertnstert.2014.02.042] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 02/22/2014] [Accepted: 02/25/2014] [Indexed: 10/25/2022]
Abstract
Cardiovascular disease (CVD) is the most common cause of death in women. Before the Women's Health Initiative (WHI) hormone trials, evidence favored the concept that menopausal hormone treatment (MHT) protects against CVD. WHI studies failed to demonstrate CVD benefit, with worse net outcomes for MHT versus placebo in the population studied. We review evidence regarding the relationship between MHT and CVD with consideration of mechanisms and risk factors for atherogenesis and cardiac events, results of observational case-control and cohort studies, and outcomes of randomized trials. Estrogen effects on CVD risk factors favor delay or amelioration of atherosclerotic plaque development but may increase risk of acute events when at-risk plaque is present. Long-term observational studies have shown ∼40% reductions in risk of myocardial infarction and all-cause mortality. Analyses of data from randomized control trials other than the WHI show a ∼30% cardioprotective effect in recently menopausal women. Review of the literature as well as WHI data suggests that younger and/or more recently menopausal women may have a better risk-benefit ratio than older or remotely menopausal women and that CVD protection may only occur after >5 years; WHI women averaged 63 years of age (12 years postmenopausal) and few were studied for >6 years. Thus, a beneficial effect of long-term MHT on CVD and mortality is still an open question and is likely to remain controversial for the foreseeable future.
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Development of an Enzyme-Linked Immunosorbent Assay System for the Determination of Asymmetric Dimethylarginine Using a Specific Monoclonal Antibody. Biosci Biotechnol Biochem 2014; 76:400-3. [DOI: 10.1271/bbb.110727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kurtoglu E, Balta S, Karakus Y, Yasar E. Other factors ought to be kept in mind when analyzing plasma asymmetric dimethylarginine levels. Am J Hypertens 2014; 27:500. [PMID: 24487815 DOI: 10.1093/ajh/hpt275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
OBJECTIVE Depression has been associated with vascular dysfunction, which may be of particular relevance in pregnancy. Asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-arginine play a critical role in vascular function. The objective of this study was to investigate differences in ADMA, SDMA, and L-arginine among pregnant women with major depression compared with pregnant women without depression. METHODS A case-control study was conducted in 21 depressed pregnant women and 42 matched controls. Maternal plasma ADMA, SDMA, and L-arginine were quantified, as well as C-reactive protein and urine excretion of ADMA, SDMA, L-arginine, and Arginase I. RESULTS Plasma L-arginine and ADMA levels were significantly lower in the first trimester in women with depression (mean [standard deviation = 37.0 [9.2] and 0.298 [0.06] μM, respectively) compared with matched controls (42.1 [11.4] and 0.336 [0.08] μM, p = .004 and p = .002, respectively) and across pregnancies (p < .001 both). Depressed pregnant women had higher levels of plasma C-reactive protein (7.5 [3.7] versus 5.1 [4.0] μg/ml, p = .027), but no differences in urine excretion of ADMA, SDMA, or L-arginine, or plasma levels of Arginase I (p > .10). CONCLUSIONS Pregnant women with depression show lower plasma levels of L-arginine and ADMA. These differences are not explained by urinary excretion or Arginase I levels. The mechanism responsible for the observed differences in depressed pregnant women requires further research.
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Kurtoglu E, Balta S, Sincer I, Korkmaz H. Letter by Kurtoglu et al Regarding Article, “Asymmetric Dimethylarginine in Response to Recombinant Tissue-Type Plasminogen Activator and Erythropoietin in Acute Stroke”. Stroke 2013; 44:e229. [DOI: 10.1161/strokeaha.113.003236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ertugrul Kurtoglu
- Department of Cardiology, Elazig Training and Research Hospital, Elazig, Turkey
| | - Sevket Balta
- Department of Cardiology, Gulhane Medical Faculty, Ankara, Turkey
| | - Isa Sincer
- Department of Cardiology, Gaziantep State Hospital, Gaziantep, Turkey
| | - Hasan Korkmaz
- Department of Cardiology, Firat University Medical School, Elazig, Turkey
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Ghebremariam YT, LePendu P, Lee JC, Erlanson DA, Slaviero A, Shah NH, Leiper J, Cooke JP. Unexpected effect of proton pump inhibitors: elevation of the cardiovascular risk factor asymmetric dimethylarginine. Circulation 2013; 128:845-53. [PMID: 23825361 DOI: 10.1161/circulationaha.113.003602] [Citation(s) in RCA: 186] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Proton pump inhibitors (PPIs) are gastric acid-suppressing agents widely prescribed for the treatment of gastroesophageal reflux disease. Recently, several studies in patients with acute coronary syndrome have raised the concern that use of PPIs in these patients may increase their risk of major adverse cardiovascular events. The mechanism of this possible adverse effect is not known. Whether the general population might also be at risk has not been addressed. METHODS AND RESULTS Plasma asymmetrical dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase. Elevated plasma ADMA is associated with increased risk for cardiovascular disease, likely because of its attenuation of the vasoprotective effects of endothelial nitric oxide synthase. We find that PPIs elevate plasma ADMA levels and reduce nitric oxide levels and endothelium-dependent vasodilation in a murine model and ex vivo human tissues. PPIs increase ADMA because they bind to and inhibit dimethylarginine dimethylaminohydrolase, the enzyme that degrades ADMA. CONCLUSIONS We present a plausible biological mechanism to explain the association of PPIs with increased major adverse cardiovascular events in patients with unstable coronary syndromes. Of concern, this adverse mechanism is also likely to extend to the general population using PPIs. This finding compels additional clinical investigations and pharmacovigilance directed toward understanding the cardiovascular risk associated with the use of the PPIs in the general population.
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Affiliation(s)
- Yohannes T Ghebremariam
- Department of Cardiovascular Sciences, Texas Methodist Hospital Research Institute, Houston, TX 77030, USA
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Do cardiac risk factors affect the homocysteine and asymmetric dimethylarginine relationship in patients with coronary artery diseases? Clin Biochem 2012; 45:1325-30. [DOI: 10.1016/j.clinbiochem.2012.06.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 06/14/2012] [Accepted: 06/19/2012] [Indexed: 12/31/2022]
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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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Yucel H, Ozaydin M, Dogan A, Erdogan D, Turker Y, Ceyhan BM, Sutcu R. Plasma concentrations of asymmetric dimethylarginine, nitric oxide and homocysteine in patients with slow coronary flow. Scandinavian Journal of Clinical and Laboratory Investigation 2012; 72:495-500. [DOI: 10.3109/00365513.2012.699637] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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The effect of simvastatin on asymmetric dimethylarginine and flow-mediated vasodilation after optimizing the LDL level — A randomized, placebo-controlled study. Vascul Pharmacol 2012; 56:122-30. [DOI: 10.1016/j.vph.2011.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 10/02/2011] [Accepted: 10/30/2011] [Indexed: 01/06/2023]
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The dual behavior of heat shock protein 70 and asymmetric dimethylarginine in relation to serum CRP levels in type 2 diabetes. Gene 2012; 498:107-11. [PMID: 22349026 DOI: 10.1016/j.gene.2012.01.085] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 01/30/2012] [Indexed: 02/06/2023]
Abstract
BACKGROUND Experimental evidence suggests that heat shock proteins (HSP) and asymmetric dimethylarginine (ADMA) are induced in the state of chronic inflammation and stress conditions. They are both inhibitors of nitric oxide synthase (NOS). The aim of this study was to evaluate the correlation between ADMA and HSP70, in patients with type 2 diabetes with respect to serum levels of C reactive protein (CRP). METHODS We quantified serum HSP70, ADMA and CRP in 80 newly-diagnosed patients with type 2 diabetes plus 80 age-, sex and BMI-matched healthy controls. The patients and controls were also stratified into groups of high and low CRP levels (cut-point: 2.5mg/ml). RESULTS Patients with type 2 diabetes had significantly higher serum HSP70 (0.52 [0.51-0.66] vs. 0.27 [0.26-0.36], p<0.001), ADMA (0.86 [0.81-0.92] vs. 0.72 [0.71-0.85], p<0.05) and CRP (2.9 [1.7-3.4] vs. 1.6[1.2-2.3], p<0.05) compared with healthy controls. Serum HSP70 and ADMA levels were significantly correlated in patients with high CRP levels (r=0.89, p<0.01), whereas there were no correlation in patients with low CRP (r=-0.37, p=0.07) and controls. This correlation was significant (r=0.77, p<0.001) in patients with high CRP and also in patients with low CRP levels (r=-0.51, p<0.05), after multiple adjustments for LDL and HDL levels. DISCUSSION We showed that, in a state of high inflammation; serum levels of ADMA parallel the HSP70 levels. However in low inflammation, they are negatively correlated. The duality in HSP70 and ADMA correlation may be related to the duality of NOS function in low and high CRP levels.
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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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Rueda‐Clausen CF, Córdoba‐Porras A, Bedoya G, Silva FA, Zarruk JG, López‐Jaramillo P, Villa LA. Increased plasma levels of total homocysteine but not asymmetric dimethylarginine in Hispanic subjects with ischemic stroke FREC‐VI sub‐study. Eur J Neurol 2011; 19:417-25. [DOI: 10.1111/j.1468-1331.2011.03534.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C. F. Rueda‐Clausen
- Grupo de Ciencias Neurovasculares, Fundación Cardiovascular de Colombia, Bucaramanga
| | - A. Córdoba‐Porras
- Grupo Neuroendotelio y Enfermedad Cerebrovascular‐Facultad de Medicina‐Universidad de Antioquia, Medellín
| | - G. Bedoya
- Genética Molecular Sede de Investigación Universitaria Universidad de Antioquia, Medellín
| | - F. A. Silva
- Grupo de Ciencias Neurovasculares, Fundación Cardiovascular de Colombia, Bucaramanga
| | - J. G. Zarruk
- Grupo de Ciencias Neurovasculares, Fundación Cardiovascular de Colombia, Bucaramanga
| | - P. López‐Jaramillo
- Research Director, Fundación Oftalmológica de Santander‐FOSCAL, Bucaramanga
| | - L. A. Villa
- Grupo Neuroendotelio y Enfermedad Cerebrovascular‐Facultad de Medicina‐Universidad de Antioquia, Medellín
- Departamento de Medicina interna, Neurología‐Facultad de Medicina Universidad de Antioquia, Medellín, Colombia
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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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Hov GG, Sagen E, Hatlen G, Bigonah A, Åsberg A, Aasarød K. Arginine/asymmetric dimethylarginine ratio and cardiovascular risk factors in patients with predialytic chronic kidney disease. Clin Biochem 2011; 44:642-6. [PMID: 21406191 DOI: 10.1016/j.clinbiochem.2011.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 02/06/2011] [Accepted: 03/02/2011] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase (NOS) that accumulates in patients with chronic kidney disease (CKD) and predicts cardiovascular outcome. Arginine is the substrate for NOS and a low arginine/ADMA ratio may lead to a reduced NO production and a worse prognosis. We have studied how other important CKD variables predict the arginine/ADMA ratio. DESIGN AND METHODS The population is 160 predialytic CKD patients (median age 61 years). We used backward stepwise regression to identify the best predictors of p-arginine, p-ADMA and arginine/ADMA ratio. RESULTS P-ADMA was predicted by estimated GFR (eGFR) (adjusted R(2)=0.17, p>0.00). Arginine/ADMA ratio was predicted by gender, eGFR, use of renin angiotensin aldosteron (RAAS) inhibitors, current smoking and use of platelet inhibitors (adjusted R(2)=0.18, p<0.00). CONCLUSIONS Reduced eGFR is associated with reduced arginine/ADMA ratio. The use of RAAS inhibitors and male gender may be protective against a low arginine/ADMA ratio.
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Affiliation(s)
- Gunhild Garmo Hov
- Department of Medical Biochemistry, St. Olavs Hospital, Trondheim University Hospital, N 7006 Trondheim, Norway.
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Toda N, Toda H. Nitric oxide-mediated blood flow regulation as affected by smoking and nicotine. Eur J Pharmacol 2010; 649:1-13. [PMID: 20868673 DOI: 10.1016/j.ejphar.2010.09.042] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 08/01/2010] [Accepted: 09/14/2010] [Indexed: 12/15/2022]
Abstract
Cigarette smoking is a major risk factor for atherosclerosis, cerebral and coronary vascular diseases, hypertension, and diabetes mellitus. Chronic smoking impairs endothelial function by decreasing the formation of nitric oxide and increasing the degradation of nitric oxide via generation of oxygen free radicals. Nitric oxide liberated from efferent nitrergic nerves is also involved in vasodilatation, increased regional blood flow, and hypotension that are impaired through nitric oxide sequestering by smoking-induced factors. Influence of smoking on nitric oxide-induced blood flow regulation is not necessarily the same in all organs and tissues. However, human studies are limited mainly to the forearm blood flow measurement that assesses endothelial function under basal and stimulated conditions and also determination of penile tumescence and erection in response to endothelial and neuronal nitric oxide. Therefore, information about blood flow regulation in other organs, such as the brain and placenta, has been provided mainly from studies on experimental animals. Nicotine, a major constituent of cigarette smoke, acutely dilates cerebral arteries and arterioles through nitric oxide liberated from nitrergic neurons, but chronically interferes with endothelial function in various vasculatures, both being noted in studies on experimental animals. Cigarette smoke constituents other than nicotine also have some vascular actions. Not only active but also passive smoking is undoubtedly harmful for both the smokers themselves and their neighbors, who should bear in mind that they can face serious diseases in the future, which may result in lengthy hospitalization, and a shortened lifespan.
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Affiliation(s)
- Noboru Toda
- Toyama Institute for Cardiovascular Research, 7-13, 1-Chome, Azuchi-machi, Chuo-ku, Osaka 541-0052, Japan.
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Gad MZ, Hassanein SI, Abdel-Maksoud SM, Shaban GM, Abou-Aisha K, Elgabarty HA. Assessment of serum levels of asymmetric dimethylarginine, symmetric dimethylarginine andl-arginine in coronary artery disease. Biomarkers 2010; 15:746-52. [DOI: 10.3109/1354750x.2010.519784] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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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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Zakrzewicz D, Zakrzewicz A, Wilker S, Boedeker RH, Padberg W, Eickelberg O, Grau V. Dimethylarginine metabolism during acute and chronic rejection of rat renal allografts. Nephrol Dial Transplant 2010; 26:124-35. [PMID: 20647192 PMCID: PMC3006445 DOI: 10.1093/ndt/gfq392] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background. Dimethylarginines are inhibitors of NO synthesis and are involved in the pathogenesis of vascular diseases. In this study, we ask the question if asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels change during fatal and reversible acute rejection, and contribute to the pathogenesis of chronic vasculopathy. Methods. The Dark Agouti to Lewis rat strain combination was used to investigate fatal acute rejection. Fischer 344 kidneys were transplanted to Lewis rats to study reversible acute rejection episode and the process of chronic rejection. Isograft recipients and untreated Lewis rats were used as controls. l-arginine derivatives were determined by HPLC, and ADMA-metabolizing enzymes were studied by quantitative RT–PCR and western blotting. Results. Renal transplantation transiently increased dimethylarginine levels independent of acute rejection. ADMA plasma levels did not importantly differ between recipients undergoing fatal or reversible acute rejection, whereas SDMA was even lower in recipients of Fisher 344 grafts. In comparison to isograft recipients, ADMA and SDMA levels were slightly elevated during reversible, but not during the process of chronic rejection. Increased dimethylarginine levels, however, did not block NO synthesis. Interestingly, protein methylation, but not ADMA degradation, was increased in allografts. Conclusions. Our data do not support the concept that renal allografts are protected from fatal rejection by dimethylarginines. Dimethylarginines may play a role in triggering chronic rejection, but a contribution to vascular remodelling itself is improbable. In contrast, differential arginine methylation of yet unknown proteins by PRMT1 may be involved in the pathogenesis of acute and chronic rejection.
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Affiliation(s)
- Dariusz Zakrzewicz
- Department of Medicine II, University of Giessen Lung Center, Aulweg 123, D-35392 Giessen, Germany
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Vladimirova-Kitova LG, Deneva-Koycheva T. Asymmetric dimethylarginine—a determinant of the effect of the high dose Simvastatin. Clin Biochem 2010; 43:843-50. [DOI: 10.1016/j.clinbiochem.2010.04.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2009] [Revised: 03/26/2010] [Accepted: 04/12/2010] [Indexed: 10/19/2022]
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Aktoz T, Aktoz M, Tatlı E, Kaplan M, Turan FN, Barutcu A, Atakan IH, Demir M, Altun A. Assessment of the relationship between asymmetric dimethylarginine and severity of erectile dysfunction and coronary artery disease. Int Urol Nephrol 2010; 42:873-9. [DOI: 10.1007/s11255-009-9696-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2009] [Accepted: 12/09/2009] [Indexed: 10/19/2022]
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Blackwell S. The biochemistry, measurement and current clinical significance of asymmetric dimethylarginine. Ann Clin Biochem 2009; 47:17-28. [PMID: 19940201 DOI: 10.1258/acb.2009.009196] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide synthase and an important cause of endothelial dysfunction. Its increased plasma concentration is associated with a variety of traditional cardiovascular risk factors, and may mediate their effects on the vascular endothelium. ADMA is also an independent predictor of cardiovascular events and mortality, and predicts outcomes in critically ill patients in the intensive care unit. This work has provided insights into the role of ADMA as an endogenous regulator of nitric oxide synthesis. At present there is no specific therapy to modify ADMA concentration, but increasing interest and work on protein arginine methyltransferases and dimethylarginine dimethylaminohydrolase, which synthesize and metabolize ADMA, respectively, might provide novel therapeutic targets.
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Affiliation(s)
- Scott Blackwell
- Department of Clinical Biochemistry, Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK.
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Abstract
Asymmetric dimethylarginine (ADMA), an endogenous methylated form of the amino acid L-arginine, inhibits the activity of the enzyme endothelial nitric oxide synthase (eNOS), with consequent reduced synthesis of nitric oxide (NO). An increased synthesis and/or a reduced catabolism of ADMA might contribute to the onset and progression of atherosclerosis and thrombosis. The detrimental effects of ADMA on endothelial function, cardiovascular homeostasis, and cardiovascular outcomes have been extensively investigated. However, little attention has been paid to another methylated form of L-arginine, symmetric dimethylarginine (SDMA), as a potential modulator of vascular homeostasis and vascular disease. The first part of this chapter discusses the synthesis, transport, and metabolism of ADMA and SDMA and summarizes the evidence linking ADMA with vascular disease and adverse cardiovascular outcomes. The second part describes the results of recent studies highlighting the important role of SDMA in modulating vascular homeostasis and vascular damage. Suggestions for future research directions on SDMA are also discussed.
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Affiliation(s)
- Arduino A Mangoni
- Department of Clinical Pharmacology, School of Medicine, Flinders University, Adelaide 5001, Australia.
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Pikula A, Böger RH, Beiser AS, Maas R, DeCarli C, Schwedhelm E, Himali JJ, Schulze F, Au R, Kelly-Hayes M, Kase CS, Vasan RS, Wolf PA, Seshadri S. Association of plasma ADMA levels with MRI markers of vascular brain injury: Framingham offspring study. Stroke 2009; 40:2959-64. [PMID: 19644064 PMCID: PMC2749945 DOI: 10.1161/strokeaha.109.557116] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Accepted: 06/08/2009] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Asymmetrical dimethylarginine (ADMA), an inhibitor of endothelial nitric oxide synthase, is a marker of endothelial dysfunction. Elevated circulating ADMA concentrations have been associated with systemic and carotid atherosclerosis, an elevated risk of developing stroke, and magnetic resonance imaging white-matter hyperintensities (WMHs). The relation of plasma ADMA to subclinical vascular brain injury has not been previously studied in a middle-aged, community-based sample. METHODS In 2013 stroke-free Framingham offspring (mean+/-SD age, 58+/-9.5 years; 53% women), we related baseline plasma ADMA levels (1995-1998) to subsequent brain magnetic resonance imaging measures (1999-2004) of subclinical vascular injury: presence of silent brain infarcts (SBIs) and large white-matter hyperintensity volumes (LWMHs; defined as >1 SD above the age-specific mean). RESULTS Prevalences of SBIs and LWMHs were 10.7% and 12.6%, respectively. In multivariable analyses adjusting for age, sex and traditional stroke risk factors, higher ADMA levels were associated with an increased risk of prevalent SBIs (odds ratio [OR] per 1-SD increase in ADMA=1.16; 95% CI, 1.01 to 1.33; P=0.04). We observed that participants in the upper 3 age-specific quartiles (Qs) of plasma ADMA values had an increased prevalence of SBIs (OR for Q2-Q4 vs Q1=1.43; 95% CI, 1.00 to 2.04; P<0.05). The prevalence of SBIs in Q1and Q2-Q4 was 8.3% and 11.6%, respectively. The prevalence of LWMHs did not differ according to ADMA concentrations. CONCLUSIONS Higher plasma ADMA values were associated with an increased prevalence of SBIs, after adjustment for traditional stroke risk factors. Thus, ADMA may be a potentially useful new biomarker of subclinical vascular brain injury, which is an important correlate of vascular cognitive impairment and risk of stroke.
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Affiliation(s)
- Aleksandra Pikula
- Boston University Schools of Medicine and Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
| | | | - Alexa S. Beiser
- Boston University Schools of Medicine and Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
| | - Renke Maas
- University of Hamburg, Germany
- University of Erlangen-Nuremberg, Germany
| | | | | | | | | | - Rhoda Au
- Boston University Schools of Medicine and Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
| | - Margaret Kelly-Hayes
- Boston University Schools of Medicine and Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
| | - Carlos S. Kase
- Boston University Schools of Medicine and Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
| | - Ramachandran S. Vasan
- Boston University Schools of Medicine and Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
| | - Philip A. Wolf
- Boston University Schools of Medicine and Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
| | - Sudha Seshadri
- Boston University Schools of Medicine and Public Health, Boston, MA
- Framingham Heart Study, Framingham, MA
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Schwedhelm E, Xanthakis V, Maas R, Sullivan LM, Schulze F, Riederer U, Benndorf RA, Böger RH, Vasan RS. Asymmetric dimethylarginine reference intervals determined with liquid chromatography-tandem mass spectrometry: results from the Framingham offspring cohort. Clin Chem 2009; 55:1539-45. [PMID: 19541865 PMCID: PMC3794429 DOI: 10.1373/clinchem.2009.124263] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Accumulating evidence links higher circulating asymmetric dimethylarginine (ADMA) to greater risk of cardiovascular disease (CVD). Relatively small differences in ADMA concentrations between healthy individuals and those with disease underscore the need to formulate reference intervals that may aid risk stratification of individuals. METHODS We formulated reference intervals for plasma ADMA concentrations using a community-based reference sample from the Framingham Offspring Study consisting of 1126 nonsmoking individuals [mean (SD) age 56 (9) years; 60% women] who were free of clinical CVD, hypertension, diabetes, and obesity and who attended a routine examination at which ADMA was assayed. ADMA concentrations were determined using a validated tandem mass spectrometry-liquid chromatography assay. RESULTS In the study sample, the mean ADMA concentration was 0.52 (0.11) micromol/L, and the reference limits were 0.311 and 0.732 (2.5th and 97.5th percentile). The sex-specific reference limits were 0.310 and 0.745 in men and 0.313 and 0.721 micromol/L in women. In multivariable regression analysis, ADMA plasma concentrations were positively correlated with age and total plasma homocysteine (both P < 0.001). CONCLUSIONS Reference limits calculated for circulating ADMA in our large community-based healthy reference sample confirm the previous observation of a relatively narrow distribution of concentrations. This suggests a tight physiological control of ADMA plasma concentrations, presumably by dimethylarginine dimethylaminohydrolase (DDAH) metabolism of ADMA.
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Affiliation(s)
- Edzard Schwedhelm
- Clinical Pharmacology Unit, Institute of Experimental and Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Murr C, Meinitzer A, Grammer T, Schroecksnadel K, Böhm BO, März W, Fuchs D. Association between Asymmetric Dimethylarginine and Neopterin in Patients with and without Angiographic Coronary Artery Disease. Scand J Immunol 2009; 70:63-7. [DOI: 10.1111/j.1365-3083.2009.02261.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Zakrzewicz D, Eickelberg O. From arginine methylation to ADMA: a novel mechanism with therapeutic potential in chronic lung diseases. BMC Pulm Med 2009; 9:5. [PMID: 19178698 PMCID: PMC2637832 DOI: 10.1186/1471-2466-9-5] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2008] [Accepted: 01/29/2009] [Indexed: 12/26/2022] Open
Abstract
Protein arginine methylation is a novel posttranslational modification regulating a diversity of cellular processes, including protein-protein interaction, signal transduction, or histone function. It has recently been shown to be dysregulated in chronic renal, vascular, and pulmonary diseases, and metabolic products originating from protein arginine methylation have been suggested to serve as biomarkers in cardiovascular and pulmonary diseases. Protein arginine methylation is performed by a class of enzymes called protein arginine methyltransferases (PRMT), which specifically methylate protein-incorporated arginine residues to generate protein-incorporated monomethylarginine (MMA), symmetric dimethylarginine (SDMA), or asymmetric dimethylarginine (ADMA). Upon proteolytic cleavage of arginine-methylated proteins, free intracellular MMA, SDMA, or ADMA is generated, which, upon secretion into the extracellular space (including plasma), directly affects the methylarginine concentration in the plasma. Free methylarginines are cleared from the body by renal excretion or hepatic metabolism. In addition, MMA and ADMA, but not SDMA, can be degraded via a class of intracellular enzymes called dimethylarginine dimethylaminohydrolases (DDAH). ADMA and MMA are endogenous inhibitors of nitric oxide synthases (NOS) and ADMA has been suggested to serve as a biomarker of endothelial dysfunction in cardiovascular diseases. This view has now been extended to the idea that, in addition to serum ADMA, the amount of free, as well as protein-incorporated, intracellular ADMA influences pulmonary cell function and determines the development of chronic lung diseases, including pulmonary arterial hypertension (PAH) or pulmonary fibrosis. This review will present and discuss the recent findings of dysregulated arginine methylation in chronic lung disease. We will highlight novel directions for future investigations evaluating the functional contribution of arginine methylation in lung homeostasis and disease with the outlook that modifying PRMT or DDAH activity presents a novel therapeutic option for the treatment of chronic lung disease.
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Sobczak A, Goniewicz ML, Szoltysek-Boldys I. ADMA and SDMA levels in healthy men exposed to tobacco smoke. Atherosclerosis 2009; 205:357-9. [PMID: 19181316 DOI: 10.1016/j.atherosclerosis.2008.12.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Revised: 12/23/2008] [Accepted: 12/26/2008] [Indexed: 11/25/2022]
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Wang J, Sim AS, Wang XL, Salonikas C, Moriatis M, Naidoo D, Wilcken DEL. Relations between markers of renal function, coronary risk factors and the occurrence and severity of coronary artery disease. Atherosclerosis 2008; 197:853-9. [PMID: 17826782 DOI: 10.1016/j.atherosclerosis.2007.07.034] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2007] [Revised: 07/30/2007] [Accepted: 07/31/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE While renal failure greatly increases coronary risk, mild renal impairment is not usually considered a major risk factor. To explore this we assessed relations between measures of mild impairment of renal function and coronary artery disease (CAD) together with other risk factors. METHODS AND RESULTS In 408 consecutive patients aged 75 years or less with angiographically defined normal or obstructed coronary arteries and an estimated glomerular filtration rate (eGFR) >45 mL/min per 1.73 m(2), we assessed relations between severity of CAD and levels of plasma cystatin C, creatinine, eGFR, lipid profile, C-reactive protein (CRP), homocysteine, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA). With univariate ANOVA, the severity of CAD was significantly associated with all indices of renal function: increased plasma cystatin C (p=0.003) and creatinine (p=0.004) and decreased eGFR (p=0.008). An elevated plasma cystatin C was associated with increases in ADMA, SDMA, CRP, homocysteine and age. ADMA, SDMA, CRP and homocysteine levels were not associated with CAD severity. eGFR was negatively associated only with SDMA and homocysteine. In multivariate analysis, increased plasma cystatin C predicted both the occurrence and the severity of CAD more strongly than other measures of renal function. CONCLUSIONS We conclude that mild renal impairment detected by elevated cystatin C is associated with both the occurrence and the severity of CAD, independent of the other risk factors we measured and that mild renal impairment results in increased plasma levels of homocysteine, ADMA and SDMA. Our findings suggest a possible mechanistic link between CAD and mild renal impairment in which cystatin C may serve as an early marker for CAD and may also participate directly in atherogenesis.
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Affiliation(s)
- Jun Wang
- Department of Cardiovascular Medicine, University of New South Wales, Prince of Wales Hospital, Sydney, Australia
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Pai JK. Asymmetric dimethylarginine as a marker of metabolic dysfunction and cardiovascular disease. CURRENT CARDIOVASCULAR RISK REPORTS 2008. [DOI: 10.1007/s12170-008-0028-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
BACKGROUND Endothelial dysfunction and subsequently impaired microvascular circulation are the leading mechanisms in the development of cardiac syndrome X (CSX). The study evaluated the plasma asymmetric dimethylarginine (ADMA) and L-arginine levels of the patients with CSX and the control group and aimed to determine any relationship between these parameters and epicardial coronary blood flow and myocardial tissue perfusion. METHODS The study group consisted of 32 patients (mean age: 52.6+/-9.4 years, 14 men) with typical exertional angina, positive exercise test, and normal coronary arteries diagnosed as CSX. Plasma ADMA, L-arginine levels, and L-arginine/ADMA ratio were compared with the values of the control group, which consisted of 17 age-matched and sex-matched individuals. Concentrations of L-arginine and ADMA were measured by high-performance liquid chromatography. In all the coronary territories, epicardial coronary flow was assessed by thrombolysis in myocardial infarction (TIMI) frame count (TFC) method, and tissue level perfusion, by myocardial blush grade (MBG) method. A MBG score less than 3 was considered an impaired myocardial perfusion, and a MBG score of '3' in all the coronary territories, a normal myocardial perfusion. RESULTS The plasma ADMA levels of the study group were higher than those of the control group (0.83+/-0.38 vs. 0.55+/-0.44 micromol/l, P=0.03), whereas plasma L-arginine levels were similar in both groups (70.25+/-21.89 vs. 76.09+/-18.22 micromol/l, P=0.36), resulting in a diminished L-arginine/ADMA ratio in the patients with CSX [82.3 (60.2-128.8) vs. 242.2 (76.7-386.4), P=0.003]. In CSX group, the patients with abnormal myocardial tissue perfusion had increased plasma ADMA levels compared with those with normal tissue perfusion (0.99+/-0.37 vs. 0.69+/-0.34 micromol/l, P=0.02), whereas plasma L-arginine levels were similar in both groups. No correlations were observed between TFC values and plasma ADMA, L-arginine levels, and L-arginine/ADMA ratio. Plasma ADMA levels, however, were negatively correlated with MBG scores (r=-0.349, P=0.014). CONCLUSION We have shown for the first time that in the patients with CSX, increased plasma ADMA levels might be associated with impaired myocardial tissue perfusion when assessed by MBG.
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