Arginine therapy: a novel strategy to induce nitric oxide production in sickle cell disease.
To determine the effects of L-arginine (L-Arg) supplementation on nitric oxide metabolite (NOx) production, oral L-Arg was given to normal controls, sickle cell disease (SCD) patients at steady state and SCD patients hospitalized with a vaso-occlusive crisis (VOC). L-Arg (0.1 g/kg) increased NOx formation by 18.8 +/- 68% in normal controls, whereas steady-state SCD patients demonstrated a paradoxical decrease in NOx of -16.7 +/- 4% (P = 0.004). In contrast, patients with VOC demonstrated a dramatic increase in NOx production by +77.7 +/- 103%, a response that was dose dependent. L-Arg appears to be the rate-limiting step in NOx production during VOC. Oral arginine may therefore benefit SCD patients by inducing an increase in NO production during VOC.
Morris
C R
CR
Department of Emergency Medicine, Children's Hospital Oakland, CA 94609, USA. johnclaud@home.com
Kuypers
F A
FA
Larkin
S
S
Sweeters
N
N
Simon
J
J
Vichinsky
E P
EP
Styles
L A
LA
D000208:Acute Disease; D001120:Arginine / Q000627:therapeutic use*; D016022:Case-Control Studies; D006801:Humans; D009569:Nitric Oxide / Q000378:metabolism*; D011446:Prospective Studies; D012805:Sickle Cell Trait / Q000188:drug therapy* / Q000378:metabolism; D013577:Syndrome; D014652:Vascular Diseases / Q000188:drug therapy* / Q000378:metabolism
D009569:Nitric Oxide; D001120:Arginine