title: Supplemental L-arginine enhances wound healing in diabetic rats.
abstract: L-arginine has been shown to enhance wound strength and collagen deposition in rodents and humans. Diabetes mellitus, which impairs wound healing, is accompanied by a reduction in nitric oxide at the wound site. The amino acid L-arginine is the only substrate for nitric oxide synthesis. We sought to determine whether supplemental L-arginine can restore the impaired wound healing of diabetic rats. Fifty-six male Lewis rats were used in this study, of which twenty-nine rats were rendered diabetic 7 days prior to surgery with intraperitoneal streptozotocin. Twenty-seven untreated rats served as controls. Animals underwent a dorsal skin incision with implantation of polyvinyl-alcohol sponges. Sixteen diabetic and 14 normal rats received 1 g/kg/day of L-arginine by injection, while the remainder received saline injections only. Animals were euthanized 10 days postwounding, and their wounds were analyzed for breaking strength. The wound sponges were assayed for total hydroxyproline and nitrite/nitrate content. Plasma and wound fluid concentrations of L-arginine, ornithine, and citrulline were determined. Wound sponge RNA was extracted and subjected to Northern blot analysis for procollagen I and III. Diabetic wounds had greatly decreased breaking strengths compared with controls. L-arginine significantly enhanced wound breaking strengths in both control (+23%) and diabetic animals (+44%), and also increased wound hydroxyproline levels in both diabetic (+40%) and control animals (+24%) as compared to their saline-treated counterparts. mRNA for procollagen I and III were elevated by L-arginine treatment in both diabetic rats and controls. Treatment with L-arginine significantly increased wound fluid nitrite/nitrate levels in diabetic animals. The data show that the impaired healing of diabetic wounds can be partially corrected by L-arginine supplementation, and that this effect is accompanied by enhanced wound nitric oxide synthesis.
authors.affiliation: Department of Surgery, the Sinai Hospital of Baltimore, and the Johns Hopkins Medical Institutions, Baltimore, Maryland 21215, USA.
authors.forename: Han Ping
authors.initials: HP
authors.lastname: Shi
authors.forename: Daniel
authors.initials: D
authors.lastname: Most
authors.forename: David T
authors.initials: DT
authors.lastname: Efron
authors.forename: Maria B
authors.initials: MB
authors.lastname: Witte
authors.forename: Adrian
authors.initials: A
authors.lastname: Barbul
mesh_terms: D000596:Amino Acids / Q000378:metabolism; D000818:Animals; D001119:Arginase / Q000378:metabolism; D001120:Arginine / Q000494:pharmacology*; D001798:Blood Proteins / Q000378:metabolism; D001835:Body Weight / Q000187:drug effects; D002956:Citrulline / Q000096:biosynthesis; D048909:Diabetes Complications; D006909:Hydroxyproline / Q000097:blood; D008297:Male; D019001:Nitric Oxide Synthase / Q000378:metabolism; D009952:Ornithine / Q000378:metabolism; D051381:Rats; D011917:Rats, Inbred Lew; D014945:Wound Healing / Q000187:drug effects*; D014947:Wounds and Injuries / Q000201:enzymology / Q000378:metabolism
chemical_list: D000596:Amino Acids; D001798:Blood Proteins; D002956:Citrulline; D001120:Arginine; D009952:Ornithine; D019001:Nitric Oxide Synthase; D001119:Arginase; D006909:Hydroxyproline