title: Oral L-arginine supplementation in cystic fibrosis patients: a placebo-controlled study.
abstract: Exhaled nitric oxide (eNO) is decreased in cystic fibrosis (CF). The effect of oral L-arginine, the precursor of enzymatic nitric oxide (NO) formation, on airway NO in patients with CF was studied. In a pilot study, oral L-arginine was given in a single dose of 200 mg x kg(-1) body weight to eight healthy controls and eight CF patients. Subsequently, the same L-arginine dose was given to 10 patients with CF (five females) t.i.d. for 6 weeks in a randomised double-blind placebo-controlled crossover study. A single dose of oral L-arginine resulted in a 5.5-fold increase of L-arginine in plasma and a 1.3-fold increase of L-arginine in sputum after 2 h. Maximum eNO, within 3 h of L-arginine intake, increased significantly in both CF patients (5.4+/-2.1 ppb versus 8.3+/-3.5 ppb) and controls (18.0+/-8.1 ppb versus 26.4+/-12.3 ppb). Supplementation of L-arginine for 6 weeks resulted in a sustained increase in eNO compared to placebo (9.7+/-5.7 ppb versus 6.3+/-3.1 ppb). An effect of L-arginine supplementation on forced expiratory volume in one second was not observed. These data indicate that airway nitric oxide formation in cystic fibrosis patients can be augmented with oral L-arginine supplementation.
authors.affiliation: Children's Hospital, University of Essen, Hufeland Str. 55, D-45122 Essen, Germany. hartmutg@hotmail.com
authors.forename: H
authors.initials: H
authors.lastname: Grasemann
authors.forename: C
authors.initials: C
authors.lastname: Grasemann
authors.forename: F
authors.initials: F
authors.lastname: Kurtz
authors.forename: G
authors.initials: G
authors.lastname: Tietze-Schillings
authors.forename: U
authors.initials: U
authors.lastname: Vester
authors.forename: F
authors.initials: F
authors.lastname: Ratjen
mesh_terms: D000293:Adolescent; D000328:Adult; D001120:Arginine / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003550:Cystic Fibrosis / Q000175:diagnosis* / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism*; D010865:Pilot Projects; D011336:Probability; D012016:Reference Values; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D009569:Nitric Oxide; D001120:Arginine