title: Asymmetric dimethylarginine levels in patients with cutaneous anthrax: a laboratory analysis.
abstract: BACKGROUND
  Asymmetric dimethylarginine (ADMA), the main endogenous inhibitor of nitric oxide synthase, is considered to be associated with endothelial dysfunction. High ADMA levels have been shown to be related with disorders causing vascular inflammation such as hypertension, hypercholesterolemia, atherosclerosis, chronic heart failure, stroke and sepsis. Cutaneous anthrax (CA) is a serious infectious disease which may cause vasculitis. The aim of the study was to investigate the serum ADMA levels in patients with CA.
  
  
  METHODS
  A total of 35 serum samples of the patients with CA and 18 control sera were tested for ADMA levels using ADMA ELISA kit (Immunodiagnostik AG, Bensheim, Germany).
  
  
  RESULTS
  ADMA levels were found to be significantly higher in the patients group than the controls (p < 0.001). In addition, ADMA levels were found to be positively associated with sedimentation rates (R = 0.413; p = 0.026), and inversely associated with international normalized ratio (INR) levels (R = -0.46; p = 0.011). A cut-off value of 0.475 of ADMA had a sensitivity of 74.3%, specificity of 77.8%, and accuracy of 75.5% in the diagnosis of CA.
  
  
  CONCLUSIONS
  Although the exact mechanism still remains unclear, ADMA levels could be related to immune activation in CA. In addition, these data might suggest the higher ADMA levels in patients could be due to the perivascular inflammation and vasculitis in CA.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Sunnetcioglu
authors.forename: Zafer
authors.initials: Z
authors.lastname: Mengeloglu
authors.forename: Ali Irfan
authors.initials: AI
authors.lastname: Baran
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karahocagil
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tosun
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Kucukbayrak
authors.forename: Mehmet Resat
authors.initials: MR
authors.lastname: Ceylan
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Akdeniz
authors.affiliation: Department of Family Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara 06110, Turkey. cenkaypak@yahoo.com.
authors.forename: Cenk
authors.initials: C
authors.lastname: Aypak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000881:Anthrax / Q000473:pathology*; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D017192:Skin Diseases, Bacterial / Q000473:pathology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C018524:N,N-dimethylarginine; D001120:Arginine