Utilidad clínica de la dimetilarginina asimétrica (ADMA), en diferentes patologíasaterosclerosis, hipertensión y enfermedad renal

Abstract

Asymmetric dimethylarginine (ADMA) is a natural component of human plasma. This substance is formed as a metabolic by-product of continuous protein storage in the body’s cells. Over a decade ago, ADMA was revealed to exert biological effects without inhibiting nitric oxide (NO) synthesis. The physiopathologic role of ADMA has been clarified in greater detail by the collaborative efforts of distinct research groups in different parts of the world. Currently, it is known that ADMA can play a major role in the pathogenesis and progression of cardiovascular disease, especially atherosclerosis. ADMA is an endogenous competitive inhibitor of eNOS, discovered in 1992 in patients with renal insufficiency, and thus called because the 2 methyls are joined to a single nitrogen of the guanido group. This compound is increased in renal insufficiency and other pathological situations such as hypercholesterolemia, atherosclerosis, and hypertension. The increase in ADMA concentrations has a strong inhibitory effect on the enzyme. This inhibition can be attenuated if the concentration of available substrate is increased. Indeed, some intervention studies indicate that arginine supplementation improves endothelial function in patients with coronary disease. In addition, longterm arginine treatment decreases the symptoms of vascular disease in patients with peripheral and coronary atherosclerosis.