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Sepsis: an arginine deficiency state?
Yvette C Luiking1, Martijn Poeze, Cornelis H Dejong
1Maastricht University/Hospital, Department of Surgery, Nutrition and Toxicology Research Institute, Maastricht, The Netherlands.
Critical Care Medicine
|October 16, 2004
Summary
Sepsis significantly impacts arginine metabolism, leading to deficiency. Arginine supplementation shows promise in treating sepsis, though further research is needed to confirm its benefits.
Area of Science:
- Biochemistry
- Critical Care Medicine
- Physiology
Background:
- Sepsis is a life-threatening condition with high morbidity and mortality.
- Arginine metabolism alterations in sepsis are not fully understood.
- L-arginine has garnered attention for its role in sepsis.
Purpose of the Study:
- To review current knowledge on arginine metabolism in sepsis.
- To discuss arginine-related therapies, including nitric oxide (NO) pathways.
- To explore the potential of arginine supplementation in sepsis treatment.
Main Methods:
- Literature review of arginine metabolism in general and in sepsis.
- Analysis of arginine-related therapies: NO administration, arginine supplementation, and NO inhibition.
- Examination of protein breakdown, de novo production, and catabolism in sepsis.
Main Results:
- Sepsis increases protein breakdown and arginine catabolism, reducing plasma arginine levels.
- Altered arginine metabolism contributes to sepsis-related hemodynamic instability and microcirculation issues.
- Arginine supplementation and NO donors showed benefits; NO synthase inhibition was not consistently beneficial.
Conclusions:
- Sepsis exhibits characteristics of an arginine-deficiency state.
- Arginine supplementation is a logical therapeutic consideration for sepsis.
- Further clinical evidence is required to validate arginine supplementation in sepsis treatment.