[The importance of regulation of endogenous methylarginine concentrations in clinical practice]

Endogenous methylarginines, the catabolism products of proteins containing post-translationally methylated arginine residues, are the modulators of arginine metabolism. Endogenous methylarginines compete with arginine about cationic aminoacid transporter and some of them, e.g. asymmetric dimethylarginine (ADMA) and N-mono-methylarginine (MMA), are competitive inhibitors of nitric oxide synthases. The changes of arginine metabolism, induced by these methylarginines, may have serious consequences, because arginine is the precursor of cell-signalling molecules such as NO, agmatine, glutamate and gamma-aminobutyric acid (GABA) and the regulatory molecules polyamines. ADMA has also prooxidant properties and increases endothelial adhesiveness for monocytes. Asymmetric methyl-arginines induce endothelial dysfunction, which may be reversed by L-arginine supplementation, what is defined as "arginine paradox". The increased plasma concentration of asymmetric methylarginines is induced by hypercholesterolemic or hyperhomocysteinemic diets and by rich sodium chloride intake. The high level of plasma asymmetric methyl-arginines accompanies atherosclerosis, hypertension, chronic renal failure, diabetes, insulin resistence, hyperthyreosis, schizophrenia and sclerosis multiplex. The causes of increased concentration ADMA and MMA in these diseases are just now discovered. The hope in the future is the modulation of methylarginines concentration by regulation of expression and activities of enzymes taking part in the metabolism of these substances, particularly of dimethyl-arginine dimethyl-aminotransferase. The main aim of the present study is to pay attention to possibility of the modulation of asymmetric methyl-arginines concentration, what may be a new way of synthase nitric oxide activity regulation in vivo and may be useful in future therapy of patologies in which synthesis of NO is troubled.