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Plasma dimethylarginines during the acute inflammatory response.
Scott Blackwell1, Denis St J O'Reilly, David Reid
1Department of Clinical Biochemistry, Royal Infirmary, Glasgow, UK.
European Journal of Clinical Investigation
|December 24, 2010
Summary
Plasma asymmetric dimethylarginine (ADMA) levels decrease during early acute inflammation following surgery. This transient reduction in ADMA may help regulate nitric oxide synthase activity during critical illness.
Area of Science:
- Biochemistry
- Critical Care Medicine
- Inflammation Research
Background:
- Asymmetric dimethylarginine (ADMA) is elevated in critically ill patients and linked to multiple organ failure.
- Plasma ADMA levels during the development of inflammatory responses remain undocumented.
- Elective knee arthroplasty serves as a model for studying acute inflammatory responses.
Purpose of the Study:
- To measure plasma ADMA concentrations during the development of an inflammatory response.
- To assess urinary excretion of dimethylamine and nitrate as markers of nitric oxide synthase (NOS) activity.
- To investigate the dynamic changes in ADMA during the post-operative inflammatory period.
Main Methods:
- Recruited 38 patients undergoing elective knee arthroplasty.
- Collected blood samples pre-operatively and up to day 5 post-operatively for ADMA and SDMA measurement via HPLC.
- Measured urinary dimethylamine and nitrate excretion (ratio to creatinine) using HPLC.
Main Results:
- Plasma ADMA decreased by 31% post-operatively, reaching a nadir on day 2.
- Symmetric dimethylarginine (SDMA) levels showed no significant changes.
- Urinary dimethylamine excretion doubled by day 5, while urinary nitrate showed a non-significant decrease.
Conclusions:
- Plasma ADMA concentration rapidly and transiently decreases within 48 hours of acute inflammation.
- The decrease in ADMA is not attributed to increased catabolism but possibly increased cellular partitioning.
- This ADMA reduction may regulate NOS activity and prevent detrimental increases in inducible NOS.
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