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l-Arginine supplementation in severe asthma.
Shu-Yi Liao1,2, Megan R Showalter3, Angela L Linderholm1
1Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, UCD, Sacramento, California, USA.
JCI Insight
|June 5, 2020
Summary
L-arginine supplementation did not significantly reduce asthma exacerbations in severe asthma patients. However, specific metabolites like PGH2 and Nα-acetyl-l-arginine may predict treatment response in future studies.
Area of Science:
- Pulmonary Medicine
- Metabolomics
- Clinical Pharmacology
Background:
- Severe asthma is linked to dysregulated l-arginine metabolism.
- The impact of l-arginine supplementation on asthma metabolite profiles remains unclear.
Purpose of the Study:
- To investigate if l-arginine supplementation reduces asthma exacerbations in severe asthma patients.
- To explore changes in l-arginine metabolite profiles following supplementation.
- To identify potential biomarkers for predicting treatment response.
Main Methods:
- A single-center, crossover, double-blind trial involving 50 severe asthma patients.
- Oral l-arginine or placebo administration (0.05 mg/kg twice daily).
- Measurement of plasma metabolites via mass spectrometry and analysis of asthma exacerbations.
Main Results:
- L-arginine supplementation did not significantly decrease asthma exacerbations overall.
- Higher citrulline and lower arginine availability index (AAI) correlated with higher fractional exhaled nitric oxide (FeNO).
- Higher AAI was associated with fewer exacerbations; PGH2 and Nα-acetyl-l-arginine predicted clinical response.
Conclusions:
- L-arginine intervention did not yield a statistically significant reduction in asthma exacerbations for the overall cohort.
- PGH2, Nα-acetyl-l-arginine, and AAI show promise as predictive biomarkers for arginine metabolome-targeted clinical trials.
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