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L-Citrulline: Novel Pharmacotherapy to Improve Outcomes in Infants and Children at Risk of Systemic or Pulmonary

Candice D Fike1, Frederick E Barr2, Judy L Aschner3

  • 1Department of Pediatrics, University of Utah Health, Salt Lake City, UT 84108, USA.

Pharmaceuticals (Basel, Switzerland)
|June 26, 2026
PubMed

Insights

L-citrulline shows promise for treating pediatric vascular diseases linked to impaired L-arginine-NO signaling. This amino acid may improve outcomes in children with heart, lung, and blood disorders, boosting nitric oxide production.

Area of Science:

  • Pediatric vascular medicine
  • Nitric oxide signaling pathways
  • Amino acid therapeutics

Background:

  • Children with heart, lung, and blood disorders face high risks of systemic and pulmonary vascular disease.
  • Impaired L-arginine-nitric oxide (NO) signaling is implicated in the pathogenesis of these pediatric vascular conditions.
  • Current treatments have limitations, leading to persistent high morbidity and mortality in affected children.

Purpose of the Study:

  • To review the therapeutic potential of L-citrulline for pediatric vascular diseases.
  • To evaluate L-citrulline's role in improving outcomes for children at risk of systemic or pulmonary vascular disease.
  • To discuss future applications of L-citrulline in vascular conditions.

Main Methods:

  • Review of current clinical evidence on L-citrulline use in pediatric populations.
  • Analysis of the L-arginine-NO pathway's role in pediatric vascular disorders.
  • Exploration of L-citrulline's mechanism of action in boosting nitric oxide production.

Main Results:

  • L-citrulline, a precursor to L-arginine, can enhance nitric oxide (NO) production.
  • This enhancement has the potential to ameliorate vascular dysfunction in both systemic and pulmonary circulations.
  • Evidence suggests L-citrulline may improve clinical outcomes in at-risk pediatric patients.

Conclusions:

  • L-citrulline represents a promising therapeutic strategy for pediatric vascular diseases.
  • Further investigation into L-citrulline's efficacy and safety in diverse pediatric vascular conditions is warranted.
  • Exploring novel applications of L-citrulline for vascular diseases currently lacking effective treatments is a key future direction.

Keywords:
bronchopulmonary dysplasiachronic kidney diseasecongenital heart diseasepulmonary hypertensionsickle cell disease

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