Everything about Asymmetric Dimethylarginine totally explained
Asymmetric dimethylarginine (ADMA) is a naturally occurring chemical found in
blood plasma. It is a
metabolic by-product of continual
protein modification processes in the
cytoplasm of all human cells. It is closely related to L-
arginine, a conditionally-essential
amino acid. ADMA interferes with L-arginine in the production of
nitric oxide, a key chemical to
endothelial and hence
cardiovascular health.
Discovery
Patrick Vallance and his
London co-workers first noted the interference role for asymmetric dimethylarginine.
Today biochemical and clinical research continues into the role of ADMA in
cardiovascular disease,
diabetes mellitus,
erectile dysfunction and certain forms of
kidney disease.
Synthesis and regulation in the body
Asymmetric dimethylarginine is created in protein
methylation, a common mechanism of post-translational protein modification. This reaction is catalyzed by an
enzyme set called S-adenosylmethionine protein N-methyltransferases (protein methylases I and II).
The methyl groups transferred to create ADMA are derived from the
methyl group donor S-adenosylmethionine, an intermediate in the metabolism of
homocysteine. (Homocysteine is an important blood chemical, because it's also a
marker of cardiovascular disease). After
synthesis, ADMA migrates into the
extracellular space and thence into blood plasma. Asymmetric dimethylarginine is measured using
high performance liquid chromatography.
ADMA concentrations are substantially elevated by native or oxidized
LDL cholesterol.
Thus a spiralling effect occurs with high endothelial LDL levels causing greater ADMA values, which in turn inhibit NO production needed to promote
vasodilation. The elimination of ADMA occurs through urine excretion and metabolism by the enzyme
dimethylarginine dimethylaminohydrolase (DDAH). The role of homocysteine as a risk factor for cardiovascular disease is suggested to be mediated by homocysteine down-regulating production of DDAH in the body.
Polyphenol antioxidants also play a role in down-regulating homocysteine.
ADMA and suggested lines of therapeutic research
With raised levels of ADMA seemingly to be associated with adverse human health consequences for cardiovascular disease, metabolic diseases and also a wide range of diseases of the elderly, the possible lowering of ADMA levels may have important therapeutic effects. However it has yet to be established whether ADMA levels can be manipulated and, more importantly, if this results in useful clinical benefits.
The association of ADMA with abnormalities of lipid regulation suggested that supplements of
free fatty acids might manipulate ADMA levels. However research has failed to show that these have an effect.
ADMA role has been linked with elevated levels of
homocysteine. Whilst approaches at modifying the later with oral supplements of
folic acid were strongly suggested, studies have shown this fails to give any clinical benefit and suggested that B vitamins might instead increase some cardiovascular risks.
Direct alteration of ADMA levels with supplements of L-arginine have been suggested.
The hope is that such intervention might not only improve endothelial function but also reduce clinical symptoms of overt cardiovascular disease.
However studies show inconsistency in results in a clinical context,
and the recent results with manipulating homocysteine levels warrant extreme care with what clinical outcomes might arise from this approach.
Statins, as well as affecting circulating cholesterol levels, also increase nitric oxide levels and so have a direct effect on blood supply to the heart. Elevated levels of ADMA seems to modify this effect and so may have consequences for patients' responsiveness to taking statins.
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