l-arginine and l-NMMA for assessing cerebral endothelial dysfunction in ischaemic cerebrovascular disease: A systematic review

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#arginine #cadasil #cerebrovascular-disorders #clinical-trials-as-topic #endothelium-vascular

l-arginine and l-NMMA for assessing cerebral endothelial dysfunction in ischaemic cerebrovascular disease: A systematic review

Karlsson et al., 2017 | Clin Exp Pharmacol Physiol | Systematic Review

Citation

Karlsson William K, Sørensen Caspar G, Kruuse Christina. l-arginine and l-NMMA for assessing cerebral endothelial dysfunction in ischaemic cerebrovascular disease: A systematic review. Clin Exp Pharmacol Physiol. 2017-Jan;44(1):13-20. doi:10.1111/1440-1681.12679

Abstract

Endothelial dysfunction (ED), in particular cerebral ED, may be an essential biomarker for ischaemic cerebrovascular disease. However, there is no consensus on methods to best estimate cerebral ED. In this systematic review, we evaluate the use of l-arginine and NG -monomethyl-l-arginine (l-NMMA) for assessment of cerebral ED. A systematic search of PubMed, EMBASE and the Cochrane Library was done. We included studies investigating cerebrovascular response to l-arginine or l-NMMA in human subjects with vascular risk factors or ischaemic cerebrovascular disease. Seven studies (315 subjects) were eligible according to inclusion and exclusion criteria. Studies investigated the effect of age (n=2), type 2 diabetes mellitus (DM) (n=1), cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) (n=1), leukoaraiosis (n=1), and prior ischaemic stroke or transient ischaemic attack (TIA) (n=2) on cerebral ED. Most studies applied transcranial Doppler to quantify cerebral ED. Endothelium-dependent vasodilatation (EDV) induced by l-arginine was impaired in elderly and subjects with leukoaraiosis, but enhanced in CADASIL patients. Studies including subjects with prior ischaemic stroke or TIA reported both enhanced and impaired EDV to l-arginine. Responses to l-NMMA deviated between subjects with type 2 DM and the elderly. We found only few studies investigating cerebral endothelial responses to l-arginine and l-NMMA in subjects with vascular risk factors or ischaemic cerebrovascular disease. Inconsistencies in results were most likely due to variations in methods and included subject populations. In order to use cerebral ED as a prognostic marker, further studies are required to evaluate the association to cerebrovascular disease.

Key Findings

In order to use cerebral ED as a prognostic marker, further studies are required to evaluate the association to cerebrovascular disease.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population elderly and
Sample Size 2
Age Range See abstract
Condition diabetes

MeSH Terms

  • Arginine
  • CADASIL
  • Cerebrovascular Disorders
  • Clinical Trials as Topic
  • Endothelium, Vascular
  • Humans
  • Vasodilation
  • omega-N-Methylarginine

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: arginine-cardiovascular

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09