Background-Hyperhomocysteinemia is a putative risk factor for cardiovascular disease, which also impairs endothelium-dependent vasodilatation. A number of other risk factors for cardiovascular disease may exert their adverse vascular effects in part by elevating plasma levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase. Accordingly, we determined if homocysteine could increase ADMA levels. Methods and Results-When endothelial or nonvascular cells were exposed to DL-homocysteine or to its precursor L-methionine, ADMA concentration in the cell culture medium increased in a dose-and time-dependent fashion. This effect was associated with the reduced activity of dimethylarginine dimethylaminohydrolase (DDAH), the enzyme that degrades ADMA. Furthermore, homocysteine-induced accumulation of ADMA was associated with reduced nitric oxide synthesis by endothelial cells and segments of pig aorta. The antioxidant pyrrollidine dithiocarbamate preserved DDAH activity and reduced ADMA accumulation. Moreover, homocysteine dose-dependently reduced the activity of recombinant human DDAH in a cell free system, an effect that was due to a direct interaction between homocysteine and DDAH. Conclusion-Homocysteine

1Dimethylarginine dimethylaminohydrolase (DDAH), an enzyme that metabolizes the endogenous nitric oxide synthase inhibitors N0-monomethyl-L-arginine and NG,NG-dimethy-L-arginine to citrulline, was identified by Western blotting in rat and human tissue homogenates.2 S-2-amino-4(3-methylguanidino)butanoic acid (4124W) inhibited the metabolism of ["4C]-N0-monomethyl-L-arginine to ["4C]-citrulline by rat liver homogenates (IC50 416 + 66 giM; n = 9), human cultured endothelial cells (IC50 250 + 34 gLM; n = 9) and isolated purified dimethylarginine dimethylaminohydrolase. 3 Addition of 4124W to culture medium increased the accumulation of endogenously-generated N',N0-dimethy-L-arginine in the supernatant of human cultured endothelial cells from 3.1 + 0.3 to 5+0.7 ,M (n= 15; P<0.005). 4 4124W (1 uM-1 mM) had no direct effect on endothelial nitric oxide synthase activity but caused endothelium-dependent contraction of rat aortic rings (1 mM 4124W increased tone by 81.5 + 9.6% of that caused by phenylephrine 100 nM). This effect was reversed by L-arginine (100 giM). 4124W reversed endothelium-dependent relaxation of human saphenous vein (19.2 + 6.7% reversal of bradykinin-induced relaxation at 1 mM 4124W). 5 These data suggest that inhibition of dimethylarginine dimethylaminohydrolase increases the intracellular concentration of N',N0-dimethyl-L-arginine sufficiently to inhibit nitric oxide synthesis.Inhibiting the activity of DDAH may provide an alternative mechanism for inhibition of nitric oxide synthases and changes in the activity of DDAH could contribute to pathophysiological alterations in NO generation.

Background-An endogenous inhibitor of nitric oxide synthase, asymmetric dimethylarginine (ADMA), is elevated in patients with type 2 diabetes mellitus (DM). This study explored the mechanisms by which ADMA becomes elevated in DM. Methods and Results-Male Sprague-Dawley rats were fed normal chow or high-fat diet (nϭ5 in each) with moderate streptozotocin injection to induce type 2 DM. Plasma ADMA was elevated in diabetic rats (1.33Ϯ0.31 versus 0.48Ϯ0.08 mol/L; PϽ0.05). The activity, but not the expression, of dimethylarginine dimethylaminohydrolase (DDAH) was reduced in diabetic rats and negatively correlated with their plasma ADMA levels (PϽ0.05). DDAH activity was significantly reduced in vascular smooth muscle cells and human endothelial cells (HMEC-1) exposed to high glucose (25.5 mmol/L). The impairment of DDAH activity in vascular cells was associated with an accumulation of ADMA and a reduction in generation of cGMP. In human endothelial cells, coincubation with the antioxidant polyethylene glycol-conjugated superoxide dismutase (22 U/mL) reversed the effects of the high-glucose condition on DDAH activity, ADMA accumulation, and cGMP synthesis.

Background-NO is a major regulator of cardiovascular physiology that reduces vascular and cardiac contractility.Accumulating evidence indicates that endogenous inhibitors may regulate NOS. The NOS inhibitors asymmetric dimethylarginine (ADMA) and N-monomethylarginine are metabolized by the enzyme dimethylarginine dimethylaminohydrolase (DDAH). This study was designed to determine if increased expression of DDAH could reduce tissue and plasma levels of the NOS inhibitors and thereby increase NO synthesis. Methods and Results-We used gene transfer and transgenic approaches to overexpress human DDAH I in vitro and in vivo. The overexpression of DDAH in cultured endothelial cells in vitro induced a 2-fold increase in NOS activity and NO production. In the hDDAH-1 transgenic mice, we observed Ϸ2-fold increases in tissue NOS activity and urinary nitrogen oxides, associated with a 2-fold reduction in plasma ADMA. The systolic blood pressure of transgenic mice was 13 mm Hg lower than that of wild-type controls (PϽ0.05). The systemic vascular resistance and cardiac contractility were decreased in response to the increase in NO production. Conclusions-DDAH

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Nc,NG-dimethyl-L-argmme (ADMA) IS an endogenously synthesized mtnc oxide (NO) synthase mhibltor which has potent pressor/vasoconstnctor effects Dimethylargmmase metabolizes ADMA to L-citrullme and plays a key role m deterrmmng the m VIVO levels of ADMA To mvestlgate the role of ADMA m the pathogenesls of hypertension, we measured 24-hour urinary excretion of ADMA (UADMA) and nitrate/nitrite (NOx) m Dahl salt-sensitive hypertensive rats and spontaneously hypertensive rats (SHR) In Dahl salt-resistant rats, high-salt &et (8% NaCI) did not increase blood pressure and increased urinary NOx (P< 01) wlthout changes in UADMA cornpaled with lowsalt diet (0 3% NaCI) In contrast, m Dahl salt-sensitive rats, hlghsalt diet Increased blood pressure (P< Ol), did not change urinary NOx excretion, and Increased UADMA (P< 01) There was a slgmficant (Y= 65, P< 01) correlation between UADMA and the level of blood pressure m Dahl salt-sensltlve rats Plasma levels of NOx and ADMA and renal chmethylargmmase content were comparable among them These results may suggest that m Dahl salt-resistant rats, blood pressure 1s kept constant during high-salt intake, possibly due to the compensatory increased production of NO, and that m Dahl salt-sensitive rats, high-salt intake increases the production of ADMA, attenuates the compensatory Increase\ m NO, and increases blood pressure These results also suggest that the systemic production of ADMA 19 not dependent on renal dlmethylargmmase SHR had significantly greater urinary NOx excretion (P< 05) and smaller UADMA than Wlstar-Kyoto rats nously have suggested that the NO production 1s preserved m SHR * Furthermore, recent evidence demonstrated the increased but not decreased production of NO m the heart9.10 and aorta" of SHR The synthesis of NO can be inhibited experimentally by some analogues of argmme mcludmg L-NMMA and ADMA), both of which have equally potent vasoconstnctor and pressor actions 12 Acute admmlstratlon of ADMA into guinea pigsI and rats'4 causes blood pressure elevation partly via elevation of total peripheral resistance I4 In humans, mtra-arterial admmlstratlon of ADMA lowers forearm blood flow 1~15 Although both L-NMMA and ADMA are synthesized I6 and metabolized I7 endogenously, the plasma concentration of dlmethylargmme 1s ten times greater than that of L-NMMA 13 Since studies m ammals suggest that the kidney may be mvolved m the excretion lx and metabolism 1Y.*O of ADMA, abnormalities of the ADMA production or ehmmatlon have been reported m human kidney diseases 13 21 Although recent evidence demonstrated high accumulation of ADMA m plasma from hypercholesterolexmc ammals**J3 and m balloon-injured vessels,*4 the role of this endogenous NO synthase mhlbltor m the pathogenesls of hypertension has not been elucidated at all Accordmgly, we hypothesized that endogenous ADMA may play a role m salt-sensitive hypertension by competltlve inhibition of NO synthesis. To test this hypothesis, urinary and plasma ADMA and NOx were evaluated m Dahl rats on different salt intakes....

NG-monomethylarginine (L-NMA) and asymmetric NG, NG-dimethylarginines (ADMA) are endogenous inhibitors of cellular L-arginine uptake and/or nitric oxide (NO) synthesis that are implicated in renal parenchymal and Dahl salt-sensitive hypertension. Since the L-arginine:(L-NMA + ADMA) ratio determines NO synthase (NOS) activity, we compared the immunohistochemical distribution of NOS with NG, NG-dimethylarginine dimethylaminohydrolase (DDAH), which inactivates dimethylarginines (DMA) and L-NMA by hydrolysis to L-citrulline. Neuronal NOS (nNOS) was expressed predominantly in tubular epithelial cells of macula densa (MD), endothelial NOS (eNOS) in vascular endothelial cells (EC), and inducible NOS (iNOS) quite widely in tubular epithelium, including proximal tubules (PT), thick ascending limbs of Henle (TAL), distal convoluted tubule and intercalated cells (IC) of the collecting duct. Immunostaining for DDAH was present in PT, TAL, MD, and IC, and was also present in the glomerulus, Bowman's capsule, and endothelium of blood vessels. DDAH was detected in small vesicles of TAL and PT by electron microscopic (EM) immunocytochemistry. To study the effects of methylarginines on tubuloglomerular feedback (TGF) response, vehicle or methylarginines (10(-3) M) were added to artificial tubular fluid (ATF) perfused orthogradely from the late PT at 40 nl. min-1 while assessing changes in glomerular capillary pressure from proximal stop flow pressure (PSF). Whereas the maximal TGF responses were unchanged by vehicle (delta TGF 0 +/- 0%) or symmetric DMA (SDMA; +1 +/- 2%, NS), they were enhanced by L-NMA (+22 +/- 4%, P < 0.001) and asymmetric DMA (ADMA; +28 +/- 3%, P < 0.001). Since L-arginine transport can regulate renal epithelial NO generation, methylarginines (10(-3) M) or vehicle were co-perfused orthogradely with [3H]-L-arginine from the late PT and collected at the early distal tubule to study arginine uptake from the perfused loop of Henle. All methylarginines reduced fractional loop [3H] absorption significantly (P < 0.001; vehicle, 84 +/- 6; ADMA, 49 +/- 6; SDMA, 56 +/- 6; L-NMA, 41 +/- 6%). In conclusion, sites of DDAH expression in the vasculature or nephron are all sites of expression of an isoform of NOS. L-NMA, ADMA, and SDMA all inhibit renal tubular L-arginine uptake, whereas L-NMA and ADMA, but not SDMA, enhance TGF responses. Therefore, DDAH may regulate the cellular L-arginine: methylarginine levels in specific renal cells, thereby governing cell-specific L-arginine uptake and NO generation in renal tubular epithelium.

Abstract-In response to vascular insults, inflammatory cytokines stimulate vascular smooth muscle cells (SMCs) to express an inducible isoform of nitric oxide synthase (iNOS). Asymmetric dimethylarginine (ADMA), an endogenous NO synthase inhibitor, is metabolized by dimethylarginine dimethylaminohydrolase (DDAH). To determine whether the ADMA-DDAH system regulates cytokine-induced NO production, cultured rat SMCs were exposed to interleukin-1␤ (IL-1␤). IL-1␤ (1 to 100 U/mL) dose-dependently stimulated not only iNOS but also DDAH expression and enzyme activity, accompanied by an increase in NO metabolite and by a decrease in ADMA content in culture media. A DDAH inhibitor (4124W, 5 mmol/L) augmented ADMA production (PϽ0.01) and decreased NO synthesis (PϽ0.01) in IL-1␤-stimulated SMCs. On the other hand, an adenovirus-mediated overexpression of DDAH reduced ADMA and enhanced NO production. Exogenous administration of NO donors (SNAP and SIN-1) dose-dependently increased NO metabolite in the culture media but had no effect on ADMA. Our results indicate two mechanisms of IL-1␤-induced NO synthesis: the direct stimulation of the expression of iNOS and the indirect stimulation of iNOS activity by upregulating DDAH and reducing ADMA. The ADMA-DDAH system may be another regulatory mechanism of inflammation-mediated NO production for human vascular diseases. Key Words: nitric oxide Ⅲ nitric oxide synthase Ⅲ interleukins Ⅲ smooth muscle Ⅲ atherosclerosis N itric oxide (NO) plays an important role in the regulation of not only vascular tone but also architecture. There are two types of nitric oxide synthase in vessels, endotheliumderived NO synthase (eNOS) and inducible NO synthase (iNOS); the former is constitutively present in the endothelium, and the latter is induced by the inflammatory stimuli in the vascular wall. 1,2 N G ,N G Ϫ Dimethyl-L-arginine (ADMA) is an endogenous NOS inhibitor that inhibits activities of both eNOS and iNOS. We and others have demonstrated that increased plasma levels of ADMA are associated with hypertension, 3 hypercholesterolemia, 4 and the clustering of coronary risk factors in vivo in humans. 5 Furthermore, a close association has been found between plasma ADMA level and carotid intima-media thickness 5 or the severity of peripheral arterial occlusive diseases. 6 These lines of evidence suggest that ADMA is involved in the pathophysiology of human vascular diseases. ADMA is metabolized by a key limiting enzyme, N G ,N G Ϫ dimethylarginine dimethylaminohydrolase (DDAH). 7-9 DDAH is identified in human aortic tissues. 10 -13 It has been reported that oxidized low-density lipoprotein upregulates the synthesis of ADMA in cultured human endothelial cells in association with decreased activity of DDAH. 13 Collectively, the ADMA-DDAH system may be involved in the regulation of endogenous NO synthesis. 14 -17 Inflammatory response plays a crucial role in human vascular diseases. 18 Monocyte-derived macrophages, recognized at every stage of disease, promote continuous activation of the cytokine ...