Assessment of asymmetrical dimethylarginine metabolism in patients with critical illness

Ghashut, Rawia A.; Blackwell, Scott; Ryan, S.; Willox, Laura; McMillan, Donald C.; Kinsella, John; Talwar, Dinesh

doi:10.1111/eci.12710

Cited by 9 publications

(7 citation statements)

References 31 publications

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“…Nijveldt and co-workers proposed high circulating ADMA concentrations as risk factors of ICU mortality in critically ill patients 27 ; moreover, ADMA is a marker of perioperative complications in patients undergoing major abdominal surgery 28 . These results were confirmed in a longitudinal study of ADMA metabolism in critically ill patients 29 .…”

Section: Introductionsupporting

confidence: 59%

Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients

Hannemann

Balfanz

Schwedhelm

et al. 2021

Sci Rep

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COVID-19 is a disease with a variable clinical course ranging from mild symptoms to critical illness, organ failure, and death. Prospective biomarkers may help to predict the severity of an individual’s clinical course and mortality risk. We analyzed asymmetric (ADMA) and symmetric dimethylarginine (SDMA) in blood samples from 31 patients hospitalized for COVID-19. We calculated associations of ADMA and SDMA with mortality and organ failure, and we developed a predictive algorithm based upon these biomarkers to predict mortality risk. Nine patients (29%) experienced in-hospital death. SDMA and ADMA serum concentrations were significantly higher at admission in COVID-19 patients who died than in survivors. Cut-offs of 0.90 µmol/L for SDMA (AUC, 0.904, p = 0.0005) and 0.66 µmol/L for ADMA (AUC, 0.874, p = 0.0013) were found in ROC analyses to best discriminate both subgroups of patients. Hazard ratio for in-hospital mortality was 12.2 (95% CI: 2.2–31.2) for SDMA and 6.3 (1.1–14.7) for ADMA above cut-off. Sequential analysis of both biomarkers allowed discriminating a high-risk group (87.5% mortality) from an intermediate-risk group (25% mortality) and a low-risk group (0% mortality). Elevated circulating concentrations of SDMA and ADMA may help to better identify COVID-19 patients with a high risk of in-hospital mortality.

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Section: Introductionsupporting

confidence: 59%

Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients

Hannemann

Balfanz

Schwedhelm

et al. 2021

Sci Rep

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“…Oxidative stress is the serious cause of organ disability in critically ill patients (Ghashut et al, 2017). Reducing the antioxidant capacity (Rogobete et al, 2017) in these patients due to inefficient oxidative phosphorylation (Lorente et al, 2018) leads to an increase in free radicals (Oliveira, Pontes-de-Carvalho, Couto, & Noronha-Dutra, 2017), which is actually a possible mechanism for damage caused by the sepsis (Kumar et al, 2018).…”

mentioning

confidence: 99%

Therapeutic effects of curcumin on sepsis and mechanisms of action: A systematic review of preclinical studies

Karimi

Ghodsi

Kooshki

et al. 2019

Phytotherapy Research

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Sepsis is a complex disease that begins with an infectious disorder and causes excessive immune responses. Curcumin is considered as an active component of turmeric that can improve the condition in sepsis due to its anti‐inflammatory and antioxidant properties. PubMed, Embase, Google Scholar, Web of Science, and Scopus databases were searched. Searching was not limited to a specific publication period. Only English‐language original articles, which had examined the effect of curcumin on sepsis, were included. At first, 1,098 articles were totally found, and 209 articles were selected after excluding duplicated data; 46 articles were remained due to the curcumin effects on sepsis. These included 23 in vitro studies and 23 animal studies. Our results showed that curcumin and various analogs of curcumin can have an inhibitory effect on sepsis‐induced complications. Curcumin has the ability to inhibit the inflammatory, oxidative coagulation factors, and regulation of immune responses in sepsis. Despite the promising evidence of the therapeutic effects of curcumin on the sepsis complication, further studies seem necessary to investigate its effect and possible mechanisms of action in human studies.

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“…Our studies show that ADMA can be safely removed from the blood using TED. The extracorporeal device would be particularly applicable for lowering ADMA in hospitalized patients known the have high ADMA such as those with acute kidney, heart, and lung injury [13, 14, 17-21], sepsis [5, 6, 8], COVID-19 [16], and admitted to the ICU [10-12].…”

Section: Discussionmentioning

confidence: 99%

“…ADMA is a strong predictor of 30day mortality in sepsis patients [6,8]. In patients admitted to ICU, high serum ADMA is associated with higher mortality [10][11][12]. Elevated ADMA level is independently associated with higher risk of all-cause mortality in end-stage renal disease [13,14] and renal transplant recipients [15].…”

Section: Introductionmentioning

confidence: 99%

A Therapeutic Extracorporeal Device for Specific Removal of Pathologic Asymmetric Dimethylarginine from the Blood

Lee¹,

Steinbach²,

Basile³

et al. 2022

Blood Purif

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Introduction: Blood levels of uremic toxin, asymmetric dimethylarginine (ADMA), are strongly associated with mortality in sepsis, renal failure, and cardiovascular and renal disease patients. Methods: An extracorporeal approach to reduce pathological ADMA was developed. The dimethylarginine dimethylaminohydrolase (DDAH) was immobilized on agarose beads to prepare a cartridge. The efficacy of cartridge for ADMA lowering in blood was investigated. Results: The DDAH beads and cartridge reduced ADMA from solution or plasma. The magnitude of ADMA removal was dependent on the quantity of DDAH linked to the beads and the flow rate. When tested in association with plasmapheresis, the DDAH-cartridge was highly effective in ADMA removal from the blood and improved the arginine/ADMA ratio in a pig model. Conclusion: A new, safe, and effective extracorporeal approach to lower ADMA was developed which may have application in improving outcomes in patients with vascular complications and risk of mortality associated with high ADMA.

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Assessment of asymmetrical dimethylarginine metabolism in patients with critical illness

Cited by 9 publications

References 31 publications

Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients

Elevated serum SDMA and ADMA at hospital admission predict in-hospital mortality of COVID-19 patients

Therapeutic effects of curcumin on sepsis and mechanisms of action: A systematic review of preclinical studies

A Therapeutic Extracorporeal Device for Specific Removal of Pathologic Asymmetric Dimethylarginine from the Blood

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