L-Citrulline as Add-On Therapy to Increase Exhaled Nitric Oxide and Improve Lung Function and Asthma Control in Obese Asthmatics

Holguín, Fernando; Sharma, Sunita; Winnica, Daniel E.; Wasil, Karen; Smith, V.L.; Cruse, M.H.; Perez, Nancy; Scialla, Timothy; Coleman, Edward; Grasemann, Hartmut; Que, Loretta G.

doi:10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a7088

Cited by 2 publications

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“…In Table (2), there is a critical decrease in plasma L-arginine levels (P < 0.001) in asthmatic children, with the reduction of arginine substrate, which may be explained by the increased need of NO in asthmatic patients to keep the dilatation of the bronchi at its basal bronchial tone, compensating the increased demand of NO in the course of oxidative stress. Our findings were in agreement with the explanation of Holguin et al (2019), who stated that in order to have typical levels of nitric oxide, it is pivotal to preserve an adjustment between arginine and ADMA. For people with adult-onset asthma and asthma with overweight, having lower levels of arginine and higher levels of ADMA essentially bring down their NO levels, which sequentially causes more wheezing, shortness of breath, and other different asthma symptoms.…”

Section: Discussionsupporting

confidence: 93%

“…This finding is promising because it proposes that expanding arginine might establish NO levels. This would have an effective positive impact on aviation profession and asthma symptoms (Holguin et al, 2019). Regarding respiratory function parameters, there were significant differences between the two groups of children (<0.01) as shown in Table (1);, in addition, there was a negative correlation between serum ADMA levels and the severity of airway obstruction as indicated by respiratory function tests shown in Figure (2).…”

Section: Discussionmentioning

confidence: 89%

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Correlation of vitamin D and asymmetric dimethylarginine in children with bronchial asthma

Marei

El-Maghraby

Ashry

2021

Journal of Radiation Research and Applied Sciences

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Bronchial Asthma is outlined as a chronic irritation of the airways in children. Vitamin D is a real immune system regulator which has a potential part in allergy. Asymmetric Dimethyl Arginine (ADMA) is an endogenic Nitric Oxide Synthase (NOS) inhibitor. This study is to determine if there is a role of vitamin D deficiency, ADMA in the pathogenesis of asthma in children, And whether the decreased arginine bioavailability and NOS suppression by ADMA contribute to respiratory tract blockage or not. We measured serum vitamin D, ADMA, nitric oxide and plasma L-arginine in 30 asthmatic and 10 healthy children. Serum 25-hydroxy vitamin D, plasma L-Arginine and serum Nitric Oxide were decreased significantly in asthmatic patients compared to healthy children. On the other hand, ADMA serum levels were increased significantly in asthmatic patients. In asthmatic children, there were positive correlations between serum vitamin D concentration and forced expiratory volume in the first, second FEV1 (% predicted). Furthermore, there were negative correlations between serum ADMA concentration and FEV1 (%predicted). In conclusion, marked reduction of vitamin D and elevated ADMA serum levels in asthmatic children has contributed to NOS-related pathophysiology, therefore ADMA and vitamin D could be considered reliable in managing oxidative stress in asthma.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 89%

Correlation of vitamin D and asymmetric dimethylarginine in children with bronchial asthma

Marei

El-Maghraby

Ashry

2021

Journal of Radiation Research and Applied Sciences

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“…Indeed, H olguin et al . [ 35 ] showed that supplementation with L-citrulline to specifically increase nitric oxide in obese patients with asthma particularly improved pre-bronchodilator FVC. Another possibility is the presence of metabolic dysfunction that might affect airway remodelling [ 13 ] to cause increases in wall thickness and secretion volume, both of which are potent mechanisms for enhanced airway closure [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…One possibility is increased smooth muscle tone [33,34]; changes in airway smooth muscle structure and function have been reported in obesity [33], and decreased levels of endogenous nitric oxide could contribute to increased airway smooth muscle tone. Indeed, HOLGUIN et al [35] showed that supplementation with L-citrulline to specifically increase nitric oxide in obese patients with asthma particularly improved pre-bronchodilator FVC. Another possibility is the presence of metabolic dysfunction that might affect airway remodelling [13] to cause increases in wall thickness and secretion volume, both of which are potent mechanisms for enhanced airway closure [36].…”

Section: Discussionmentioning

confidence: 99%

Physiological signature of late-onset nonallergic asthma of obesity

et al. 2020

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IntroductionObesity can lead to a late-onset nonallergic (LONA) form of asthma for reasons that are not understood. We sought to determine whether this form of asthma is characterised by any unique physiological features.MethodsSpirometry, body plethysmography, multiple breath nitrogen washout (MBNW) and methacholine challenge were performed in four subject groups: Lean Control (n=11), Lean Asthma (n=11), Obese Control (n=11) and LONA Obese Asthma (n=10). The MBNW data were fitted with a novel computational model that estimates functional residual capacity (FRC), dead space volume (VD), the coefficient of variation of regional specific ventilation (CV,V′E) and a measure of structural asymmetry at the level of the acinus (sacin).ResultsBody mass index and waist circumference values were similar in both obese groups, and significantly greater than in lean asthmatic individuals and controls. Forced vital capacity was significantly lower in the LONA Asthma group compared with the other groups (p<0.001). Both asthma groups exhibited similar hyperresponsiveness to methacholine. FRC was reduced in the Obese LONA Asthma group as measured by MBNW, but not in obese controls, whereas FRC was reduced in both obese groups as measured by plethysmography. VD, CV,V′E and sacin were not different between groups.ConclusionsChronic lung compression characterises all obese subjects, as reflected by reduced plethysmographic FRC. Obese LONA asthma is characterised by a reduced ability to recruit closed lung units, as seen by reduced MBNW FRC, and an increased tendency for airway closure as seen by a reduced forced vital capacity.

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L-Citrulline as Add-On Therapy to Increase Exhaled Nitric Oxide and Improve Lung Function and Asthma Control in Obese Asthmatics

Cited by 2 publications

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Correlation of vitamin D and asymmetric dimethylarginine in children with bronchial asthma

Correlation of vitamin D and asymmetric dimethylarginine in children with bronchial asthma

Physiological signature of late-onset nonallergic asthma of obesity

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