Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although leukoaraiosis can be considered as a part of the normal aging process, it is strongly associated with stroke, cognitive impairment and other disabilities. The pathogenesis of leukoaraiosis is poorly understood, even if chronic ischemia with consequent arteriolosclerosis probably due to endothelial dysfunction has been suggested. To date, treatment focuses only on prevention of lesion formation and progression by aggressive control of risk factors, beginning at an early age and continuing throughout life. L-Arginine, a semi-essential amino acid, is a precursor of NO in the reaction catalyzed by endothelial nitric oxide synthase and, it has been recently found to importantly influence endothelial function. Arginine supplementation has been demonstrated to be safe and effective therapy for many health conditions, particularly vascular diseases such as intermittent claudication, angina pectoris, erectile dysfunction and MELAS. Thus we hypothesize that, since a lack of endothelium-derived NO may be responsible for several features of LA, long-term administration of high oral doses of L-Arg may slow LA progression and the associated functional impairment.
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PMID:Does L-arginine supplementation play a role in cerebral small vessels disease? Implication in the treatment of leukoaraiosis. 2180 4

Supplemental arginine has shown promise as a safe therapeutic option to improve endogenous nitric oxide (NO) regulation in cardiovascular diseases associated with endothelial dysfunction. In clinical studies in adults, L-arginine, an endogenous amino acid, was reported to improve cardiovascular function in hypertension, pulmonary hypertension, preeclampsia, angina, and MELAS (mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes) syndrome. L-citrulline, a natural precursor of L-arginine, is more bioavailable than L-arginine because it avoids hepatic first-pass metabolism and has a longer circulation time. Although not yet well-studied, arginine/citrulline has immense therapeutic potential in some life-threatening diseases in children. However, the optimal clinical development of arginine or citrulline in children requires more information about pharmacokinetics and exposure-response relationships at appropriate ages and under relevant disease states. This article summarizes the preclinical and clinical studies of arginine/citrulline in both adults and children, including currently available pharmacokinetic information. The pharmacology of arginine/citrulline is confounded by several patient-specific factors such as variations in baseline arginine/citrulline due to developmental ages and disease states. Currently available pharmacokinetic studies are insufficient to inform the optimal design of clinical studies, especially in children. Successful bench-to-bedside clinical translation of arginine supplementation awaits information from well-designed pharmacokinetic/pharmacodynamic studies, along with pharmacometric approaches.
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PMID:Therapeutic Potential of Citrulline as an Arginine Supplement: A Clinical Pharmacology Review. 3214 Sep 97