The metabolism of asymetric dimethyl arginine (ADMA) and its relationships between oxidative injury, endothelium damage and several diseases

Asymetric dimethyl arginin (ADMA) is a methylated arginine derivative which has been investigated for its role in clinical diagnosis. It is produced by adding of methyl groups to the arginine residues within proteins with an enzymatic catalytic reaction, protein arginine methyl transferase (PRMT). Almost the 90% of ADMA has been metabolized by dimethyl arginine dimethyl aminohydrolase (DDAH), while the other small portion, 10%, is excreted by urinary system. On the other hand, ADMA is a nitric oxide synthase inhibitor. Oxidative stress changes ADMA amount by affecting the enzyme activities which are involved in the metabolism of ADMA. It increases in renal failure and decreases after hemodialysis procedure in patients who undergone hemodialysis regularly. ADMA amount has been found increased in patients who have risk factors for cardiovascular disease. ADMA level was found to be increased and nitric oxide levels decreased in coronary arteries from patients with vasospastic angina pectoris. Also, ADMA induces cardiac ventricular contraction and reduces heart rate. Finally ADMA levels decrease in heart failure. ADMA levels were found to be increased in pulmonary hypertension because of the deduction of DDAH activity. In addition to cardiovascular diseases, ADMA has been connected with some diseases like insulin resistance syndrome, type II diabetes, and liver diseases. ADMA has possibly been account for maternal vascular dilatation and blood pressure changes in normotansif pregnants. There are a lot of evidence showing the role of ADMA in the pathogenesis of preeclampsia. The studies on clinical perspectives of ADMA have been continued and there are enough proof for ADMA’s role in several diseases. Nowadays, scientists who work this exiting area have been trying to resolve the question erasing the main idea “can it be an indicator for these diseases”