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Annals of Clinical Biochemistry

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This version was published on 1 January 2010
Ann Clin Biochem 2010;47:17-28
doi:10.1258/acb.2009.009196
© 2010 Association for Clinical Biochemistry

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The biochemistry, measurement and current clinical significance of asymmetric dimethylarginine

Scott Blackwell


Department of Clinical Biochemistry, Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK


Email: Scottblackwell01{at}yahoo.co.uk

Asymmetric dimethylarginine (ADMA) is an endogenous competitive inhibitor of nitric oxide synthase and an important cause of endothelial dysfunction. Its increased plasma concentration is associated with a variety of traditional cardiovascular risk factors, and may mediate their effects on the vascular endothelium. ADMA is also an independent predictor of cardiovascular events and mortality, and predicts outcomes in critically ill patients in the intensive care unit. This work has provided insights into the role of ADMA as an endogenous regulator of nitric oxide synthesis. At present there is no specific therapy to modify ADMA concentration, but increasing interest and work on protein arginine methyltransferases and dimethylarginine dimethylaminohydrolase, which synthesize and metabolize ADMA, respectively, might provide novel therapeutic targets.


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