The biochemistry, measurement and current clinical significance of asymmetric dimethylarginine

This version was published on 1 January 2010

Ann Clin Biochem 2010;47:17-28
© 2010 Association for Clinical Biochemistry


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Review Articles

Scott Blackwell

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

Email: Scottblackwell01{at}

Asymmetric dimethylarginine (ADMA) is an endogenous competitiveinhibitor of nitric oxide synthase and an important cause ofendothelial dysfunction. Its increased plasma concentrationis associated with a variety of traditional cardiovascular riskfactors, and may mediate their effects on the vascular endothelium.ADMA is also an independent predictor of cardiovascular eventsand mortality, and predicts outcomes in critically ill patientsin the intensive care unit. This work has provided insightsinto the role of ADMA as an endogenous regulator of nitric oxidesynthesis. At present there is no specific therapy to modifyADMA concentration, but increasing interest and work on proteinarginine methyltransferases and dimethylarginine dimethylaminohydrolase,which synthesize and metabolize ADMA, respectively, might providenovel therapeutic targets.

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