L-Arginine Pathway in COPD Patients with Acute Exacerbation: A New Potential Biomarker

Istvan Ruzsics, Lajos Nagy, Sandor Keki, Veronika Sarosi, Balazs Illes, Zsolt Illes, Ildiko Horvath, Lajos Bogar, Tihamer Molnar

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

BACKGROUND: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains a major cause of mortality. Clinical criteria of AECOPD are subjective. Biomarkers for AECOPD may aid in the initiation of early treatment. Increased production of asymmetric and symmetric dimethylarginine (ADMA, SDMA) is related to hypoxia. In COPD, a rise in ADMA results in a shift of L-arginine breakdown, contributing to airway obstruction. We aimed to compare serum levels of ADMA, SDMA and L-arginine in patients with and without AECOPD.

METHODS: L-arginine metabolites quantified by high-performance liquid chromatography in venous blood samples and partial capillary oxygen pressure were prospectively investigated in 32 patients with COPD, 12 with AECOPD and 30 healthy subjects.

RESULTS: Both ADMA and SDMA were significantly higher in AECOPD compared to stable COPD (p = 0.004 and p < 0.001, respectively). Oxygen content in capillaries correlated with serum ADMA concentration. However, the concentration of L-arginine was not different between AECOPD and stable COPD. Both ADMA and SDMA separated AECOPD with high sensitivity and specificity (AUC: 0.81, p = 0.001; AUC: 0.91, p < 0.001, respectively). A cut-off value ≥0.57 for SDMA was an independent variable to confirm AECOPD in a regression model (OR: 1.632, p = 0.001). All markers were significantly higher in the sera of both patient groups compared to the controls (p < 0.05, respectively).

CONCLUSIONS: COPD is associated with elevated L-arginine, ADMA and SDMA serum levels. In patients with AECOPD, production of ADMA and SDMA are more pronounced presumably due to more severe hypoxic insult. Methylated arginine derivatives in the sera may help early recognition of AECOPD.

Original languageEnglish
JournalC O P D
Volume13
Issue number2
Pages (from-to)139-145
Number of pages7
ISSN1541-2555
DOIs
Publication statusPublished - 2016

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Chronic Obstructive Pulmonary Disease
Serum
Area Under Curve
Oxygen
Airway Obstruction

Cite this

Ruzsics, Istvan ; Nagy, Lajos ; Keki, Sandor ; Sarosi, Veronika ; Illes, Balazs ; Illes, Zsolt ; Horvath, Ildiko ; Bogar, Lajos ; Molnar, Tihamer. / L-Arginine Pathway in COPD Patients with Acute Exacerbation : A New Potential Biomarker. In: C O P D. 2016 ; Vol. 13, No. 2. pp. 139-145.
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title = "L-Arginine Pathway in COPD Patients with Acute Exacerbation: A New Potential Biomarker",
abstract = "BACKGROUND: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains a major cause of mortality. Clinical criteria of AECOPD are subjective. Biomarkers for AECOPD may aid in the initiation of early treatment. Increased production of asymmetric and symmetric dimethylarginine (ADMA, SDMA) is related to hypoxia. In COPD, a rise in ADMA results in a shift of L-arginine breakdown, contributing to airway obstruction. We aimed to compare serum levels of ADMA, SDMA and L-arginine in patients with and without AECOPD.METHODS: L-arginine metabolites quantified by high-performance liquid chromatography in venous blood samples and partial capillary oxygen pressure were prospectively investigated in 32 patients with COPD, 12 with AECOPD and 30 healthy subjects.RESULTS: Both ADMA and SDMA were significantly higher in AECOPD compared to stable COPD (p = 0.004 and p < 0.001, respectively). Oxygen content in capillaries correlated with serum ADMA concentration. However, the concentration of L-arginine was not different between AECOPD and stable COPD. Both ADMA and SDMA separated AECOPD with high sensitivity and specificity (AUC: 0.81, p = 0.001; AUC: 0.91, p < 0.001, respectively). A cut-off value ≥0.57 for SDMA was an independent variable to confirm AECOPD in a regression model (OR: 1.632, p = 0.001). All markers were significantly higher in the sera of both patient groups compared to the controls (p < 0.05, respectively).CONCLUSIONS: COPD is associated with elevated L-arginine, ADMA and SDMA serum levels. In patients with AECOPD, production of ADMA and SDMA are more pronounced presumably due to more severe hypoxic insult. Methylated arginine derivatives in the sera may help early recognition of AECOPD.",
author = "Istvan Ruzsics and Lajos Nagy and Sandor Keki and Veronika Sarosi and Balazs Illes and Zsolt Illes and Ildiko Horvath and Lajos Bogar and Tihamer Molnar",
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Ruzsics, I, Nagy, L, Keki, S, Sarosi, V, Illes, B, Illes, Z, Horvath, I, Bogar, L & Molnar, T 2016, 'L-Arginine Pathway in COPD Patients with Acute Exacerbation: A New Potential Biomarker', C O P D, vol. 13, no. 2, pp. 139-145. https://doi.org/10.3109/15412555.2015.1045973

L-Arginine Pathway in COPD Patients with Acute Exacerbation : A New Potential Biomarker. / Ruzsics, Istvan; Nagy, Lajos; Keki, Sandor; Sarosi, Veronika; Illes, Balazs; Illes, Zsolt; Horvath, Ildiko; Bogar, Lajos; Molnar, Tihamer.

In: C O P D, Vol. 13, No. 2, 2016, p. 139-145.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - L-Arginine Pathway in COPD Patients with Acute Exacerbation

T2 - A New Potential Biomarker

AU - Ruzsics, Istvan

AU - Nagy, Lajos

AU - Keki, Sandor

AU - Sarosi, Veronika

AU - Illes, Balazs

AU - Illes, Zsolt

AU - Horvath, Ildiko

AU - Bogar, Lajos

AU - Molnar, Tihamer

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains a major cause of mortality. Clinical criteria of AECOPD are subjective. Biomarkers for AECOPD may aid in the initiation of early treatment. Increased production of asymmetric and symmetric dimethylarginine (ADMA, SDMA) is related to hypoxia. In COPD, a rise in ADMA results in a shift of L-arginine breakdown, contributing to airway obstruction. We aimed to compare serum levels of ADMA, SDMA and L-arginine in patients with and without AECOPD.METHODS: L-arginine metabolites quantified by high-performance liquid chromatography in venous blood samples and partial capillary oxygen pressure were prospectively investigated in 32 patients with COPD, 12 with AECOPD and 30 healthy subjects.RESULTS: Both ADMA and SDMA were significantly higher in AECOPD compared to stable COPD (p = 0.004 and p < 0.001, respectively). Oxygen content in capillaries correlated with serum ADMA concentration. However, the concentration of L-arginine was not different between AECOPD and stable COPD. Both ADMA and SDMA separated AECOPD with high sensitivity and specificity (AUC: 0.81, p = 0.001; AUC: 0.91, p < 0.001, respectively). A cut-off value ≥0.57 for SDMA was an independent variable to confirm AECOPD in a regression model (OR: 1.632, p = 0.001). All markers were significantly higher in the sera of both patient groups compared to the controls (p < 0.05, respectively).CONCLUSIONS: COPD is associated with elevated L-arginine, ADMA and SDMA serum levels. In patients with AECOPD, production of ADMA and SDMA are more pronounced presumably due to more severe hypoxic insult. Methylated arginine derivatives in the sera may help early recognition of AECOPD.

AB - BACKGROUND: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains a major cause of mortality. Clinical criteria of AECOPD are subjective. Biomarkers for AECOPD may aid in the initiation of early treatment. Increased production of asymmetric and symmetric dimethylarginine (ADMA, SDMA) is related to hypoxia. In COPD, a rise in ADMA results in a shift of L-arginine breakdown, contributing to airway obstruction. We aimed to compare serum levels of ADMA, SDMA and L-arginine in patients with and without AECOPD.METHODS: L-arginine metabolites quantified by high-performance liquid chromatography in venous blood samples and partial capillary oxygen pressure were prospectively investigated in 32 patients with COPD, 12 with AECOPD and 30 healthy subjects.RESULTS: Both ADMA and SDMA were significantly higher in AECOPD compared to stable COPD (p = 0.004 and p < 0.001, respectively). Oxygen content in capillaries correlated with serum ADMA concentration. However, the concentration of L-arginine was not different between AECOPD and stable COPD. Both ADMA and SDMA separated AECOPD with high sensitivity and specificity (AUC: 0.81, p = 0.001; AUC: 0.91, p < 0.001, respectively). A cut-off value ≥0.57 for SDMA was an independent variable to confirm AECOPD in a regression model (OR: 1.632, p = 0.001). All markers were significantly higher in the sera of both patient groups compared to the controls (p < 0.05, respectively).CONCLUSIONS: COPD is associated with elevated L-arginine, ADMA and SDMA serum levels. In patients with AECOPD, production of ADMA and SDMA are more pronounced presumably due to more severe hypoxic insult. Methylated arginine derivatives in the sera may help early recognition of AECOPD.

U2 - 10.3109/15412555.2015.1045973

DO - 10.3109/15412555.2015.1045973

M3 - Journal article

C2 - 26514682

VL - 13

SP - 139

EP - 145

JO - C O P D

JF - C O P D

SN - 1541-2555

IS - 2

ER -