Effect of Oral Arginine Supplementation on Exhaled Nitric Oxide Concentration in Sickle Cell Anemia and Acute Chest Syndrome

Abstract

In contrast to our earlier study, ACS+ patients had similar FE(NO) values when compared with ACS- and HC patients. All SCD patients were arginine deficient at baseline and showed impairment in respiratory physiology when compared with HC patients. After arginine supplementation, FE(NO) concentration increased in all groups to a similar degree, and lung function and physiologic parameters were minimally affected. The physiologic significance of alterations in FE(NO) in SCD patients and its relationship to ACS predilection requires further delineation.

Reduced forced expiratory flow but not increased exhaled nitric oxide or airway responsiveness to methacholine characterises paediatric sickle cell airway disease

“…Exhaled nitric oxide (FeNO) levels in children with asthma are used as an indicator of eosinophilic airway inflammation, but studies in SCD children are few. FeNO has been reported as higher,13 similar14 or lower15 in SCD patients compared with healthy controls.…”

Novel Therapeutic Strategies for Adult Obese Asthmatics

“…Direct infusion of L-arginine to the peripheral or pulmonary arterial beds, has been tested in acute and chronic disease states, including coronary heart disease, pre-eclampsia and myocardial infarction, because of its bronchodilator and vasodilator actions 39–41 . L-arginine can also be used as a primary therapeutic in sickle cell disease patients with acute chest syndrome, where deficiency in NOS3-derived NO contributes to red cell sickling and vasoconstriction 42 augmenting NO production and improving outcomes in this disease.…”

Pulmonary Complications of Sickle Cell Disease

“…In SCD, it is believed that increased arginase activity results in a relative deficiency and decreased NO production. Oral arginine supplementation has been reported to increase exhaled NO levels in both patients with SCD and healthy control subjects (96). Administration of large arginine doses appeared to reduce pulmonary pressures in patients with SCD-PH.…”