Arginine therapy: a novel strategy to induce nitric oxide production in sickle cell disease

Abstract

To determine the effects of l ‐arginine ( l ‐Arg) supplementation on nitric oxide metabolite (NO x ) production, oral l ‐Arg was given to normal controls, sickle cell disease (SCD) patients at steady state and SCD patients hospitalized with a vaso‐occlusive crisis (VOC). l ‐Arg (0·1 g/kg) increased NO x formation by 18·8 ± 68% in normal controls, whereas steady‐state SCD patients demonstrated a paradoxical decrease in NO x of −16·7 ± 4% ( P = 0·004). In contrast, patients with VOC demonstrated a dramatic increase in NO x production by +77·7 ± 103%, a response that was dose dependent. l ‐Arg appears to be the rate‐limiting step in NO x production during VOC. Oral arginine may therefore benefit SCD patients by inducing an increase in NO production during VOC.