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J Cyst Fibros. 2013 Sep;12(5):468-74. doi: 10.1016/j.jcf.2012.12.008. Epub 2013 Jan 14.

A randomized controlled trial of inhaled L-arginine in patients with cystic fibrosis.

Author information

1
Division of Respiratory Medicine, Department of Pediatrics, the Hospital for Sick Children, University of Toronto, Toronto, Canada. hartmut.grasemann@sickkids.ca

Abstract

BACKGROUND:

Cystic fibrosis (CF) airways are nitric oxide (NO) deficient. We studied safety and efficacy of repeated inhalations of nebulized L-arginine, the substrate for NO synthase (NOS), in patients with CF.

METHODS:

Double-blind, randomized, placebo-controlled crossover treatment trial of twice daily inhalation of 500 mg L-arginine for two weeks compared to inhalation of saline in 19 CF patients (ClinicalTrials.gov Identifier: NCT00405665).

RESULTS:

L-arginine inhalation was well tolerated and resulted in a significant increase in exhaled NO. FEV1 increased by an average of 56 ml compared to -8 ml after saline solution; but this difference did not reach statistical significance. Sputum concentrations of L-ornithine, the product of arginase activity, increased significantly while the L-ornithine derived polyamines did not. There was no change in inflammatory markers in sputum.

CONCLUSION:

Repeated inhalation of L-arginine in CF patients was safe and well tolerated. Inhaled L-arginine increased NO production without evidence for changes in airway inflammation.

KEYWORDS:

Airway inflammation; Clinical trial; Nitric oxide; Polyamines; l-Arginine

PMID:
23333044
DOI:
10.1016/j.jcf.2012.12.008
[Indexed for MEDLINE]
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