tailieunhanh - Báo cáo khoa học: "Live and let die: asymmetric dimethylarginine and septic shock"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Live and let die: asymmetric dimethylarginine and septic shock. | Available online http content 10 6 169 Commentary Live and let die asymmetric dimethylarginine and septic shock Rainer H Boger Clinical Pharmacology Unit Institute of Experimental and Clinical Pharmacology University Hospital Hamburg-Eppendorf Germany Corresponding author Rainer H Boger boeger@ Published 3 November 2006 This article is online at http content 10 6 169 2006 BioMed Central Ltd Critical Care 2006 10 169 doi cc5076 See related research by O Dwyer et al. http content 10 5 R139 Abstract Nitric oxide NO is an important mediator of host defence and of vascular tone. In septic shock upregulation of inducible NO synthase leads to the production of vast amounts of NO which contribute to pathogen elimination but also to inappropriate vasodilation and to loss of vascular resistance. Asymmetric dimethylarginine ADMA is an endogenous inhibitor of NO synthases shown to contribute to the regulation of vascular tone. ADMA was recently identified as a marker of organ dysfunction and mortality in intensive care patients and as a novel cardiovascular risk factor. In the present issue of Critical Care a study by O Dwyer and colleagues identifies ADMA as a potential regulator of NO production in septic shock. Being an inhibitor of NO production ADMA may at least partly counteract pathological hypotension but at the same time may impair the NO-dependent host defence. A mechanism is proposed by which the interplay between ADMA and inducible NO synthase activity is mediated. ADMA levels should be determined in future studies evaluating the regulation of NO in the intensive care setting. In the present issue of Critical Care O Dwyer and colleagues 1 report the results of a study in 47 patients with septic shock. Asymmetric dimethylarginine ADMA levels were elevated in these patients at the time of admission to the intensive care unit ICU as compared with a group of 10 healthy controls. ADMA levels in septic .