Published ahead of print on April 20, 2006, doi:10.1164/rccm.200509-1439OC
© 2006 American Thoracic Society doi: 10.1164/rccm.200509-1439OC
Inhaled L-Arginine Improves Exhaled Nitric Oxide and Pulmonary Function in Patients with Cystic FibrosisChildren's Hospital, University of Duisburg-Essen, Essen, Germany Correspondence and requests for reprints should be addressed to Hartmut Grasemann, M.D., The Hospital for Sick Children, Division of Respiratory Medicine, 555 University Ave., Toronto, ON, M5G 1X8 Canada. E-mail: hartmut.grasemann{at}sickkids.ca Rationale: Nitric oxide formation is deficient in airways of patients with cystic fibrosis (CF). Since nitric oxide has bronchodilatory effects, nitric oxide deficiency may contribute to airway obstruction in CF. Objectives: We reasoned that inhalation of L-arginine, the precursor of enzymatic nitric oxide formation, could improve airway nitric oxide formation and pulmonary function in patients with CF. Measurements: Exhaled nitric oxide, pulmonary function, and peripheral oxygen saturation were measured before and after a single inhalation of nebulized L-arginine solution in patients with CF and in healthy subjects. A saline solution of similar osmolarity (1.7%) was used as control. Results: Nebulized L-arginine not only significantly increased exhaled nitric oxide concentrations but also resulted in a sustained improvement of FEV1 in patients with CF. Oxygen saturation also increased significantly after the inhalation of L-arginine. Nebulized saline resulted in a small but significant increase in exhaled nitric oxide but a decrease in FEV1 in patients with CF. In control subjects inhalation of L-arginine increased exhaled nitric oxide concentrations, but FEV1 decreased. No effect of saline on exhaled nitric oxide, pulmonary function, or oxygen saturation was observed in healthy subjects. Conclusions: These data suggest that a single inhalation of L-arginine acutely and transiently improves pulmonary function in CF through the formation of nitric oxide. Augmentation of airway nitric oxide formation by inhalation of L-arginine is a promising therapeutic approach in patients with CF.
Key Words: administration, inhalation • respiratory therapy • respiratory tract disease This article has been cited by other articles:
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