From the Department of Physiology, Saint-Petersburg State University, Russia (E.S.K., A.G.M.).
Division of Angiology, Department of Internal Medicine III, University Center for Vascular Medicine, University Hospital "Carl Gustav Carus", Technische Universität Dresden, Germany (N.J., N.W., R.N.R.).
Arterioscler Thromb Vasc Biol. 2019 May;39(5):869-875. doi: 10.1161/ATVBAHA.118.312218.
A series of recent epidemiological studies have implicated the endogenous nonproteinogenic amino acid l-homoarginine as a novel candidate cardiovascular risk factor. The association between homoarginine levels and the risk of adverse cardiovascular outcomes is inverse (ie, high cardiovascular risk is predicted by low rather than high homoarginine levels), which makes it plausible to normalize systemic homoarginine levels via oral supplementation. The emergence of homoarginine as a potentially treatable protective cardiovascular risk factor has generated a wave of hope in the field of cardiovascular prevention. Herein, we review the biochemistry, physiology, and metabolism of homoarginine, summarize the strengths and weaknesses of the epidemiological evidence linking homoarginine to cardiovascular disease and its potential protective cardiovascular effects, and identify priorities for future research needed to define the clinical utility of homoarginine as a prognostic factor and therapeutic target in cardiovascular disease.
一系列最近的流行病学研究表明，内源性非蛋白氨基酸 l-同型精氨酸是一种新的候选心血管危险因素。同型精氨酸水平与不良心血管结局风险之间呈负相关（即，高心血管风险由低而非高同型精氨酸水平预测），这使得通过口服补充使系统同型精氨酸水平正常化成为可能。同型精氨酸作为一种潜在可治疗的保护性心血管危险因素的出现，在心血管预防领域引发了一波希望。在此，我们综述了同型精氨酸的生物化学、生理学和代谢，总结了将同型精氨酸与心血管疾病及其潜在的保护性心血管作用联系起来的流行病学证据的优缺点，并确定了未来研究的优先事项，以确定同型精氨酸作为心血管疾病预后因素和治疗靶点的临床应用价值。
