L-arginine as a therapeutic approach for the verotoxigenic Escherichia coli-induced hemolytic uremic syndrome and thrombotic thrombocytopenic purpura.

Infection with verotoxigenic Escherichia coli, mainly strain O157:H7, has been incriminated in the cause of the hemolytic uremic syndrome and thrombotic thrombocytopenic purpura. Both syndromes, which cause serious problems in children and elderly patients, are not readily treated. Conventional treatment with antibiotics has been reported to not only stimulate bacteria to increase toxin production, but also to enhance its release from the cell. This in turn increases the severity of the disease. An alternative approach to the control of the disease would involve treatment with the amino acid L-arginine, in high amounts through total parenteral nutrition. L-arginine will generate high amounts of nitric oxide which will decrease platelet aggregation and increase vasodilation. Both effects will decrease the development of the tubular occlusion and the accompanied hypertension. In summary, we hypothesize that L-arginine can be used to control two diseases caused by E. coli O157:H7.