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Oral L-arginine supplementation in cystic fibrosis patients: a placebo-controlled study

¹ Children's Hospital, ² Dept of Human Genetics, ³ Dept of Pharmacy, University of Duisburg-Essen, Essen, Germany

CORRESPONDENCE: H. Grasemann, Children's Hospital, University of Essen, Hufeland Str. 55, D-45122 Essen, Germany. Fax: 49 2017235983. E-mail: hartmutg@hotmail.com

Keywords: Cystic fibrosis, L-arginine, lung function, nitric oxide

Received: July 21, 2004
Accepted September 1, 2004

Exhaled nitric oxide (eNO) is decreased in cystic fibrosis (CF). The effect of oral L-arginine, the precursor of enzymatic nitric oxide (NO) formation, on airway NO in patients with CF was studied.

In a pilot study, oral L-arginine was given in a single dose of 200 mg·kg^–1 body weight to eight healthy controls and eight CF patients. Subsequently, the same L-arginine dose was given to 10 patients with CF (five females) t.i.d. for 6 weeks in a randomised double-blind placebo-controlled crossover study.

A single dose of oral L-arginine resulted in a 5.5-fold increase of L-arginine in plasma and a 1.3-fold increase of L-arginine in sputum after 2 h. Maximum eNO, within 3 h of L-arginine intake, increased significantly in both CF patients (5.4±2.1 ppb versus 8.3±3.5 ppb) and controls (18.0±8.1 ppb versus 26.4±12.3 ppb). Supplementation of L-arginine for 6 weeks resulted in a sustained increase in eNO compared to placebo (9.7±5.7 ppb versus 6.3±3.1 ppb). An effect of L-arginine supplementation on forced expiratory volume in one second was not observed.

These data indicate that airway nitric oxide formation in cystic fibrosis patients can be augmented with oral L-arginine supplementation.

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