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ASİMETRİK DİMETİLARJİNİN ve KLİNİK ÖNEMİ

ASYMMETRIC DIMETHYL ARGININE AND ITS CLINICAL IMPLICATION

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Abstract (2. Language): 
Asymmetric Dimethyl Arginine (ADMA) is an endogenous inhibitor of nitric oxide (NO) synthase and causes local vasospasm and endothelial dysfunction by inhibiting local NO production. Therefore ADMA is evaluated as a secondary risk factor for coronary artery disease. This article will review; a) ADMA synthesis and catabolism, b) relationship of ADMA with various physiological and pathophysiological conditions and c) clinical application areas. Atherosclerosis development is a complex process and endothelial dysfunction plays a crucial role in patients with coronary atherosclerosis. Elevated endogenous NO synthase inhibitor ADMA levels represent a novel risk factor for the development of endothelial dysfunction. Elevated plasma ADMA levels have been demonstrated in patients with coronary artery disease, hypertension, cor pulmonale, stroke, renal failure, alzheimer and hyperhomocysteinemia. Strategies to reduce plasma ADMA levels may be a new approach in therapeutic applications in endothelial dsyfunction-related disease.
Abstract (Original Language): 
Asimetrik dimetil arginin (ADMA) endojen Nitrik Oksit sentaz inhibitörüdür. Lokal Nitrik Oksit (NO) sentezini engelleyerek vazospazma ve endotel disfonksiyonuna neden olmakta ve koroner arter hastalık gelişimi için risk faktörü olarak kabul edilmektedir. Bu makalede ADMA sentezi, yıkımı, çeşitli fizyolojik ve patofizyolojik olaylardaki düzeyi ve klinik kullanım alanları irdelenecektir. Ateroskleroz gelişim süreci kompleks bir süreçtir ve multifaktöryel nedenlere dayanmaktadır. Artmış kan basıncı etyolojisinde, NO sentezindeki azalma ile seyreden vazokonstriksiyon önemli rol oynamaktadır. Yine endotel disfonksiyonunda azalmış NO düzeyleri önemli etkilere sahiptir. Endotel disfonksiyonu kronik bir süreç sonucu gelişmekte ve bu sürece katkıda bulunan parametreler önemli risk faktörü olarak değerlendirilmektedir. NO sentezini azaltan ADMA’nın endojen bir inhibitör molekül oluşu son zamanlarda ADMA üzerine olan çalışmaları yoğunlaştırmıştır. Yüksek ADMA düzeylerinin renal hastalıklarla, preeklampsi, Alzheimer, siroz, cor pulmonale ile ilişkili olduğu gözlemlenmiştir. Endotel disfonksiyonunun önemli nedenlerinden biri olan ADMA düzeylerini azaltmaya yönelik stratejiler, ilgili hastalıkların tedavisinde yeni yaklaşımlara yol açabilir.
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