Annals of Hematology

, Volume 84, Issue 5, pp 282–286 | Cite as

Plasma levels of asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, are elevated in sickle cell disease

  • J. B. SchnogEmail author
  • T. Teerlink
  • F. P. L. van der Dijs
  • A. J. Duits
  • F. A. J. Muskiet
  • CURAMA study group
Original Article


In recent years an important role has been ascribed to a reduced nitric oxide (NO) availability in the pathophysiology of sickle cell disease (SCD). Endogenously produced inhibitors of NO synthase, in particular asymmetric dimethylarginine (ADMA), are currently considered of importance in various vascular disease states characterized by reduced NO availability. We determined ADMA levels in plasma of 12 adult sickle cell patients (eight HbSS and four HbSC), and compared these to plasma levels in race- and age-matched controls. Sickle cell patients were characterized by strongly elevated levels of ADMA [HbSS: median 0.63 μmol/l (interquartile range 0.54–0.85), HbSC: 0.43 μmol/l (0.40–0.46), HbAA: 0.33 μmol/l (0.32–0.35) p<0.001]. ADMA levels were highest in HbSS patients with lowest hemoglobin levels and highest leukocyte counts, and in HbSS patients ADMA levels were positively associated with serum levels of soluble vascular cell adhesion molecule-1. These results suggest an important role of ADMA in limiting NO availability in SCD, and its role in the pathophysiology of SCD should be further investigated.


Sickle cell disease Arginine Nitric oxide Asymmetric dimethylarginine (ADMA) Hemolysis Endothelium 


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • J. B. Schnog
    • 1
    • 2
    • 6
    Email author
  • T. Teerlink
    • 3
  • F. P. L. van der Dijs
    • 4
  • A. J. Duits
    • 2
  • F. A. J. Muskiet
    • 5
  • CURAMA study group
  1. 1.Department of Internal MedicineSlotervaart HospitalAmsterdamThe Netherlands
  2. 2.Red Cross Blood Bank FoundationCuraçaoNetherlands Antilles
  3. 3.Department of Clinical ChemistryVU University Medical CenterAmsterdamThe Netherlands
  4. 4.Department of Clinical ChemistryMC Haaglanden-WesteindeThe HagueThe Netherlands
  5. 5.Department of Pathology and Laboratory MedicineGroningen University HospitalGroningenThe Netherlands
  6. 6.Department of Internal Medicine (9B)AmsterdamThe Netherlands

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