Molecular and Cellular Biochemistry

, Volume 244, Issue 1–2, pp 139–141 | Cite as

Oral L-arginine can reverse digital necrosis in Raynaud's phenomenon

  • Christopher M. Rembold
  • Carlos R. Ayers


Raynaud's phenomenon is characterized by transient reduction in blood supply through the small arteries in the hands and feet. Severe Raynaud's phenomenon can cause digital necrosis. It has been hypothesized that nitric oxide may have a role in Raynaud's phenomenon. We report two cases in which oral L-arginine reversed digital necrosis in Raynaud's phenomenon and two additional cases in which the symptoms of severe Raynaud's phenomenon were improved with oral L-arginine. These reports suggest that a defect in nitric oxide synthesis or metabolism is present in Raynaud's phenomenon. They also suggest a potential role for oral L-arginine therapy in Raynaud's phenomenon, especially in Raynaud's phenomenon with digital necrosis.

L-arginine nitric oxide Raynaud's phenomenon digital necrosis 


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  1. 1.
    Lewis T: Experiments relating to the peripheral mechanisms involved in the spasmodic arrest of the circulation in the fingers, a variety of Raynaud's disease. Heart 15: 7-99, 1929Google Scholar
  2. 2.
    Belch JJ: Raynaud's phenomenon. Cardiovasc Res 33: 25-30, 1997Google Scholar
  3. 3.
    Chen XL, Rembold CM: Nitroglycerin relaxes rat tail artery primarily by lowering Ca2+ sensitivity and partially by repolarization. Am J Physiol Heart Circ Physiol 271: H962-H968, 1996Google Scholar
  4. 4.
    Rembold CM, Foster B, Strauss JD, Wingard CJ, Van Eyk JE: cGMP mediated phosphorylation of heat shock protein 20 may cause smooth muscle relaxation without myosin light chain dephosphorylation. J Physiol (Lond) 524: 865-878, 2000Google Scholar
  5. 5.
    Murad F: Regulation of cytosolic guanylyl cyclase by nitric oxide: the NO-cyclic GMP signal transduction system. Adv Pharmacol 26: 19-33, 1994Google Scholar
  6. 6.
    Khan F, Litchfield SJ, McLaren M, Veale DJ, Littleford RC, Belch JJ: Oral L-arginine supplementation and cutaneous vascular responses in patients with primary Raynaud's phenomenon. Arth Rheum 40: 352-357, 1997Google Scholar
  7. 7.
    Khan F, Belch JJ: Skin blood flow in patients with systemic sclerosis and Raynaud's phenomenon: Effects of oral L-arginine supplementation. J Rheumatol 26: 2389-2394, 1999Google Scholar
  8. 8.
    Singh S, De Trafford JC, Baskerville PA, Martin JF: Response of digital arteries to endothelium dependent and independent vasodilators in patients with Raynaud's phenomenon. Eur J Clin Invest 25: 182-185, 1995Google Scholar
  9. 9.
    Freedman RR, Girgis R, Mayes MD: Acute effect of nitric oxide on Raynaud's phenomenon in scleroderma (letter). Lancet 28: 354-739, 1999Google Scholar

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Christopher M. Rembold
    • 1
  • Carlos R. Ayers
    • 1
  1. 1.Cardiovascular Division, Departments of Internal Medicine and PhysiologyUniversity of Virginia Health SystemCharlottesvilleUSA

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