Skip to main content

The Role of l-Arginine in Wound Healing

Part of the Nutrition and Health book series (NH)

Abstract

Wound healing is required to effectively stabilise and repair injury (Sen et al. Wound Repair Regen 17:763–771, 2009; Enoch and Leaper. Surgery 23:37–42, 2005). In an optimal system, the process of wound healing occurs in an orderly and controlled series of phases: homeostasis, inflammation, proliferation and remodelling (Singer and Clark. N Engl J Med 341:738–746, 1999; Eming et al. J Invest Dermatol 127:514–525, 2007). However, complications including infection and inappropriate activation of the immune system can impair this process and result in delayed healing and the development of chronic wounds. Such complications impact significantly on health-care resources, and in 2010, the cost of treating and caring for wounds in the United States alone was estimated at $25 billion (Enoch and Leaper. Surgery 23:37–42, 2005). It is therefore important to determine factors that influence the wound healing process to optimise and facilitate appropriate healing.

Keywords

  • Wound healing
  • l-Arginine
  • Arginase
  • Nitric oxide
  • Inducible nitric oxide synthase
  • Urea cycle

This is a preview of subscription content, access via your institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-3-319-26009-9_45
  • Chapter length: 12 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   169.00
Price excludes VAT (USA)
  • ISBN: 978-3-319-26009-9
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   219.99
Price excludes VAT (USA)
Hardcover Book
USD   219.99
Price excludes VAT (USA)
Fig. 45.1
Fig. 45.2
Fig. 45.3

References

  1. Sen C, Gordillo G, Roy S, et al. Human skin wounds: a major and snowballing threat to public health and economy. Wound Repair Regen. 2009;17:763–71.

    CrossRef  PubMed  PubMed Central  Google Scholar 

  2. Enoch S, Leaper D. Basic science of wound healing. Surgery. 2005;23:37–42.

    Google Scholar 

  3. Singer A, Clark R. Cutaneous wound healing. N Engl J Med. 1999;341:738–46.

    CrossRef  CAS  PubMed  Google Scholar 

  4. Eming SA, Krieg T, Davidson JM. inflammation in wound repair: molecular and cellular mechanisms. J Invest Dermatol. 2007;127:514–25.

    CrossRef  CAS  PubMed  Google Scholar 

  5. Robinson W. Use of urea to stimulate healing in chronic purulent wounds. Am J Surg. 1936;33:192–7.

    CrossRef  Google Scholar 

  6. Albina J, Mills C, Henry W, Caldwell M. Temporal expression of different pathways of l-arginine metabolism in healing wounds. J Immunol. 1990;144:3877–80.

    CAS  PubMed  Google Scholar 

  7. Seifter E, Rettura G, Barbul A, Levenson SM. l-Arginine: an essential amino acid for injured rats. Surgery. 1978;84:224–30.

    CAS  PubMed  Google Scholar 

  8. Wu G, Morris SM. l-Arginine metabolism: nitric oxide and beyond. Biochem J. 1998;336:1–17.

    CrossRef  CAS  PubMed  PubMed Central  Google Scholar 

  9. Appleton J. l-Arginine: clinical potential of a semi-essential amino acid. Altern Med Rev. 2002;7:512–22.

    PubMed  Google Scholar 

  10. Witte M, Thornton F, Tantry U, Barbul A. l-Arginine supplementation enhances diabetic wound healing: involvement of nitric oxide synthase and arginase pathways. Metabolism. 2002;51:1269–73.

    CrossRef  CAS  PubMed  Google Scholar 

  11. Shi H, Efron D, Most D, et al. Supplemental dietary l-arginine enhances wound healing in normal but not inducible nitric oxide synthase knockout mice. Surgery. 2000;128:374–8.

    CrossRef  CAS  PubMed  Google Scholar 

  12. Tong BC, Barbul A. Cellular and physiological effects of l-arginine. Mini Rev Med Chem. 2004;4:823–32.

    CrossRef  CAS  PubMed  Google Scholar 

  13. Popovic PJ, Zeh HJ, Ochoa JB. l-Arginine and immunity. J Nutr. 2007;137:S1681–6.

    Google Scholar 

  14. Shi H, Wang S, Zhang G, Zhang Y, Barbul A. Supplemental l-arginine enhances wound following trauma/hemorrhagic shock. Wound Repair Regen. 2007;15:66–70.

    CrossRef  CAS  PubMed  Google Scholar 

  15. Stechmiller JK, Childress B, Cowan L. l-Arginine supplementation and wound healing. Nutr Clin Pract. 2005;20:52–61.

    CrossRef  PubMed  Google Scholar 

  16. Witte M, Barbul A. Role of nitric oxide in wound repair. Am J Surg. 2002;183:404–12.

    CrossRef  Google Scholar 

  17. Park JE, Abrams MJ, Efron PA, Barbul A. Excessive nitric oxide impairs wound collagen accumulation. J Surg Res. 2013;183:487–92.

    CrossRef  CAS  PubMed  Google Scholar 

  18. Rizk M, Witte M, Barbul A. Nitric oxide and wound healing. World J Surg. 2004;28:301–6.

    CrossRef  PubMed  Google Scholar 

  19. Kapoor M, Appleton I. Wound healing: abnormalities and future therapeutic targets. Curr Anaesth Crit Care. 2005;16:88–93.

    CrossRef  Google Scholar 

  20. Luo J, Chen A. Nitric oxide: a newly discovered function on wound healing. Acta Pharmacol Sin. 2005;26:259–64.

    CrossRef  CAS  PubMed  Google Scholar 

  21. Amadeu TP, Seabra AB, de Oliveira MG, Monte-Alto-Costa A. Nitric oxide donor improves wound healing if applied on inflammatory and proliferative phase. J Surg Res. 2008;149:84–93.

    CrossRef  CAS  PubMed  Google Scholar 

  22. Shearer J, Richards J, Mills C, Caldwell M. Differential regulation of macrophage l-arginine metabolism: a proposed role in wound healing. Am Physiol Soc. 1997;272:181–90.

    Google Scholar 

  23. Curran J, Winter D, Bouchier-Hayes D. Biological fate and clinical implications of l-arginine metabolism in tissue healing. Wound Repair Regen. 2006;14:376–86.

    CrossRef  PubMed  Google Scholar 

  24. Campbell L, Saville CR, Murray PJ, et al. Local arginase 1 activity is required for cutaneous wound healing. J Invest Dermatol. 2013;133:2461–70.

    CrossRef  CAS  PubMed  PubMed Central  Google Scholar 

  25. Ponrasu T, Jamuna S, Mathew A, et al. Efficacy of L-proline administration on the early responses during cutaneous wound healing in rats. Amino Acids. 2013;45:179–89.

    CrossRef  CAS  PubMed  Google Scholar 

  26. Li J, Chen J, Kirsner R. Pathophysiology of acute wound healing. Clin Dermatol. 2007;25:9–18.

    CrossRef  CAS  PubMed  Google Scholar 

  27. Beldon P. Basic science of wound healing. Surgery. 2010;28:409–12.

    Google Scholar 

  28. Werner S, Grose R. Regulation of wound healing by growth factors and cytokines. Physiol Rev. 2003;83:835–70.

    CAS  PubMed  Google Scholar 

  29. Baum C, Arpey C. Normal cutaneous wound healing: clinical correlation with cellular and molecular events. Dermatol Surg. 2005;31:674–86.

    CrossRef  CAS  PubMed  Google Scholar 

  30. Park JE, Barbul A. Understanding the role of immune regulation in wound healing. Am J Surg. 2004;187:11S–6.

    CrossRef  CAS  PubMed  Google Scholar 

  31. Stoecklein VM, Osuka A, Lederer JA. Trauma equals danger—damage control by the immune system. J Leukoc Biol. 2012;92:539–51.

    CrossRef  CAS  PubMed  PubMed Central  Google Scholar 

  32. Kirk S, Hurson M, Regan M, Holt D, Wasserkrug H, Barbul A. l-Arginine stimulates wound healing and immune function in elderly human beings. Surgery. 1993;114:155–60.

    CAS  PubMed  Google Scholar 

  33. Mosser DM, Zhang X. Activation of murine macrophages. Curr Protoc Immunol. 2008; Chapter 14.2.

    Google Scholar 

  34. Gordon S, Martinez FO. Alternative activation of macrophages: mechanism and functions. Immunity. 2010;32:593–604.

    CrossRef  CAS  PubMed  Google Scholar 

  35. Lee R, Efron D, Tantry U, Barbul A. Nitric Oxide in the healing wound: a time course study. J Surg Res. 2001;101:104–8.

    CrossRef  CAS  PubMed  Google Scholar 

  36. Cobbold C, Sherratt L. Mathematical modeling of nitric oxide activity in wound healing can explain keloid and hypertrophic scarring. J Theor Biol. 2000;204:257–88.

    CrossRef  CAS  PubMed  Google Scholar 

  37. Young A, McNaught C. The physiology of wound healing. Surgery. 2011;29:475–9.

    Google Scholar 

  38. Dhar I, Dhar A, Wu L, Desai K. l-Arginine attenuates methylglyoxal- and high glucose-induced endothelial dysfunction and oxidative stress by endothelial nitric-oxide synthase-independent mechanism. J Pharmacol Exp Ther. 2012;342:196–204.

    CrossRef  CAS  PubMed  Google Scholar 

  39. Prabhakar SS, Zeballos GA, Montova-Zavala M, Leonard C. Urea inhibits inducible nitric oxide synthase in macrophage cell line. Am J Physiol. 1997;273:1882–8.

    Google Scholar 

  40. Boucher JL, Custot J, Vadon S, et al. N omega-hydroxyl-l-arginine, an intermediate in the l-arginine to nitric oxide pathway, is a strong inhibitor of liver and macrophage arginase. Biochem Biophys Res Commun. 1994;203:1614–21.

    CrossRef  CAS  PubMed  Google Scholar 

  41. Heffernan D, Dudley B, McNeil PL, Howdieshell TR. Local l-arginine supplementation results in sustained wound nitric oxide production and reductions in vascular endothelial growth factor expression and granulation tissue formation. J Surg Res. 2006;133:46–54.

    CrossRef  CAS  PubMed  Google Scholar 

  42. Bohl K, Leibovich J, Belem P, et al. Effects of nitric oxide releasing poly(vinyl alcohol) hydrogel dressings on dermal wound healing in diabetic mice. Wound Repair Regen. 2002;10:286–94.

    CrossRef  Google Scholar 

  43. Luk P, Sinha S, Lord R. Upregulation of inducible nitric oxide synthase (iNOS) expression in faster-healing chronic leg ulcers. J Wound Care. 2005;14:373–81.

    CrossRef  CAS  PubMed  Google Scholar 

  44. Kim S, Huri D, Snyder S. Inducible nitric oxide synthase binds, S-nitrosylates, and activates cyclooxygenase-2. Science. 2005;23:1966–70.

    CrossRef  Google Scholar 

  45. Wilgus TA, Bergdall VK, Tober KL, et al. The impact of cyclooxygenase-2 mediated inflammation on scarless fetal wound healing. Am J Pathol. 2004;165:753–61.

    CrossRef  CAS  PubMed  PubMed Central  Google Scholar 

  46. Igarashi K, Kashiwagi K. Polyamines: mysterious modulators of cellular functions. Biochem Biophys Res Commun. 2000;271:559–64.

    CrossRef  CAS  PubMed  Google Scholar 

  47. Shi H, Fishel R, Efron D, et al. Effect of supplemental ornithine on wound healing. J Surg Res. 2002;106:299–302.

    CrossRef  CAS  PubMed  Google Scholar 

  48. Frias Soriano L, Lage Vazquez MA, Maristany CP, et al. The effectiveness of oral nutritional supplementation in the healing of pressure ulcers. J Wound Care. 2004;13:319–22.

    CrossRef  CAS  PubMed  Google Scholar 

  49. Heyman H, Van de Looverbosch DE, Meijer EP, Schols JM. Benefits of an oral nutritional supplement on pressure ulcer healing in long-term care residents. J Wound Care. 2008;17:476–88.

    CrossRef  CAS  PubMed  Google Scholar 

  50. Witte MB, Barbul A. General principles of wound healing. Surg Clin North Am. 1997;77:509.

    CrossRef  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Geoffrey P. Candy PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Gould, A.N., Candy, G.P. (2017). The Role of l-Arginine in Wound Healing. In: Patel, V., Preedy, V., Rajendram, R. (eds) L-Arginine in Clinical Nutrition. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-26009-9_45

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-26009-9_45

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-26007-5

  • Online ISBN: 978-3-319-26009-9

  • eBook Packages: MedicineMedicine (R0)