Arginine in Critical Care: Preclinical Aspects

Reference work entry


Understanding the multiple biological roles of arginine and/or its metabolites is essential towards understanding the potential therapeutic use of these molecules in the critically ill patient. Arginine is a conditionally essential amino acid that through its multiple metabolic pathways can play diverse biological roles. For example, as a precursor of nitric oxide, it can play significant functions in vasodilation, hemodynamic stability, and platelet aggregation. As an amino acid, arginine is essential for normal T lymphocyte function. Arginine is also central in the detoxification of ammonia. Perhaps the most significant breakthrough in the last 10 years is the identification of arginase 1 expression in cells of the immune system – namely, myeloid cells; through regulation of arginine availability, arginase 1 serves to modulate nitric oxide production and T lymphocyte function. Pathologic expression of arginase 1 is observed in a growing number of illnesses leading to a state of arginine deficiency. Replacement of arginine during pathologic states of arginine deficiency may be beneficial under certain clinical conditions.


Nitric Oxide Nitric Oxide Production Arginine Metabolism Arginine Supplementation Dietary Arginine 
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List of Abbreviations


Arginine decarboxylase


Asymmetric dimethyl arginine


Argininosuccinate lyase


Argininosuccinate synthase




Eukaryotic initiation factor 2 alpha


General control non-derepressible 2


Inducible nitric oxide synthase

mCAT-1 mCAT-2

Cationic amino acid transport systems


Nitric oxide


Nitric oxide synthase


Ornithine transcarbomoylase




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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Nestle Health Care NutritionLivingstonUSA

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