L-arginine improves vascular function in patients with systemic lupus erythematosus

Abstract

Objective: Systemic lupus erythematosus (SLE) is a chronic, inflammatory disorder, experiencing an excess of cardiovascular morbidity and mortality. Arterial stiffness (AS) and Endothelial dysfunction are key events in the initiation, progression, and rupture of atheromatous plaque. L-arginine corrects derangements in the vascular endothelial nitric oxide dependent signaling pathway. Thus, the aim of our study was to evaluate the effect of L-Arginine on AS and endothelial function in patients with SLE. Materials and Methods: Twenty-Five (22F, 3M) SLE patients, demographic data, associated risk factors, disease activity, and treatment regimen were collected. Pulse Wave Velocity (PWV) and Reflection index (RI) was determined non-invasively by PeriScope and Autodicrowin, respectively. PWV reflects large artery stiffness, whereas RI represents small artery tone. Patients were randomized to receive either placebo or L-arginine (3 g t.i.d) for 2 weeks. Paired Student 't' Test and percentage change was used for statistical comparison. Results: L-arginine treatment improved Carotid femoral PWV (P < 0.002) and excellent improvement in change in RI (P < 0.0001). There was significant change in hemodynamic parameters. In placebo group, neither there was statistical change in carotid femoral PWV nor change in RI. Conclusion: L-arginine supplementation has been shown to restore vascular function and to improve the clinical symptoms in SLE patients with vascular dysfunction.