Abstract
Ghebremariam et al1 brilliantly demonstrated that proton pump inhibitors (PPIs) inhibit dimethylarginine dimethylaminohydrolase, a key enzyme metabolizing the endogenous nitric oxide synthase antagonist asymmetrical dimethylarginine. This finding offers a novel mechanism for the putative ability of PPIs to attenuate benefits of antiplatelet agents, an effect initially attributed to the interaction of PPIs with clopidogrel activation by a hepatic enzyme (CYP2C19).2 …
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