Clinical Presentation of Preeclampsia and the Diagnostic Value of Proteins and Their Methylation Products as Biomarkers in Pregnant Women with Preeclampsia and Their Newborns

Figure 11

Overview of the synthesis and metabolism of ADMA. Synthesis of ADMA involves the methylation of arginine residues with the help of N-methyltransferase (protein arginine N-methyltransferases, PRMTs) which converts the methyl donor S-adenosylmethionine (SAM) to S-adenosylhomocysteine (SAH) followed by proteolytic breakdown of the proteins, which generates ADMA and N-monomethyl-L-arginine (L-NMMA). Elimination of ADMA is partly achieved via urinary excretion. However, ADMA is mainly eliminated through its metabolism to citrulline and dimethylamine by the enzyme dimethylarginine dimethylaminohydrolase (DDAH) [145].