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Drug | Investigated conditions | Hypothesized mechanism | Results | References |
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Statins | Diabetes mellitus, stroke, hypercholesterolemia | Increase DDAH expression, increased bioavailability of tetrahydrobiopterin | Decreased ADMA serum levels (18–50%) | [100, 109] |
Fibrate | Hypertriglyceridemia | Increase DDAH activity through NF-kB suppression via PPAR-α receptors | Uncertain effect on ADMA serum levels, increase L-arginine/ADMA ratio | [111] |
Niacine | Dyslipidemia | Depletion of methyl groups for niacine metabolism and consequent reduction in ADMA synthesis | Decreased ADMA serum levels (10%) | [112] |
ACE inhibitors/ARB | Chronic glomerulonephritis, hypertension | Decreased NADPH oxidase upregulation by RAA system, with consequent reduced ROS-mediated DDAH inhibition | Decreased ADMA serum levels (10–16%) | [113, 114] |
Thiazolidinediones | Diabetes mellitus | Through PPAR-γ receptor activation: reduced insulin resistance, increased expression of DDAH in renal tubules, suppressed activity of NF-kB | Controversial; from no reduction to reduction of ADMA serum levels (10%), possible protection against ADMA effect | [115] |
Metformin | Diabetes mellitus Polycystic ovarian syndrome | Partially unknown, apparently not mediated by PRTM or DDAH Competitive antagonist of ADMA | Decreased ADMA serum levels (27%) | [116] |
Nebivolol | Hypertension | Upregulation of DDAH, downregulation of PRTM | Decreased ADMA serum levels (37–44%) | [117, 118] |
Acetylsalicylic acid | Coronary artery disease | Upregulation of DDAH and eNOS | Decreased ADMA serum levels (30%) | [119] |
Estrogens | Postmenopausal women | Upregulation of DDAH via ERα | Decreased ADMA serum levels (18–20%) | [120, 121] |
Folate and B group vitamins | Hypertension, hyperhomocysteinemia, chronic heart failure | Increased bioavailability of methylenetetrahydrofolate | Decreased ADMA serum levels (14%), acute decrease during e.v. infusion | [122, 123] |
α-Lipoic acid | End-stage renal disease, diabetes mellitus | Activation and upregulation of DDAH via STAT3 | Decreased ADMA serum levels (9%) | [124] |
N-Acetylcysteine | End-stage renal disease | Partially unknown, direct activation DDAH, or ROS scavenging | Decreased ADMA serum levels (30%) | [125] |
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