In 1992, asymmetrical dimethylarginine (ADMA) was first described as an endogenous inhibitor of the arginine-nitric oxide (NO) pathway. From then, its role in regulating NO production has attracted increasing attention. Nowadays, ADMA is regarded as a novel cardiovascular risk factor. The role of the kidney and the liver in the metabolism of ADMA has been extensively studied and both organs have proven to play a key role in the elimination of ADMA. Although the liver removes ADMA exclusively via degradation by the enzyme dimethylarginine dimethylaminohydrolase (DDAH), the kidney uses both metabolic degradation via DDAH and urinary excretion to eliminate ADMA. Modulating activity and/or expression of DDAH is still under research and may be a potential therapeutic approach to influence ADMA plasma levels. Interestingly, next to its association with cardiovascular disease, ADMA also seems to play a role in other clinical conditions, such as critical illness, hepatic failure, and preeclampsia. To elucidate the clinical significance of ADMA in these conditions, the field of research must be enlarged.

中文翻译：

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不对称二甲基精氨酸的临床意义。

1992年，不对称二甲基精氨酸（ADMA）首先被描述为精氨酸一氧化氮（NO）途径的内源性抑制剂。从那时起，其在调节NO产生中的作用已引起越来越多的关注。如今，ADMA被认为是一种新型的心血管危险因素。肾脏和肝脏在ADMA代谢中的作用已被广泛研究，并且两个器官都被证明在消除ADMA中起关键作用。尽管肝脏仅通过二甲基精氨酸二甲基氨基水解酶（DDAH）的降解来去除ADMA，但肾脏同时使用通过DDAH进行的代谢降解和尿液排泄来消除ADMA。DDAH的活性和/或表达调节仍在研究中，可能是影响ADMA血浆水平的潜在治疗方法。有趣的是 除了与心血管疾病有关，ADMA还似乎在其他临床疾病中发挥作用，例如危重疾病，肝功能衰竭和先兆子痫。为了阐明ADMA在这些情况下的临床意义，必须扩大研究领域。