[New possibilities in treatment of atherosclerosis--increase of nitric oxide synthesis by L-arginine supplementation].

: Diseases such as heart attack, stroke or critical atherosclerotic leg ischaemia are very common in the developed countries. It is estimated that they are the main cause of deaths in the age group over 40 years. Patients with advanced leg ischaemia can be treated surgically. However in distal disseminated occlusions, surgery is technically impossible. In such cases amputation is the treatment of choice, but postoperative death ratio in this group is still high. That is why new ways of atherosclerosis treatment are needed. Progress in vascular biology brings new methods of treatment. Discovering of vasodilatory effect of nitric oxide makes us seek for ways of increasing its endogenous synthesis in endothelium of blood vessels. Studies on angiogenic cytokine application, amplification of NO synthesis expression and other gene engineering techniques are carried out in order to increase the concentration of nitric oxide in endothelium. It has been found that an increase of nitrix oxide synthesis can be achieved by administering L-arginine. Numerous trials suggest that supplementation of this amino acid can be of great therapeutic importance in patients with various atherosclerotic diseases. Clinical effectiveness of L-arginine is comparable to conventional pharmacotherapy. It seems that in the near future L-arginine supplementation may contribute to better results of atherosclerosis treatment.