Liu S, Li N, Jin JJ, Yu YW. Double-edged sword of L-arginine in diabetes: Exploring anti-inflammatory and antioxidant strategies. World J Diabetes 2025; 16(4): 104007 [DOI: 10.4239/wjd.v16.i4.104007]
Corresponding Author of This Article
Yong-Wei Yu, Assistant Professor, Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. yuyongwei@zju.edu.cn
Research Domain of This Article
Biochemistry & Molecular Biology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Apr 15, 2025; 16(4): 104007 Published online Apr 15, 2025. doi: 10.4239/wjd.v16.i4.104007
Double-edged sword of L-arginine in diabetes: Exploring anti-inflammatory and antioxidant strategies
Shuai Liu, Ning Li, Jia-Jia Jin, Yong-Wei Yu
Shuai Liu, Department of Cardiology, The First People’s Hospital of Jiashan, Jiaxing 314100, Zhejiang Province, China
Ning Li, Department of Cardiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Jia-Jia Jin, Yong-Wei Yu, Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
Co-first authors: Shuai Liu and Ning Li.
Co-corresponding authors: Jia-Jia Jin and Yong-Wei Yu.
Author contributions: Liu S and Li N contribute equally to this study as co-first authors; Yu YW and Jin JJ contribute equally to this study as co-corresponding authors; Liu S and Li N wrote the manuscript; Yu YW and Jin JJ designed the study and revised the manuscript; all listed authors consent to the submission.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong-Wei Yu, Assistant Professor, Intensive Care Unit, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou 310003, Zhejiang Province, China. yuyongwei@zju.edu.cn
Received: December 9, 2024 Revised: January 21, 2025 Accepted: February 10, 2025 Published online: April 15, 2025 Processing time: 84 Days and 1 Hours
Abstract
The article by Mansouri et al provides a comprehensive investigation into the effects of L-arginine (L-Arg) on diabetic cardiomyopathy. The authors conclude that while a low dose (0.5 g/kg) of L-Arg improves lipid profiles and reduces body weight, higher doses (≥ 1 g/kg) exacerbate oxidative stress, inflammation, and myocardial damage. In this letter, we aim to expand on the potential role of anti-inflammatory and antioxidant strategies in mitigating these adverse effects. Specifically, we focus on nuclear factor erythroid 2-related factor 2 activation and nitric oxide synthase modulation. These strategies could enhance the clinical utility of L-Arg by preserving its metabolic benefits while reducing its cardiotoxic risks. We believe this perspective will stimulate future research on L-Arg-based therapies in patients with diabetes, with an emphasis on optimizing dosage and exploring synergistic co-therapies.
Core Tip: L-arginine (L-Arg) exhibits dose-dependent effects in diabetic cardiomyopathy, with low doses improving lipid profiles and high doses exacerbating oxidative stress and inflammation. This letter emphasizes the need for targeted interventions, such as nuclear factor erythroid 2-related factor 2 activation, nitric oxide synthase modulation, and combination therapies, to mitigate these adverse effects and enhance L-Arg’s clinical safety, offering safer therapeutic options for diabetic patients at risk of cardiovascular complications.
