Key result
Recurrent myocardial ischemia up-regulated DDAH1 expression in the midmyocardium, which was associated with a significant reduction in myocardial interstitial fluid ADMA.
Repetitive myocardial ischemia up-regulates DDAH1 expression via inflammatory mediators, leading to decreased ADMA levels, which may facilitate coronary collateral growth.
Animal data link DDAH1 to ischemia-driven collateralization; hypothesis-generating and requires human validation before any clinical consideration.
Pharmacologic inhibition of nitric oxide production inhibits growth of coronary collateral vessels. Dimethylarginine dimethylaminohydrolase 1 (DDAH1) is the major enzyme that degrades asymmetric dimethylarginine (ADMA), a potent inhibitor of nitric oxide synthase. Here we examined regulation of the ADMA-DDAH1 pathway in a canine model of recurrent myocardial ischemia during the time when coronary collateral growth is known to occur. Under basal conditions, DDAH1 expression was non-uniform across the left ventricular (LV) wall, with expression strongest in the subepicardium. In response to ischemia, DDAH1 expression was up-regulated in the midmyocardium of the ischemic zone, and this was associated with a significant reduction in myocardial interstitial fluid (MIF) ADMA. The decrease in MIF ADMA during ischemia was likely due to increased DDAH1 because myocardial protein arginine N-methyl transferase 1 (PRMT1) and the methylated arginine protein content (the source of ADMA) were unchanged or increased, respectively, at this time. The inflammatory mediators interleukin (IL-1β) and tumor necrosis factor (TNF-α) were also elevated in the midmyocardium where DDAH1 expression was increased. Both of these factors significantly up-regulated DDAH1 expression in cultured human coronary artery endothelial cells. Taken together, these results suggest that inflammatory factors expressed in response to myocardial ischemia contributed to up-regulation of DDAH1, which was responsible for the decrease in MIF ADMA.
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Zhang et al. (2017) studied recurrent myocardial ischemia. recurrent myocardial ischemia vs. basal conditions was evaluated on DDAH1 expression and myocardial interstitial fluid ADMA levels. Recurrent myocardial ischemia up-regulated DDAH1 expression in the midmyocardium, which was associated with a significant reduction in myocardial interstitial fluid ADMA.
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