Changes in Serum Levels of ADMA, SDMA and L-NMMA with Helicobacter Pylori Eradication

Objective: Increased asymmetric dimethylarginine (ADMA) levels are associated with reduced nitric oxide (NO) levels in many systems, particularly the cardiovascular system, and cause adverse effects. The objective of this study is to evaluate the effect of eradication therapy in patients infected with Helicobacter pylori (H. pylori) on the serum level of ADMA and other metabolic products of methylarginine. Methods: Patients who were found positive both in urea breath tests and stool antigen tests were considered to have H. pylori infection. These patients received eradication therapy for 14 days (twice daily pantoprazole 40 mg, twice daily amoxicillin 1000 mg, and twice daily clarithromycin 500 mg). Blood samples were taken to measure serum ADMA, symmetric dimethylarginine (SDMA), and N-monomethyl-Larginine (L-NMMA) levels before eradication therapy and 3 months after the therapy for patients for whom eradication was achieved. Results: A total of 23 of the 45 patients included in the study were female, whereas 22 were male. The mean age of the patients was 32.4 +/- 8 years. Significant reductions in the serum ADMA, SDMA, and L-NMMA levels of the patients were observed post-eradication therapy versus pre-eradication therapy. Conclusion: This study demonstrated significant reductions in serum ADMA, SDMA, and L-NMMA levels with H. pylori eradication. Further extensive long-term studies are needed to evaluate the positive effects that reduced serum ADMA, SDMA, and L-NMMA levels after H. pylori eradication can have on all systems, particularly the cardiovascular system.