Abstract
Asymmetric dimethylarginine (ADMA) and monomethyl arginine (L-NMMA) are endogenously produced amino acids that inhibit all three isoforms of nitric oxide synthase (NOS)1. ADMA accumulates in various disease states, including renal failure, diabetes and pulmonary hypertension, and its concentration in plasma is strongly predictive of premature cardiovascular disease and death2,3,4. Both L-NMMA and ADMA are eliminated largely through active metabolism by dimethylarginine dimethylaminohydrolase (DDAH)5 and thus DDAH dysfunction may be a crucial unifying feature of increased cardiovascular risk. However, despite considerable interest in this pathway and in the role of ADMA as a cardiovascular risk factor, there is little evidence to support a causal role of ADMA in pathophysiology. Here we reveal the structure of human DDAH-1 and probe the function of DDAH-1 both by deleting the DDAH1 gene in mice and by using DDAH-specific inhibitors which, as we demonstrate by crystallography, bind to the active site of human DDAH-1. We show that loss of DDAH-1 activity leads to accumulation of ADMA and reduction in NO signaling. This in turn causes vascular pathophysiology, including endothelial dysfunction, increased systemic vascular resistance and elevated systemic and pulmonary blood pressure. Our results also suggest that DDAH inhibition could be harnessed therapeutically to reduce the vascular collapse associated with sepsis.
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Acknowledgements
We thank the following for experimental assistance: L. Newman, S. Jey, S. Thakker, H. Gill, V. Taylor and A. Cole. This work was funded by grants from the British Heart Foundation (PG20007 and PG/02/165/14797), the Wellcome Trust (065612/Z/01) and Medical Research Council (G0000002). P.V., J.L. and M.N. are part of the European Vascular Genomics Network funded by the European Union (contract number LSHM-CT-2003-503254). This study received financial support from the European Commission under the 6th Framework Programme (contract number LSHM-CT-2005-018725, PULMOTENSION). N.Q.M. and J.M.-R. are funded by Cancer Research UK.
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Contributions
J.L. generated the Ddah1 gene–deleted mice, oversaw all molecular and cellular studies and was involved in every aspect of the work reported in this paper. M.N. undertook experiments and oversaw all aspects of functional phenotyping and pharmacological experiments. M.N., R.S. and A.R. contributed to the in vivo cardiovascular experiments. M. Malaki., B.T., M.M. and S.A. contributed to the ex vivo cardiovascular experiments. C.S. helped characterize the molecular phenotype of the mice. B.W.-S. undertook experiments on pulmonary endothelial cells. S.R. designed and synthesied the DDAH inhibitors with D.S. B.O'H. expressed, purified and crystallised DDAH-1 and collected the X-ray data. J.M.-R. solved, built and refined all structures. N.Q.M. supervised the structural biology aspects of the project. P.V. was involved in formulating the hypothesis, and in the design, analysis and interpretation of all experiments. P.V., J.L., M.N., J.M.-R. and N.Q.M. wrote the final manuscript.
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UCL holds patents on DDAH and the chemical structures identified in this manuscript. The funding agencies (BHF and Wellcome Trust) and UCL and Birkbeck College stand to gain financially from these patents. Since this work was completed, P.V. left UCL and is now a full-time employee of GSK and holds shares in GSK. GSK has had no input into the work and has no financial interest in the work described in this paper.
Supplementary information
Supplementary Fig. 1
Construct development for DDAH-1 knockout mice and biochemical characterisation of DDAH1+/− mice. (PDF 170 kb)
Supplementary Fig. 2
Effect of DDAH inhibitors on NOS activity in vitro (PDF 22 kb)
Supplementary Fig. 3
Effect of L-291 on endothelium denuded rat aorta (PDF 10 kb)
Supplementary Fig. 4
Effects of i.v. administration of L-291 on mouse plasma levels. (PDF 11 kb)
Supplementary Fig. 5
Dimethylarginine levels and nitrite release from cultured primary pulmonary endothelial cells from mice. (PDF 14 kb)
Supplementary Fig. 6
Functional reactivity to calcium ionophore in isolated vessels from DDAH1+/− mice or mice treated with L-291 (PDF 25 kb)
Supplementary Fig. 7
Ex vivo analysis of pulmonary vasculature from DDAH1 +/− mice (PDF 313 kb)
Supplementary Fig. 8
Schematic summarising the main findings of study. (PDF 380 kb)
Supplementary Table 1
Crystallographic data collection and refinement (PDF 21 kb)
Supplementary Table 2
EC50 values from functional studies on isolated mouse aortic rings. (PDF 13 kb)
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Leiper, J., Nandi, M., Torondel, B. et al. Disruption of methylarginine metabolism impairs vascular homeostasis. Nat Med 13, 198–203 (2007). https://doi.org/10.1038/nm1543
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DOI: https://doi.org/10.1038/nm1543
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