Yang SJ. Dose-dependent L-arginine cardiotoxicity in diabetic cardiomyopathy: Mechanisms and clinical implications. World J Diabetes 2025; 16(6): 104851 [DOI: 10.4239/wjd.v16.i6.104851]
Corresponding Author of This Article
Si-Jun Yang, Department of Laboratory Medicine, Huangshi Maternity and Children's Health Hospital, Affiliated Maternity and Children's Health Hospital of Hubei Polytechnic University, No. 9 Guilin South Road, Xialu District, Huangshi 435000, Hubei Province, China. yangsijun@ncu.edu.cn
Research Domain of This Article
Nutrition & Dietetics
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. Jun 15, 2025; 16(6): 104851 Published online Jun 15, 2025. doi: 10.4239/wjd.v16.i6.104851
Dose-dependent L-arginine cardiotoxicity in diabetic cardiomyopathy: Mechanisms and clinical implications
Si-Jun Yang
Si-Jun Yang, Department of Laboratory Medicine, Huangshi Maternity and Children's Health Hospital, Affiliated Maternity and Children's Health Hospital of Hubei Polytechnic University, Huangshi 435000, Hubei Province, China
Author contributions: Yang SJ drafted and revised the article, read and approved the final version of the manuscript to be published.
Supported by National Natural Science Foundation of China, No. 81670747; and Huangshi Municipal Health Commission Key Projects, No. WJ2024006.
Conflict-of-interest statement: The author reports 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: Si-Jun Yang, Department of Laboratory Medicine, Huangshi Maternity and Children's Health Hospital, Affiliated Maternity and Children's Health Hospital of Hubei Polytechnic University, No. 9 Guilin South Road, Xialu District, Huangshi 435000, Hubei Province, China. yangsijun@ncu.edu.cn
Received: January 20, 2025 Revised: March 12, 2025 Accepted: March 21, 2025 Published online: June 15, 2025 Processing time: 146 Days and 7.1 Hours
Core Tip
Core Tip: This letter critiques Mansouri et al's study on L-arginine (L-Arg) in diabetic cardiomyopathy, revealing dose-dependent cardiotoxicity: While low doses (0.5 g/kg) may modestly improve lipid profiles, higher doses (≥ 1 g/kg) exacerbate myocardial injury via prooxidant [nuclear factor E2-related factor (Nrf-2) depletion] and proinflammatory (inducible nitric oxide synthase-driven peroxynitrite) mechanisms. The findings challenge the perception of L-Arg as universally safe, especially in diabetics with endothelial dysfunction. Urgent clinical translation is needed to validate safe thresholds in humans, alongside tailored guidelines for vulnerable populations. Future research should prioritize human trials, combination therapies (e.g., Nrf-2 activators), and regulatory frameworks for supplement standardization.
