Coronary artery disease (CAD) results from the buildup of plaque in arteries that carry blood to cardiac muscle. Without sufficient blood and oxygen supply, cardiac muscle is unable to function properly and may lead to chest pain or heart attacks. As the leading cause of death in the United States, CAD is an important area of research, and a lot still needs to be done in terms of improving treatments and preventative measures for those with CAD as well as those at risk for it.
Current treatment options involve invasive techniques such as surgically introducing stents or grafts. Stents are metal tubes that hold the blocked arteries open while grafts are vessels used to bypass blocked arteries. Although these types of treatment are generally reserved for particularly serious cases of CAD, it would be easier on the patients if treatments were not as invasive. Fortunately, a recent study suggests that ammonia could play a role in treating cardiovascular disease.
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Researchers have found that introducing ammonia orally increases the production of an antioxidant that protects the endothelium. Endothelial cells line arteries and lead to the buildup of plaque when they are damaged. As a result, maintenance of their numbers and viability is important for preventing plaque buildup and ultimately, CAD. The antioxidant involved in this process of maintenance is known as heme oxygenase-1 (HO-1), which protects endothelial cells by producing carbon monoxide. Although we are all aware of its toxic effects, interestingly, naturally produced carbon monoxide within our bodies is involved in many protective pathways, which in this case prevents endothelial cells from dying. In this study, ammonia was found to possibly prevent CAD by increasing the production of HO-1. Researchers gave mice different doses of ammonia dissolved in water and found a 300% increase in HO-1 expression. However, direct administration of ammonia may be too toxic, so the researchers introduced it naturally by using glutamine, an amino acid that can be converted into ammonia by cells. They found that using this indirect method of introducing ammonia also led to the same results, an increased production of HO-1.
Overall, the research is still in its preliminary states in terms of drawing conclusions as to whether ammonia may be used to prevent or treat CAD. The researchers believe the next step would be to test whether glutamine would have an effect on mice with CAD. If that too proves successful, then the treatment may also work for humans.
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