Abstract
Background : Cardiovascular disease has taken up to average 30% of death diagnoses in the world. Prevalent attempts of physicians to treat this disease came down to using focally targeted drugs to transiently relieve cardiovascular diseases. Since the method only cured symptoms and needed to be pharmacologically monitored, physicians and scientists have been struggling to find other treatment strategies. This problem led us to search for other methods dealing with CVD via preventive therapy, which did not require such close monitoring by physicians in its use.
Method : Materials used in the review were obtained predominantly through online journal browsing accessed using Universitas Indonesia's remote library. There were 14 literatures found closely related to L-citrulline and cardiovascular diseases. Literatures comprised of medical textbooks, recent research papers, and journals of medical reviews. Literature selection consisted of key words matching, abstract skimming, information summarizing. The selected literatures were then organized into a review. Available search terms were key words stated in the first section of review with further expansion.
Results : From numerous literature browsing, L-citrulline showed potential therapeutics in treating and preventing CVDs. This compound, found mostly in Citrus sp., contains chemical traits that could affect other bodily substances with its own metabolic pathways. It possesses vast pharmacological capabilities, but boosting nitric oxide (NO) production via endothelial nitric oxide synthase (eNOS) pathway is the dominant one in cardiovascular system. By enhancing NO bioavailability, it suppresses the risk of oxidative stress in myocardial tissue due to ischemia, hypoxia, cardiac pressure-overload, and post-infarct reperfusion. Sufficient amount of plasma NO would diminish the formation of peroxynitrite since it is a substantial byproduct of uncoupled eNOS during cardiac muscle tissue oxidative stress. L-citrulline also has the ability treat pulmonary hypertension via vasodilation without significantly reducing systemic arterial pressure.
Conclusion : Understanding of L-citrulline effects on eNOS pathway in generation of NO and its uncoupling mechanisms could be used as a foundation in developing alternative treatment and prevention of oxidative stress induced CVD.
