Supplementation

Based on its pluripotent functions, arginine has been widely used in supplemental nutrition for surgical patients, patients with burns, and patients with sepsis and cancer in order to modify the inflammatory response, to enhance organ perfusion, and to stimulate wound healing. However, the benefits of argi-nine supplementation in these conditions are not uniformly proven and accepted. Moreover, arginine is never given alone but is always provided in a mixture of amino acids and other nutrients. The use of NO donors that have vasodilatory actions is an established therapeutic modality in coronary artery disease and for erectile dysfunction. Given this fact it remains worthwhile to clarify the need for arginine supplementation as the natural substrate for NO synthesis in other conditions.

Using citrulline as an arginine-delivering substrate has been suggested, but has not been applied clinically. Ornithine is supplied as part of the ornithine-a-ketoglutarate molecule (see glutamine). Creatine is widely used by professional and recreational athletes as a nutritional supplement, although the ascribed performance-enhancing effects have not been proven.

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