Creatine, guanidinoacetate and homoarginine in statin-induced myopathy

Amino Acids. 2020 Jul;52(6-7):1067-1069. doi: 10.1007/s00726-020-02865-w. Epub 2020 Jun 27.

Abstract

Our study evaluated the effect of creatine and homoarginine in AGAT- and GAMT-deficient mice after simvastatin exposure. Balestrino and Adriano suggest that guanidinoacetate might explain the difference between AGAT- and GAMT-deficient mice in simvastatin-induced myopathy. We agree with Balestrino and Adriano that our data shows that (1) creatine possesses a protective potential to ameliorate statin-induced myopathy in humans and mice and (2) homoarginine did not reveal a beneficial effect in statin-induced myopathy. Third, we agree that guanidinoacetate can be phosphorylated and partially compensate for phosphocreatine. In our study, simvastatin-induced damage showed a trend to be less pronounced in GAMT-deficient mice compared with wildtype mice. Therefore, (phospo) guanidinoacetate cannot completely explain the milder phenotype of GAMT-deficient mice, but we agree that it might contribute to ameliorate statin-induced myopathy in GAMT-deficient mice compared with AGAT-deficient mice. Finally, we agree with Balestino and Adriano that AGAT metabolites should further be evaluated as potential treatments in statin-induced myopathy.

Publication types

  • Letter

MeSH terms

  • Amidinotransferases / deficiency
  • Amino Acid Metabolism, Inborn Errors
  • Animals
  • Creatine / metabolism*
  • Creatine / pharmacology
  • Developmental Disabilities
  • Glycine / analogs & derivatives*
  • Glycine / metabolism
  • Guanidinoacetate N-Methyltransferase / deficiency
  • Homoarginine / metabolism*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Intellectual Disability
  • Mice
  • Muscular Diseases / chemically induced
  • Muscular Diseases / metabolism*
  • Phosphocreatine / metabolism
  • Speech Disorders

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Phosphocreatine
  • Homoarginine
  • Guanidinoacetate N-Methyltransferase
  • Amidinotransferases
  • glycocyamine
  • Creatine
  • Glycine

Supplementary concepts

  • Arginine-Glycine Amidinotransferase Deficiency