Abstract
NO production catalyzed by INOS (inducible NO synthase) is thought to take place mainly in macrophages after activation by inflammatory mediators. In the body NO is oxidized to nitrite and nitrate which is excreted in the urine. The concentration of inflammatory mediators in small bowel biopsy specimens in coeliac disease is increased. The latter could induce increase NO production by stimulation of intestinal macrophage INOS, resulting in high levels of urinary NO oxidation products, nitrite and nitrate (NOx). The aim of the present study was to evaluate the urinary NOx/creatinine ratios in children with active coeliac disease (n=12), in healthy control children (n=11) and in sick control children (n=18). The griess reagent method was used for the measurement of urinary NOx. Mean and standard deviation for the NOx/creatinine ratios in coeliac disease patients was 2,01 ± 1,37 (range 0,57-5,11). These values were 0,11 ± 0,07 (range 0,03-0,25) for the healthy control children and 0,20 ± 0,20 (range 0,03-0,71) for the sick control patients. Values for coeliac disease patients were significantly different from those of both healthy controls (p<0.0001) and sick controls(p<0.0001). All active coeliac disease patients showed increased NOx/creatinine ratios. We conclude that urinary NOx/creatinine ratios could be used as an indicator of mucosal immune activation in coeliac disease patients.
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