Background: Inducible nitric oxide synthase is expressed in the small intestine of patients with coeliac disease. This produces increased plasma concentration of nitric oxide end products (NOx), most marked in those i...Background: Inducible nitric oxide synthase is expressed in the small intestine of patients with coeliac disease. This produces increased plasma concentration of nitric oxide end products (NOx), most marked in those ingesting gluten. The timecourse of change in NOx with a gluten free diet (GFD) and its correlation with histology and coeliac serology were studied. Methods: Fasting plasma NOx was determined by the Greiss reaction in 20 coeliac patients at diagnosis and 2, 4 and 6 months after commencing a GFD. Endomysial and gliadin antibodies were checked at the same time. Duodenal biopsies were taken at diagnosis and at 6 months, and then graded according to the Marsh classification. Results: Plasma NOx fell rapidly following the introduction of a GFD (mean before GFD 95.8 μM to 61.5 μM at 2 months), and further still by 6 months (mean=37.0 μM). Reductions at 2 and 6 months were statistically significant compared with baseline (P < 0.01 and P < 0.005, respectively: Wilcoxon signed ranks test). Plasma NOx was correlated with histological grade initially (P = 0.03: Kruskal Wallis) but not after 6 months on a GFD (P = 0.24). Coeliac serology correlated poorly with histology. Conclusions: Plasma NOx falls rapidly following GFD in coeliac disease and is related to histological grade initially. However, values vary widely between individuals, which may limit its use as a clinical tool.展开更多
文摘Background: Inducible nitric oxide synthase is expressed in the small intestine of patients with coeliac disease. This produces increased plasma concentration of nitric oxide end products (NOx), most marked in those ingesting gluten. The timecourse of change in NOx with a gluten free diet (GFD) and its correlation with histology and coeliac serology were studied. Methods: Fasting plasma NOx was determined by the Greiss reaction in 20 coeliac patients at diagnosis and 2, 4 and 6 months after commencing a GFD. Endomysial and gliadin antibodies were checked at the same time. Duodenal biopsies were taken at diagnosis and at 6 months, and then graded according to the Marsh classification. Results: Plasma NOx fell rapidly following the introduction of a GFD (mean before GFD 95.8 μM to 61.5 μM at 2 months), and further still by 6 months (mean=37.0 μM). Reductions at 2 and 6 months were statistically significant compared with baseline (P < 0.01 and P < 0.005, respectively: Wilcoxon signed ranks test). Plasma NOx was correlated with histological grade initially (P = 0.03: Kruskal Wallis) but not after 6 months on a GFD (P = 0.24). Coeliac serology correlated poorly with histology. Conclusions: Plasma NOx falls rapidly following GFD in coeliac disease and is related to histological grade initially. However, values vary widely between individuals, which may limit its use as a clinical tool.
文摘目的 探讨实验性糖尿病（diabetes mellitus,DM）大鼠肺组织晚期糖基化终末产物（advanced glycosylated endproducts,AGEs）、肺表面活性物质蛋白质A（surfactant proteins A,SP-A）的变化.方法 48只SD雄性大鼠随机分为DM组和对照组,每组24只.链脲佐菌素（streptozotocin,STZ）60mg/kg尾静脉注射制造DM模型.分别于造模成功后4、12、20周末杀检.免疫组织化学方法 观察肺组织AGEs、SP-A的变化,并进行图像分析（灰度值以0为黑,最大值为白）.结果 （1）AGEs：DM大鼠肺泡上皮细胞、支气管黏膜上皮细胞、血管内皮细胞及平滑肌细胞可见大量AGEs阳性细胞,平均灰度值低于对照组（4周93.92±7.92 vs 104.75±8.20;12周76.25±6.76 vs 93.50±7.56;20周47.63±7.96 vs 142.38±19.76;P均＜0.05）,随着DM病程的增加逐渐降低.（2）SP-A：4周DM大鼠肺泡Ⅱ型细胞、肺泡巨噬细胞、克拉拉细胞可见少量阳性细胞,12、20周可见大量SP-A阳性细胞,平均灰度值均低于对照组（12周75.63±6.70 vs 110.50±13.20;20周47.38±4.84 vs 97.25±9.87;P均＜0.01）.结论 DM大鼠随着病程的增加,出现肺泡Ⅱ型细胞的损伤,可能与AGEs的沉积有关.
