Effect of a gluten‐free diet on plasma nitric oxide products in coeliac disease
Authors: Spencer, H. L.; Daniels, I.; Shortland, J.; Long, R. G.; Murray, I. A.
Source: Scandinavian Journal of Gastroenterology, Volume 39, Number 10, October 2004 , pp. 941-945(5)
Publisher: Informa Healthcare
Abstract: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 (NO x ), most marked in those ingesting gluten. The time-course of change in NO x with a gluten-free diet (GFD) and its correlation with histology and coeliac serology were studied. Methods: Fasting plasma NO x 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 NO x 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 NO x 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 NO x 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.
Document Type: Research Article
Affiliations: Dept. of Gastroenterology, Royal Cornwall Hospital, Truro, UK
Publication date: October 1, 2004