ABSTRACT
Recent studies point to the potential importance of nitric oxide [NO] in the modulation of sinusoidal blood flow and in the pathogenesis of portal hypertension [PH] So, the aim of the work is to compare the serum level of NO and tumor necrosis factor [TNF] in patients with chronic liver disease [bilharzial hepatic fibrosis [BHF] and liver cirrhosis],normal control and septicaemic, patients. Septicaemic patients were considered as a reference value since they had the highest value of endotoxaemia. This study included 39 patients subdivided into 3 groups. Group I, included 9 patients with BHF, group II, included included 10 immunocompromised patients with septicaemia. In addition, 10 healthy controls of matched age and sex were also included and considered a control group. All patients and controls in this study were subjected to thorough history taking, clinical examination, complete blood picture, hepatic and renal function tests, abdominal ultrasound, TNF [assay by ELISA and NO assay indirectly by assessment of its stable degradation products nitrite and nitrate. The levels of NO and TNF [were statistically significantly elevated in septicaemic patients when compared with their levels in patients having BHF, liver cirrhosis and normal controls. NO had a protective rather than damaging effect on the liver. Care had to be paid with the use of drugs that cause intestinal decontamination and eventually decrease endotoxaemia and prevent the induction of vascular NO synthase