ABSTRACT
OBJECTIVES: The aim of the study was to determine serum nitric oxide (NO) metabolites and correlate them to gluten-free diet (GFD) compliance, the parameters of morphological and functional condition of the small intestine in patients with celiac disease (CD) in a long-term follow-up. PATIENTS AND METHODS: The study included 35 children (age median 8.0 years) with previously diagnosed CD, among them 15 - on a strict GFD and 20 - on a semistrict GFD. 32 patients (age median 7.5 years) with functional abdominal pain were recruited as controls. Nitrites (NO(2)), nitrates (NO(3)), total content of nitrites and nitrates (NOx) in serum were determined using the Griess reaction. CD patients underwent small intestine morphometry and absorption D-xylose test. RESULTS: Compared to the controls, the CD patients on a strict GFD had no significant differences in NO(2), NO(3), NOx content, while in patients violating GFD these parameters were significantly higher. In comparison with the patients on a strict GFD, the patients on a semistrict GFD had higher median values of NO(3) (p = 0.002) and NOx (p = 0.0000). Serum NOx correlated negatively with the height of villi (p = 0.0001), D-xylose excretion (p = 0.0063), and correlated positively with the depth of crypts (p = 0.0082) and cellular density of villi stroma (p = 0.0067). CONCLUSION: CD patients not keeping to a strict GFD have an increased level of nitric oxide metabolites in serum. NOx content is associated with morphometric parameters of the small intestine that proves the participation of NO in the pathogenesis of histological changes in CD (Tab. 3, Ref. 39).
Subject(s)
Celiac Disease/blood , Celiac Disease/diet therapy , Diet, Gluten-Free/methods , Nitric Oxide Synthase Type II/blood , Nitric Oxide/blood , Biometry , Celiac Disease/pathology , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Intestine, Small/pathology , Male , Risk AssessmentABSTRACT
AIM: The purpose of the study was to determine the characteristics of endogenous intoxication parameters, biochemical protection and reveal their interaction in children with celiac disease. MATERIALS AND METHODS: 81 children aged from 1 to 16 years with celiac disease were examined in acute and remission periods. In erythrocytes, blood serum and urine we determined low and moderate molecular weight substances (LMMWS), oligopeptides OP); in erythrocytes--the value of erythrocyte mechanical hemolysis (MH), malondialdehyde (MDA) content, the activity of glutathione reductase GR) and superoxide dismutase (SOD); in blood serum--ceruloplasmin (CP) level, alcohol dehydrogenase (ADH) activity; in erythrocytes and blood serum--glutathione transferase (GT), and calculated intoxication index (II). RESULTS: In children with celiac disease in acute and remission periods LMMWS, OP, II levels in blood were statistically significantly high, while LMMWS level in urine was low. In both periods MH activity was high (p < 0.001), and GSR (p < 0.001) and SOD (p < 0.01) levels were low. We revealed the correlation between MDA and II (r = 0.67; p = 0.006), erythrocyte LMMWS and SOD (r = -0.61; p = 0.015), erythrocyte LMMWS and ADH (r = 0.62; p = 0.006), between GT and OP in urine (r = -0.31; p = 0.026), GTand MDA (r = 0.68; p = 0.000), GT and MH (r = -0.46; p = 0.004), between MDA and CP (r = 0.57; p = 0.002) that made it possible to develop the models of dependence of the parameters in relation to each other. CONCLUSION: In celiac disease there is endogenous intoxication. The changes of the first and the second phases of biotransformation, antioxidant protection is an essential factor of the disease pathogenesis, since they have an effect on endogenous intoxication formation that should be taken into consideration in therapy.
