Plasma nitrite and Nitrate levels as a noninvasive marker of pathology after human small bowel transplantation

Yimin Sun, Zhen Zhu, Alan Norman Langnas, Wendy J. Grant, Jean F. Botha, Yong Zhao, Debra L. Sudan, David F Mercer

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Introduction: Small bowel transplantation provides a potentially life-saving treatment of severe intestinal failure. Lack of a noninvasive marker of disease makes diagnosis of rejection dependent on frequent endoscopy and biopsy. We hypothesized that increased plasma nitrite and nitrate (NOx) levels measured after small bowel transplant would be associated with abnormal final pathology. Methods: We measured total plasma NOx levels (the stable end products of the l-arginine/nitric oxide biosynthetic pathway) in 120 prospectively collected samples taken from 27 patients after small bowel transplantation. We used immunohistochemistry to detect inducible nitric oxide synthetase expression in 19 tissue biopsies from 9 patients. Results: We found NOx concentrations to be statistically different between pathologic categories (e.g., normal, mild, moderate, and severe rejections, nonspecific enteritis), although there was sufficient overlap to prompt caution clinically. After establishing from the dataset a "normal" plasma NOx level of 50 μM, we found that combined assessment of plasma NOx levels and clinical suspicion of pathology could accurately predict which patients were histologically normal and those requiring further evaluation with endoscopy and biopsy. Conclusions: We conclude that serum NOx levels are significantly associated with small bowel pathology after transplant, although not specifically enough with rejection to be relied on for clinical discrimination.

Original languageEnglish (US)
Pages (from-to)307-311
Number of pages5
JournalTransplantation
Volume89
Issue number3
DOIs
StatePublished - Feb 1 2010

Fingerprint

Nitrites
Nitrates
Transplantation
Pathology
Biopsy
Endoscopy
Transplants
Clinical Pathology
Enteritis
Biosynthetic Pathways
Nitric Oxide Synthase
Arginine
Nitric Oxide
Immunohistochemistry
Serum
Therapeutics

Keywords

  • Nitric oxide
  • Noninvasive markers
  • Rejection
  • Small bowel transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Plasma nitrite and Nitrate levels as a noninvasive marker of pathology after human small bowel transplantation. / Sun, Yimin; Zhu, Zhen; Langnas, Alan Norman; Grant, Wendy J.; Botha, Jean F.; Zhao, Yong; Sudan, Debra L.; Mercer, David F.

In: Transplantation, Vol. 89, No. 3, 01.02.2010, p. 307-311.

Research output: Contribution to journalArticle

Sun, Yimin ; Zhu, Zhen ; Langnas, Alan Norman ; Grant, Wendy J. ; Botha, Jean F. ; Zhao, Yong ; Sudan, Debra L. ; Mercer, David F. / Plasma nitrite and Nitrate levels as a noninvasive marker of pathology after human small bowel transplantation. In: Transplantation. 2010 ; Vol. 89, No. 3. pp. 307-311.
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