Increased luminal nitric oxide concentrations in the small intestine of patients with coeliac disease

Background Inflammation is known to be associated with enhanced nitric oxid e production. A role for nitric oxide in coeliac disease has been suggested because of increased expression of the inducible isoform of nitric oxide s ynthase in the small intestine of patients with untreated coeliac disease. Design During small bowel endoscopy in 11 control subjects, 10 patients wit h untreated coeliac disease and seven patients with treated coeliac disease , gas was aspirated from different parts of the upper gastrointestinal trac t and immediately analysed using a chemiluminescence technique. Luminal nit ric oxide concentrations were also quantified in 13 control subjects who ha d undergone colonoscopy. Results Jejunal luminal nitric oxide concentrations were more than 20 times higher in patients with coeliac disease than in normal control subjects (m ean 755 +/- 173 ppb, range 215-1690 ppb, vs. mean 31 +/- 9 ppb, range 1-83 ppb, P < 0.001). Jejunal luminal nitric oxide levels in patients with treat ed coeliac disease (mean 54 +/- 18 ppb, range 3-126 ppb) did not differ fro m those of control subjects. Conclusions This study shows that intraluminal jejunal nitric oxide concent rations are significantly increased in patients with untreated active coeli ac disease.