Iwashita E
National Defense Medical College, The Second Department of Internal Medicine, Tokorozawa, Saitama, Japan.
J Gastroenterol Hepatol. 1998 Apr;13(4):391-5. doi: 10.1111/j.1440-1746.1998.tb00652.x.
Although current nitric oxide (NO) electrodes are simple, selective and sensitive, they are fragile and hard to use in clinical studies of patients. By preparing an improved NO electroneedle that overcomes these defects, we directly measured mucosal NO concentrations in 11 patients (six male, five female; mean 26.0 years old) with ulcerative colitis (UC) and five normal volunteers (three male, two female; mean 28.3 years old) in situ. An electroneedle was inserted into colonic mucosa through a biopsy channel during colonoscopy. The information concerning the concentration of NO generated and the appearances of the colonic mucosa at the same site were obtained simultaneously. In the ulcerative colitis patients, NO concentrations were significantly increased at all 24 mucosal sites tested. These included sites where: there was an absence of visible inflammation (five sites); the mucosa was mildly inflamed (eight sites); the mucosa was moderately inflamed (five sites); or severely inflamed (six sites). The NO concentrations in ulcerative colitis patients were 12-72 times higher than the NO levels in normal controls (10 sites). At the same 10 sites in four ulcerative colitis patients, the high NO concentrations were decreased by 53% after glucocorticoid treatment. These data are consistent with those of previous studies utilizing different NO electrodes. Excess mucosal NO is generated from inducible NO synthase in the inflamed mucosa itself and the invading inflammatory cells. Our results suggested that mucosal NO could be a marker for the extent of inflammation and its various actions correlated with the pathogenesis, natural history and prognosis of UC. Using the NO microelectrode system reported here, the concentration of NO generated can be monitored in real-time while observing the mucosal condition at the same site during endoscopy. This novel NO electrode may contribute to understanding the role of NO in colonic mucosal inflammation.
尽管目前的一氧化氮（NO）电极简单、具有选择性且灵敏，但它们很脆弱，难以用于患者的临床研究。通过制备一种改进的NO电针来克服这些缺陷，我们直接原位测量了11例溃疡性结肠炎（UC）患者（6例男性，5例女性；平均年龄26.0岁）和5名正常志愿者（3例男性，2例女性；平均年龄28.3岁）的结肠黏膜NO浓度。在结肠镜检查期间，通过活检通道将电针插入结肠黏膜。同时获取有关同一部位产生的NO浓度以及结肠黏膜外观的信息。在溃疡性结肠炎患者中，所有24个测试的黏膜部位的NO浓度均显著升高。这些部位包括：无可见炎症的部位（5个部位）；黏膜轻度发炎的部位（8个部位）；黏膜中度发炎的部位（5个部位）；或严重发炎的部位（6个部位）。溃疡性结肠炎患者的NO浓度比正常对照组（10个部位）的NO水平高12 - 72倍。在4例溃疡性结肠炎患者的相同10个部位，糖皮质激素治疗后高NO浓度降低了53%。这些数据与先前使用不同NO电极的研究结果一致。过量的黏膜NO由发炎黏膜本身和侵入的炎症细胞中的诱导型NO合酶产生。我们的结果表明，黏膜NO可能是炎症程度的标志物，其各种作用与UC的发病机制、自然病程和预后相关。使用本文报道的NO微电极系统，可以在内窥镜检查期间实时监测产生的NO浓度，同时观察同一部位的黏膜状况。这种新型NO电极可能有助于理解NO在结肠黏膜炎症中的作用。
