Long-lasting NO overproduction in cirrhotic patients with spontaneous bacterial peritonitis

Abstract

Nitric oxide production was studied in cirrhotic patients with spontaneous bacterial peritonitis (SBP) or with other infections. We followed up on the time course of serum nitrate levels in 51 hospitalized patients aged between 34 and 81 years. Four groups were defined: patients with SBP (group 1, n = 14), patients with bacteremia (group 2, n = 11), patients with urinary tract infection (group 3, n = 11) and patients in a stable clinical condition (group 4, n = 20). The four groups did not differ in terms of Pugh score (11 ± 1, 10 ± 1, 11 ± 1, and 10 ± 1, respectively). Serum nitrate levels averaged 31 ± 2 μmol/L in group 4 (84 samples). On the day results of cytobacteriological examination were positive, mean serum nitrate levels were 75 ± 17, 63 ± 9, and 36 ± 9 μmol/L, respectively, in groups 1 (17 cases), 2 (11 cases), and 3 (11 cases) (P < .001 and < .001). Our data indicate that SBP in cirrhotic patients led to a long- lasting increased local production of NO. This overproduction may contribute to maintaining splanchnic vasodilation and thus worsen the hyperkinetic state in these patients.