Skip to main content
SpringerLink
Log in

Low Plasma Nitrite in Infantile Hypertrophic Pyloric Stenosis Patients

  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

There is now substantial evidence that reduced expression of neuronal nitric oxide synthase (nNOS) is implicated in the pathogenesis of infantile hypertrophic pyloric stenosis (IHPS). This study aimed to investigate the role of plasma nitric oxide (NO) in patients with IHPS. Blood and pylorous biopsies of 13 IHPS patients were examined. The control group consisted of 19 age-matched healthy infants and 22 age-matched acute gastroenteritis patients. Plasma nitrite (NO2 –) and nitrate (NO3 –) levels were detected with an NO analyzer. Pylorus biopsies of 13 IHPS patients were examined for nitric oxide synthase isoform expression. Plasma nitrite levels in the 13 IHPS patients were significantly lower than in the age-matched healthy controls (0.97 ± 0.19 vs. 3.53 ± 0.79μ M; P < 0.001) and the acute gastroenteritis controls (0.97 ± 0.19 vs.1.39 ± 0.45μ M; P = 0.006). Decreased expression of nNOS in the nerve fibers of the pylorus circular muscle was found in the 13 IHPS patients. The decreased plasma nitrite levels rose to the normal range (3.27 ± 0.77 M) after pyloromyotomy. There was no significant correlation between plasma nitrite levels and muscle wall thickness in IHPS patients. We conclude that NO is implicated in the occurrence of IHPS and the plasma nitrite level is valuable for the diagnosis of IHPS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hernanz-Schulman M: Infantile hypertrophic pyloric stenosis. Radiology 227:319–331, 2003

    PubMed  Google Scholar 

  2. Bell MJ: Infantile pyloric stenosis: experience with 305 cases at Louisville Children’s Hospital. Surgery 64:983–989, 1968

    Google Scholar 

  3. Rendle-Short J, Zachary RB: Congenital pyloric stenosis in older babies. Arch Dis Child 30:70–71, 1955

    Article  PubMed  CAS  Google Scholar 

  4. Hulka F, Campbell TJ: Evolution in the recognition of infantile hypertrophic pyloric stenosis. Pediatrics 100:e9–e13, 1997

    Article  PubMed  CAS  Google Scholar 

  5. Li CG, Rand MJ: Nitric oxide and vasoactive intestinal polypeptide mediate nonadrenergic noncholinergic inhibitory transmission to smooth muscle of the rat gastric fundus. Eur J Pharmacol 191:303–309, 1990

    Article  PubMed  CAS  Google Scholar 

  6. Bayguinoy O, Sanders KM: Role of nitric oxide as an inhibitory neurotransmitter in the canine pyloric sphincter. Am J Physiol 264:G975–G983, 1993

    Google Scholar 

  7. Nathan C, Xie QW: Regulation of biosynthesis of nitric oxide. J Biol Chem 269:13725–13728, 1994

    PubMed  CAS  Google Scholar 

  8. Marsden PA, Schappert KT, Chen HS, Flowers M, Sundell CL, Wilcon JN: Molecular cloning and characterization of human endothelial nitric oxide synthase. FEBS 307:287–293, 1992

    Article  CAS  Google Scholar 

  9. Kusafuka T, Puri P: Altered messenger RNA expression of the neuronal nitric oxide synthase gene in infantile hypertrophic pyloric stenosis. Pediatr Surg Int 12:576–579, 1997

    PubMed  CAS  Google Scholar 

  10. Huang PL, Dawson TM, Bredt DS, Snyder SH, Fishman MC: Targeted disruption of the neuronal nitric oxide synthase gene. Cell 75:1273–1286, 1993

    Article  PubMed  CAS  Google Scholar 

  11. Mearin F, Mourelle M, Guarner F, Salas A, Rivero-Moreno A, Moncada S: Patients with achalasia lack nitric oxide synthase in the gastro-esophageal junction. Eur J Clin Invest 23:724–728, 1993

    Article  PubMed  CAS  Google Scholar 

  12. Vanderwinden JM, Mailleux P, Schiffmann SN, Vanderhaeghien JJ, De Laet MH: Nitric oxide synthase activity in infantile hypertrophic pyloric stenosis. N Engl J Med 327:511–515, 1992

    Article  PubMed  CAS  Google Scholar 

  13. Wang FS, Wang CJ, Sheen-Chen SM, Kuo YR, Chen RF, Yang KD: Superoxide mediates shock wave induction of ERK-dependent osteogenic transcription factor (CBFA1) and mesenchymal cell differentiation toward osteoprogenitors. J Biol Chem 277:10931–10937, 2002

    Article  PubMed  CAS  Google Scholar 

  14. Desai KM, Sessa WC, Vane JR: Involvement of nitric oxide in the reflex relaxation of stomach to accommodation to food or fluid. Nature 351:477–479, 1991

    Article  PubMed  CAS  Google Scholar 

  15. Saur D, Vanderwinden JM, Seidler B, Schmid RM, De Laet MH, Allescher HD: Single-nucleotide promoter polymorphism alter transcription of neuronal nitric oxide synthase exon 1c in infantile hypertrophic pyloric stenosis. Proc Natl Acad Sci USA 101:662–667, 2004

    Article  CAS  Google Scholar 

  16. Abel RM, Bishop AE, Dore CJ, Spitz L, Polak JM: A quantitative study of the morphological and histochemical changes within the nerves and muscle in infantile hypertrophic pyloric stenosis. J Pediatr Surg 33:682–687, 1998

    Article  PubMed  CAS  Google Scholar 

  17. Torres J, Sharpe M, Rosquist A, Cooper CE, Wilson MT: Cytochrome c oxidase rapidly metabolizes nitric acid to nitrite. FEBS Lett 475:263–266, 2000

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Li-Tung Huang MD & Mao-Meng Tiao MD (Dr.)

  2. Departments of Pediatric Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Shin-Yee Lee MD & Chih-Sung Hsieh MD

  3. Departments of Pathology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan

    Jui-Wei Lin MD

Authors
  1. Li-Tung Huang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mao-Meng Tiao MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shin-Yee Lee MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chih-Sung Hsieh MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jui-Wei Lin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mao-Meng Tiao MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Huang, LT., Tiao, MM., Lee, SY. et al. Low Plasma Nitrite in Infantile Hypertrophic Pyloric Stenosis Patients. Dig Dis Sci 51, 869–872 (2006). https://doi.org/10.1007/s10620-006-9341-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-006-9341-8

Key Words

Search

Navigation