Role of nitric oxide in the pathogenesis of shigellosis and cholera in children

Abstract

Objective: Evaluate the role of nitric oxide in the pathogenesis of shigeltosis and cholera in children. Methodology: Concentrations of nitrite, a stable metabolite of nitric oxide (by Griess reaction) in urine and serum samples of 24 patients aged 1-5 years (10 shigellosis, 14 cholera) were determined. Tests were done on admission to hospital with acute diarrhoea and repeated at early convalescence after 3-7 days of specific antimicrobial therapy. Results: In children with shigellosis, urinary nitrite excretion (nM/mg creatinine) was significantly increased during acute illness compared to early convalescence, median (range): 7061 (1046-18264) vs. 4316 (2369-12428. p<0.05). Concentration of nitric oxide in serum (mmol/L) also significantly (p<0.05) increased during acute illness compared to convalescence values: 206 (159-214) vs. 104 (102-273). Similarly, in children with cholera, both urinary and serum nitrite excretions were significantly (p<0.05) elevated during acute illness compared to convalescence: 5034±1345 vs. 2178±404 (urine); 450±89 vs. 201±56 (serum). Conclusion: These results indicate that production of nitric oxide is increased both in acute shigellosis and cholera, more markedly in the former infection because of colonic inflammation. Urinary nitrite excretion can be a useful marker of severity of these infections.