NITRIC OXIDE IN DEFENSE OF PERITONEAL CAVITY AGAINST MICROBIAL PATHOGENS--CAPD

一氧化氮（NO）及其代谢产物过氧亚硝酸盐（peroxinitrite）是近年来出现的一种新型的 作为激活的巨噬细胞的主要分泌产物， 多形细胞在提供防御广泛的 微生物的这些代谢产物在CAPD患者中的作用 而急性腹膜炎患者尚待阐明。从理论上讲， NO的过量产生可能对间皮细胞有害， 腹膜腔，而它的缺陷可能会强调 易感染 初步数据显示， 大多数急性细菌性腹膜炎患者NO水平升高， 生产腹膜炎的恢复与 没有一代人。我们提出了一个假设， 一氧化氮可能是防御屏障缺陷的原因， 细菌感染的持续性发生在频繁， 复发性腹膜炎这一假设将在纵向和 CAPD患者的横断面研究。亚硝酸盐的浓度，L- 精氨酸和ADMA将在慢性期间的指定时间间隔测定 治疗和腹膜炎过程中。将对数据进行分析 关于感染的频率、治疗的成功，以及 其他临床参数。我们预计， L-精氨酸代谢受损的患者-这些患者可能 受益于L-精氨酸代谢的治疗校正。

Nitric oxide (NO) and its metabolite peroxinitrite have recently emerged as principal secretory products of activated macrophages and elicited polymorphonuclear cells in providing the defense against a broad range of microorganisms. The role of these metabolic products in patients on CAPD and in those with acute peritonitis awaits elucidation. Theoretically, an excessive production of NO may be deleterious to the mesothelial cells of the peritoneal cavity., whereas its deficiency may underscore the predilection to infection. Preliminary data demonstrates that the majority of patients with acute bacterial peritonitis have increased NO production. The recovery from peritonitis is associated with the decline in NO generation. We put forward a hypothesis that deficient production of nitric oxide may be responsible for the defective defense barrier and persistence of bacterial infection which occurs in patients with frequent, recurring peritonitis. This hypothesis will be tested in longitudinal and cross-sectional studies of CAPD patients. The concentration of nitrite, L- arginine and ADMA will be determined at specified interval during chronic treatment and during the course of peritonitis. The data will be analyzed with reference to the frequency of infections, success of therapy, and other clinical parameters. We anticipate to circumscribe a subgroup of patients with impairment in L-arginine metabolism-these patients may benefit from therapeutic correction of L-arginine metabolism.