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Excess nitric oxide in ulcerative colitis may be generated by nitric oxide synthase independent pathways
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Editor,—Kimura et al(Gut1998;42:180–7) provide further data in support of the proposal that production of nitric oxide (NO) in ulcerative colitis (UC) is ascribable primarily to the action of inducible NO synthase (NOS) on l-arginine.1-3
This reaction relies on molecular oxygen as a substrate (fig1).4 However, the Po 2 of gas in the normal colon is low (sometimes only 1–2 mm Hg), not only as a result of bacterial utilisation of oxygen, but also reflecting mucosal hypoxia as a result of cellular metabolism and counter current diffusion of oxygen between mucosal capillaries.5 In active UC, mucosal ischaemia and conversion of oxygen to reactive oxygen …