Monocyte production of nitric oxide (NO) in severe acute pancreatitis

To clarify the correlation between the kinetics of nitric oxide (NO) production and the occurrence of organ dysfunction in acute pancreatitis, we examined the production of NO₂ and NO₃ by monocytes in five patients with severe pancreatitis and organ dysfunction (four males and one female, aged 24–52 years: group S), and compared the results with those in five patients with mild pancreatitis (three males and two females, aged 24–52 years: group M) and 12 healthy volunteers (9 males and three females, aged 25–44: group C). The time course of induced NO production by cultured monocytes obtained from these subjects was also examined, using a NO-sensitive electrode. The levels of NO₂ and NO₃ production by monocytes in vitro, with or without stimulation, were significantly higher (P<0.05), the time required for NO production by cultured monocytes was significantly shorter (P<0.01), and the duration of NO production by monocytes was significantly longer (P<0.01), in group S compared with the other groups. These findings indicate that, in patients with severe acute pancreatitis, the NO-producing mechanism of monocytes is not only primed but also triggered. Further-more, it seems that NO production by monocytes is directly correlated with the incidence of organ dysfunction.