Nitric oxide metabolites, nitrative stress, and paraoxonase activity in hepatopulmonary syndrome

Paul R J Ames, Marianna Guardascione, Joana R. Batuca, Alessia Arcaro, Fabrizio Gentile, Lucio Amitrano

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7 Citations (Scopus)


Aim. To investigate possible abnormalities of vasoactive compounds, nitrative stress, and antioxidant activity of paraoxonase (PONa) in human hepatopulmonary syndrome (HPS), we determined endothelin-1 (ET), nitric oxide (NOx) metabolites, PONa alongside crude plasma nitrotyrosine (NT) as surrogate marker of nitrative stress. Material and methods. Liver cirrhosis (LC) patients with HPS (n = 12) were matched by age, sex, and Child-Pugh score to LC patients without HPS (n = 15) and to healthy controls (CTR) (n = 15); plasma NO2 - (nitrite) (vascular metabolite), NO3 - (nitrate) (inflammatory metabolite), and PONa were determined by a colorimetric assay, ET, and NT by immunoassays. Results. HPS patients showed higher level of ET (p = 0.0002), NO2 - (p = 0.002), NO3 - (p = 0.0001), NT (p <0.0001), and lower PONa (p = 0.0004) than CTR; post-hoc analysis revealed greater ET (p <0.05) and NO3 - (p <0.005) in LC patients with HPS than in LC patients without HPS. NT correlated to Child-Pugh score within HPS (p = 0.04) and LC (p = 0.02). Conclusion. Our HPS patients are characterized by elevated plasma levels of ET and NOx metabolites and lower PONa. Reduced PONa alongside elevated NO3 - and NT suggests that defective antioxidation may favor nitrative stress and both may be implicated in the pathogenesis of HPS.

Original languageEnglish
Pages (from-to)73-77
Number of pages5
JournalScandinavian Journal of Gastroenterology
Issue number1
Publication statusPublished - 2 Jan 2016


  • hepatopulmonary syndrome
  • nitrative stress
  • paraoxonase


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