July- August, 2014/ Vol 2/ Issue 4 ISSN 2321-127X Research Article International Journal of Medical Research and Review Available online at: www.ijmrr.in 324 | Page Evaluation of Arginase and Nitric oxide levels in Sepsis Mulgund SR 1 , Abhang SA 2 1 Mrs Shruti R Mulgund, Lecturer, Department of Biochemistry, Sinhgad Dental College & hospital, Pune, Maharashtra 2 Dr Subodhini A Abhang, Associate Proffessor, Department of Biochemistry, B J G Medical College, Pune, Maharashtra Address for correspondence: Mrs Shruti Mulgund, Email: shruti.mulgund@gmail.com …………………………………………………………………………………………………………………………….. Abstract Introduction: Sepsis is one of the challenges for the doctors who treat critically ill patients. Delay in diagnosis and late administration of antibiotics have been shown to increase mortality in this cohort. In the present study CRP is used as a traditional marker of an acute inflammatory state and infection. In last couple of years use of Arginase as immune marker has increased enormously. An interplay between Arginase and Nitric oxide has also been reported in immune cells including macrophages, lymphocytes etc. due to limited availability of Arginine in sepsis. Keeping all these facts in mind, present study was designed. Aims and Objectives: To find out the diagnostic role of Arginase and Nitric oxide in sepsis and to compare with CRP level. Material & Methods: Thirty patients admitted in MICU of Sassoon Hospital, Pune having SIRS and thirty age, sex matched healthy controls were included in this study. Intravenous blood samples were obtained and analyzed. CRP was done by kit method, Arginase activity was estimated by Roman and Ray method while NO levels were measured by Cortas & Wakid method. Results and Conclusion: The results of this study showed significant increase in the levels of CRP. Serum arginase was also increased significantly with concomitant decrease in the levels of nitric oxide when compared with healthy controls. So we can conclude from the results that nitric oxide and arginase levels along with CRP may be useful in diagnosis of sepsis. Key words: Arginase, Nitric Oxide, CRP, Sepsis ……………………………………………………………………………………………………………………………….. Introduction Sepsis is defined as the presence of the Systemic Inflammatory Response Syndrome (SIRS) and a presumed or confirmed infection. Even today, this life threatening complication of infection is associated with significant morbidity and mortality in the Intensive Care Unit (ICU), where it is the most common cause of mortality [1]. Sepsis is one of the challenges for the doctors who treat critically ill patients. Delay in diagnosis and late administration of antibiotics have been shown to increase the mortality in this cohort. Thus, the importance of infection as an inducer of a systemic inflammatory response is underlined. A variety of inflammatory mediators are released by activated blood cells, vascular cells and different parenchymal cells during sepsis [2]. On this background some inflammatory markers like C- Reactive Protein (CRP), Nitric oxide (NO) and Arginase were studied. CRP is used as a marker of an acute inflammatory state and infection. Inspite of being a traditional marker of Manuscript received: 1 st June 2014 Reviewed: 10 th June 2014 Author Corrected: 23 rd June 2014 Accepted for Publication: 26 th June 2014 sepsis it is not specific enough for clinicians to give their clinical judgment. In past decade lot of research on NO is being carried out. NO is believed to play a key role in the pathogenesis of sepsis, although many aspects of involvement of NO remain poorly defined [1]. NO has profound biological effects in the cardiovascular, nervous and immune system and derangements in NO homeostasis have been found in many pathological conditions. NO is a highly reactive molecule and is synthesized from L-Arginine by the enzyme Nitric Oxide Synthase (NOS). L-Arginine is a common substrate for two enzymes viz; NOS and Arginase. Use of Arginase as an immune marker has also increased enormously in the last couple of years. This is due to the fact that the enzyme is crucially involved in various aspects of inflammation [3]. The literature regarding Arginase both as a marker of sepsis or as a therapeutic agent is increasing and gaining importance day by day. So the present study was undertaken to see changes in levels of NO and the efficacy of Arginase activity as a marker of sepsis.