Serum Citrulline and Ornithine: Potential Markers of Coeliac Disease Activity

Douda, Ladislav; Hyšpler, Radomír; Mžik, Martin; Vokurková, Doris; Drahošová, Marcela; Řeháček, Vít; Čermáková, Eva; Douda, Tomáš; Cyrany, Jiří; Fejfar, Tomáš; Jirkovský, Václav; Kopáčová, Marcela; Kupková, Blanka; Vašátko, Tomáš; Tachecí, Ilja; Bureš, Jan

doi:10.14712/18059694.2022.22

Acta Medica > Archive > 2022, Vol. 65 > Issue 3 > Serum Citrulline and Ornithine:…

Acta Med. 2022, 65: 75-82

https://doi.org/10.14712/18059694.2022.22

Serum Citrulline and Ornithine: Potential Markers of Coeliac Disease Activity

Ladislav Douda^a, Radomír Hyšpler^b, Martin Mžik^b, Doris Vokurková^c, Marcela Drahošová^c, Vít Řeháček^d, Eva Čermáková^e, Tomáš Douda^a, Jiří Cyrany^a, Tomáš Fejfar^a, Václav Jirkovský^a, Marcela Kopáčová^a, Blanka Kupková^a, Tomáš Vašátko^a, Ilja Tachecí^a

, Jan Bureš^f

^a2nd Department of Internal Medicine – Gastroenterology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
^bInstitute of Clinical Biochemistry and Diagnostics, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
^cDepartment of Clinical Immunology and Allergology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
^dTransfusion Department, University Hospital Hradec Králové, Czech Republic
^eDepartment of Medical Biophysic, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic
^fBiomedical Research Centre, University Hospital Hradec Králové, Hradec Králové, Czech Republic

Received October 14, 2022
Accepted December 15, 2022

Introduction: To date, there is not generally accepted and universal indicator of activity, and functional integrity of the small intestine in patients with coeliac disease. The aim of our study was to investigate whether serum concentrations of the non-essential amino acids citrulline and ornithine might have this function. Methods: We examined serum citrulline and ornithine concentrations in a subgroup of patients with proven coeliac disease and healthy controls (blood donors). Results: A total of 94 patients with coeliac disease (29 men, mean age 53 ± 18 years; 65 women, mean age 44 ± 14 years) and 35 healthy controls (blood donors) in whom coeliac disease was serologically excluded (10 men, mean age 51 ± 14 years; 25 women, mean age 46 ± 12 years) were included in the study. Significantly lower concentrations of serum ornithine were found in patients with coeliac disease (mean 65 ± 3 μmol/L; median 63 μmol/L, IQR 34 μmol/L, p < 0.001). No statistically nor clinically significant differences were found in the citrulline concentrations between the study and control group. Conclusions: Serum ornithine (but not citrulline) may be useful for assessing the functional status of the small intestine in uncomplicated coeliac disease. Further studies involving more detailed analysis of dietary and metabolic changes in patients will be needed to reach definitive conclusions.