title: Evidence of free radical-mediated injury (isoprostane overproduction) in scleroderma.
abstract: OBJECTIVE
  Free radical-induced oxidative stress with consequent lipid peroxidation and resultant tissue damage has been suggested as a potential mechanism of the pathogenesis of scleroderma. However, because reliable measurement of lipid peroxidation in vivo is difficult, it has not been possible to adequately examine this hypothesis. We have previously described a series of bioactive prostaglandin F2-like compounds, termed F2-isoprostanes, produced in vivo in humans by the non-cyclooxygenase, free radical-catalyzed, peroxidation of arachidonic acid and have shown them to be a reliable measure of lipid peroxidation in vivo. In the present study, we determined whether scleroderma is associated with enhanced oxidative stress.
  
  
  METHODS
  As a measure of oxidative stress, we determined urinary concentrations of a tetranor-dicarboxylic acid metabolite of F2-isoprostanes (F2IP-M) by mass spectrometry in 8 patients with scleroderma (representing a wide spectrum of disease, including limited disease with refractory digital ulceration or pulmonary hypertension, and diffuse disease) and in 10 healthy control subjects.
  
  
  RESULTS
  F2IP-M concentrations were significantly higher in patients with scleroderma (mean +/- SEM 3.41 +/- 0.64 ng/mg of creatinine) than in healthy controls (1.22 +/- 0.14 ng/mg of creatinine) (P = 0.002). These elevations occurred in patients with limited disease and in those with diffuse disease.
  
  
  CONCLUSIONS
  The increased level of urinary F2IP-M supports the hypothesis that free radical-induced oxidative injury occurs in scleroderma and provides a biologic marker whose relationship to disease activity and disease therapy may be important. These findings may also provide a rationale for exploring whether antioxidant therapy may influence the natural course of the disease.
authors.affiliation: Vanderbilt University, Nashville, Tennessee 37232, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Stein
authors.forename: S B
authors.initials: SB
authors.lastname: Tanner
authors.forename: J A
authors.initials: JA
authors.lastname: Awad
authors.forename: L J
authors.initials: LJ
authors.lastname: Roberts
authors.forename: J D
authors.initials: JD
authors.lastname: Morrow
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000502:physiology*; D011461:Prostaglandins F, Synthetic / Q000652:urine*; D012595:Scleroderma, Systemic / Q000503:physiopathology / Q000652:urine*; D013929:Thromboxane B2 / Q000031:analogs & derivatives / Q000652:urine
chemical_list: D011461:Prostaglandins F, Synthetic; D013929:Thromboxane B2; C049235:11-dehydro-thromboxane B2