title: Urinary nitric oxide levels are increased and correlated with plasma concentrations in patients with Behçet's disease: is it a new urinary activity marker?
abstract: Nitric oxide (NO) is a free radical and serves many functions within the kidney. Excess NO causes glomerular injury. Behçet's disease (BD) is a systemic immunoinflammatory vasculitis, affecting every organ in the body including the kidneys (subclinic glomerulonephritis). We investigated the role of urinary total nitrite levels (end product of NO) in BD and evaluated whether urinary concentrations were correlated with its plasma levels or disease activity. Thirty-six consecutive Behçet's patients (19 men, 17 women; 35.9 years), and 20 age- and sex-matched healthy control volunteers (12 men, eight women; 33.2 years) were divided into an active (n = 16) and inactive (n = 20) period. Urinary and serum NO levels ( micromol/mg urinary creatinine) were higher in BD patients (4.1 +/- 0.3) than control subjects (1.7 +/- 0.2; P < 0.001). Serum NO levels in Behçet's patients and control subjects were 51.3 +/- 9.8 and 21.7 +/- 7.3 micromol/L, respectively (P < 0.001). Active patients had higher urinary NO excretion (4.9 +/- 0.3) than inactive patients (3.3 +/- 0.3; P < 0.01). Urinary NO levels were correlated with its serum levels (r2 = 0.69, P < 0.001). Higher urinary NO levels found in BD may be produced by the kidney as a result of an inflammatory stimulation. As excess NO is toxic to the tissues, increased NO levels may play a role in mediating subclinic glomerular injury of such patients. However, we could not determine the exact site(s) of NO synthesis by the kidney, such as the glomeruli, blood vessels and/or the tubular cells. Whatever the source, urinary NO levels may be used as a new activity marker in the diagnosis and follow up of BD by serial measurements.
authors.affiliation: Department of Ophthalmology, Erciyes University Medical Faculty, Kayseri, Turkey. evereklioglu@hotmail.com
authors.forename: Cem
authors.initials: C
authors.lastname: Evereklioglu
authors.forename: Emin
authors.initials: E
authors.lastname: Ozbek
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cekmen
authors.forename: Nihayet
authors.initials: N
authors.lastname: Mehmet
authors.forename: Fuat
authors.initials: F
authors.lastname: Duygulu
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ozkiris
authors.forename: Mustafa
authors.initials: M
authors.lastname: Calip
authors.forename: Hamdi
authors.initials: H
authors.lastname: Er
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Turkoz
mesh_terms: D000328:Adult; D001528:Behcet Syndrome / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001806:Blood Urea Nitrogen; D016022:Case-Control Studies; D003404:Creatinine / Q000097:blood; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood* / Q000652:urine*; D009573:Nitrites / Q000097:blood / Q000652:urine; D011237:Predictive Value of Tests; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D009573:Nitrites; D009569:Nitric Oxide; D003404:Creatinine