title: Nitric oxide-derived species in synovial fluid from patients with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To evaluate superoxide anion (O2-), nitrite/nitrate (NO2-/NO3-), and nitrotyrosine (NT) production and the contribution of myeloperoxidase (MPO) to the production of NT-containing proteins in the synovial fluid (SF) of patients with juvenile idiopathic arthritis (JIA). The affected tissues in inflammatory arthritis produce large amounts of nitric oxide (NO) or peroxynitrite (ONOO-) but there are no reports of NO or ONOO- participation in JIA. We also attempted to correlate our findings with variables of disease activity and articular damage.
  
  
  METHODS
  We analyzed 40 patients with JIA, mean age 12.7 years, mean disease duration 7.8 years. O2- production was measured by cytochrome C reduction after incubation of 106 synovial fluid (SF) cells with or without phorbol myristate acetate (PMA), formyl-methionyl-leucyl-phenylalanine (FMLP) or opsonized zymosan. SF and serum NO2-/NO3- levels were measured by Griess reaction; NT was detected by Western blot. Myeloperoxidase (MPO) activity was estimated spectrophotometrically. Clinical and laboratory variables [erythrocyte sedimentation rate, C reactive protein (CRP), and radiological score] and interleukin 6 (IL-6) levels were evaluated.
  
  
  RESULTS
  NO2-/NO3- production was greatly enhanced in the joints of JIA patients (54.6 +/- 3.2 micro M) when compared with serum (13.9 +/- 0.6 micro M; p < 0.001). NO2-/NO3- levels in SF were positively correlated with the number of infiltrating lymphomononuclear cells. NT-modified proteins detected in the SF showed a high correlation with radiological score, disease duration, CRP, and IL-6.
  
  
  CONCLUSIONS
  Our results confirm the increased oxidative stress in children with JIA, suggesting a high in situ production of NO. The positive correlation between the expression of NT-modified proteins and variables of disease activity and damage is additional evidence that nitrogen and oxygen species may be involved in the joint destruction seen in patients with JIA.
authors.affiliation: Paediatric Division, Department of Internal Medicine, School of Medicine, Institute of Biomedical Sciences, University of São Paulo, Brazil.
authors.forename: Ana Paola N
authors.initials: AP
authors.lastname: Lotito
authors.forename: Marcelo N
authors.initials: MN
authors.lastname: Muscará
authors.forename: Maria Helena B
authors.initials: MH
authors.lastname: Kiss
authors.forename: Simone A
authors.initials: SA
authors.lastname: Teixeira
authors.forename: Gilberto S
authors.initials: GS
authors.lastname: Novaes
authors.forename: Ieda Maria M
authors.initials: IM
authors.lastname: Laurindo
authors.forename: Clovis A
authors.initials: CA
authors.lastname: Silva
authors.forename: Suzana Beatriz V
authors.initials: SB
authors.lastname: Mello
mesh_terms: D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000473:pathology; D008262:Macrophage Activation / Q000276:immunology; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D009195:Peroxidase / Q000378:metabolism; D026361:Reactive Nitrogen Species / Q000378:metabolism*; D013481:Superoxides / Q000378:metabolism; D013582:Synovial Fluid / Q000166:cytology / Q000378:metabolism*; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000378:metabolism
chemical_list: D026361:Reactive Nitrogen Species; D013481:Superoxides; D009569:Nitric Oxide; C002744:3-nitrotyrosine; D014443:Tyrosine; D009195:Peroxidase