Serum nitric oxide metabolites and disease activity in patients with systemic sclerosis.
There is no surrogate marker in serum for defining disease activity in scleroderma (SSc). Nitric oxide (NO), which regulates vasodilation and possesses pro-inflammatory actions, has been implicated in the pathogenesis of SSc. We compared serum NO(x) (total nitrate and nitrite) level in SSc patients to healthy controls and evaluated its correlation with detailed symptomatology and scoring systems for various organ involvement. Symptoms and physical findings that suggested disease activity in regard to various organs were documented. Lung function test, high-resolution computed tomographic (HRCT) scan of thorax and echocardiography were performed. Serum NO(x) was measured by chemiluminescence. Serum NO(x) levels in SSc (n = 43) were significantly higher (72.4 +/- 47.8 microM) than age- and sex-matched controls (n = 41; 37.1 +/- 13.5 microM; p < 0.001). Serum NO(x) were not found to be associated with lung fibrosis defined by lung function parameters or inflammation and fibrosis scores on HRCT. Twenty-two patients were found to have elevated serum NO(x) level defined as mean +/- 2 SD of normal controls. Logistic regression analysis revealed that age (OR 1.12, p = 0.02) and elevated pulmonary arterial pressure (PAP) (n = 9; OR 145.3, p = 0.01) were predictive factors for elevated serum NO(x). Prednisolone use was associated with lower serum NO(x) level (OR 0.06, p = 0.04). Elevated PAP of increasing severity was found to be associated with higher level of serum NO(x) (p = 0.004 by trend). Serum NO(x) in SSc patients were elevated compared to healthy controls. Serum NO(x) level was determined by multiple factors including age, prednisolone use, and elevated PAP.
Mok
Mo Yin
MY
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong. mymok@netvigator.com
Fung
Peter Chin Wah
PC
Ooi
Clara
C
Tse
Hung Fat
HF
Wong
Yik
Y
Lam
Yui Ming
YM
Wong
Woon Sing
WS
Lau
Chak Sing
CS
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood* / Q000276:immunology / Q000378:metabolism; D011239:Prednisolone / Q000494:pharmacology; D012595:Scleroderma, Systemic / Q000097:blood* / Q000188:drug therapy / Q000276:immunology; D012720:Severity of Illness Index
D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D009569:Nitric Oxide; D011239:Prednisolone
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