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Serum nitric oxide metabolites and disease activity in patients with systemic sclerosis

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Abstract

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 μM) than age- and sex-matched controls (n = 41; 37.1 ± 13.5 μM; 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.

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Authors and Affiliations

  1. Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong

    Mo Yin Mok, Peter Chin Wah Fung, Hung Fat Tse, Yui Ming Lam, Woon Sing Wong & Chak Sing Lau

  2. Department of Radiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong

    Clara Ooi & Yik Wong

  3. Division of Rheumatology, Queen Mary Hospital, Pokfulam Road, Hong Kong, Hong Kong

    Mo Yin Mok

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  1. Mo Yin Mok
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  2. Peter Chin Wah Fung
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Correspondence to Mo Yin Mok.

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Mok, M.Y., Fung, P.C.W., Ooi, C. et al. Serum nitric oxide metabolites and disease activity in patients with systemic sclerosis. Clin Rheumatol 27, 315–322 (2008). https://doi.org/10.1007/s10067-007-0708-9

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  • DOI: https://doi.org/10.1007/s10067-007-0708-9

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