Nitric oxide synthesis is increased in patients with systemic lupus erythematosus

Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Rheumatology International (Impact Factor: 1.52). 08/1998; 18(2):41-3. DOI: 10.1007/s002960050055
Source: PubMed


Nitric oxide (NO) is believed to have a role in the inflammatory process. NO production was measured in 26 patients with systemic lupus erythematosus (SLE) and 20 healthy volunteers, using spectrophotometrically determined serum nitrite and citrulline as surrogate markers. Both nitrite and citrulline levels were significantly higher in patients with SLE than in controls (P < 0.001). Twelve and 10 patients, respectively, with SLE had nitrite and citrulline levels that were two standard deviations higher than the mean level of controls. These patients had a significantly higher measure of disease activity (SLE Disease Activity Index). These data show that there is increased NO production in SLE and that it may serve as a marker for disease activity.

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    • "For instance, reduced NO is associated with hypertension in preeclampsia [12] and Prinzmetal's angina [13]. Elevated levels of NO have also been associated with autoimmune diseases such as rheumatoid arthritis [14], systemic lupus erythematosus [15] and multiple sclerosis [16]. High levels of NO are also related to the processes in transplant rejection [17] and in septic shock [18]. "
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    • "inhibit antioxidant enzyme function), but others merely reflect the degree of oxidative stress in the local environment. These metabolites include lipid peroxidation end products (malondialdehyde, F2-isoprostane, HNE, acrolein and Ox-LDL), oxidized proteins (protein carbonyl and protein nitrotyrosine), DNA oxidation (8-OHdG), nitric oxide and antioxidant enzymes (SOD, CAT, GPx, GR and total antioxidant capacity [17,44,45]. "
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    • "Several studies have established that the proinflammatory action of IL-17 depends considerably on its ability to induce inducible NOS (iNOS) and stimulates significant NO production in various cell types, including chondrocytes, astrocytes, fibroblasts and endothelial cells6. The possible role of NO in the pathogenesis of different systemic autoimmune disorders has also been indicated, since elevated NO levels have been shown in pSS, SLE and RA patients82829. "
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    ABSTRACT: The interleukin (IL)-17 producing T-helper cells have been linked to pathogenesis of autoimmunity and mostly investigated in rheumatoid arthritis (RA). In this study we tested the IL-17 levels, as well as the levels of nitric oxide (NO) as possible IL-17-induced product, in patients with primary Sjögren's syndrome (pSS), an intricate and complex chronic autoimmune disorder of exocrine glands. Serum IL-17 levels and nitrite concentrations determined in patients with pSS (n=30) were compared with the values obtained in patients with RA (n=10) and healthy controls (n=15). The values obtained for IL-17 in pSS patients were also associated with the patients' clinical characteristics, particularly the rheumatoid factor (RF) and total antinuclear antibodies (tANA) levels. Serum concentrations of IL-17 were significantly (P<0.01) higher in patients with pSS (12.9 ± 28.0 pg/ml) as compared to those obtained in healthy individuals (0.2 ± 0.6 pg/ml), but not as high as the values obtained for the patients with RA (34.5 ± 56.2 pg/ml). The mean IL-17 levels were significantly (P<0.05) higher in the pSS patients positive for rheumatoid factor (20.3 ± 33.3 pg/ml) than in RF-negatives (0.3 ± 0.6 pg/ml). Mean serum concentrations of IL-17 were also higher in antinuclear antibody (ANA)-positive samples (19.8 ± 33.5 pg/ml) in comparison to ANA-negative sera (1.1 ± 3.1 pg/ml) (P<0.05). The NO levels also showed elevated values in both pSS and RA patients, as compared to the healthy controls, since mean nitrite levels in patients with pSS and RA were 38.2 ± 29.2 μM and 41.7 ± 21.1 μM, respectively, while those in healthy controls were significantly lower, at 19.2 ± 10.5 μM. The findings of this study showed that there was increased IL-17 and NO production in patients with primary SS, especially if they had associated elevated rheumatoid factor and antinuclear antibody values.
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