Increased alveolar nitric oxide in early systemic sclerosis

Clinical and Experimental Rheumatology

Dirk M Wuttge¹  Roger Hesselstrand¹  Agneta Scheja¹  David Aronsson¹  Leif Bjermer¹  Gracijela Bozovic¹  Ellen Tufvesson¹ 

关键词: Systemic sclerosis;    pulmonary fibrosis;    inflammation;    nitric oxide;   

DOI  :  

学科分类：医学（综合）

来源: Pacini Editore SpA

【 摘 要 】

OBJECTIVES: Assessment of inflammatory activity in interstitial lung disease of systemic sclerosis (SSc) is difficult. Nitric oxide (NO) has gained attention in the pathogenesis of SSc. The aim of the study was to investigate alveolar NO concentration (CANO) in SSc patients with short disease duration and to relate CANO to radiologic findings. METHODS: In a prospective study, 34 consecutive patients with disease duration of less than 2 years from onset of first non-Raynaud symptom and 26 healthy controls were enrolled. Exhaled NO was measured and CANO was calculated. CANO levels were related to the radiologic extent of pulmonary fibrosis measured as the extent of traction bronchiectasis within areas of ground glass opacities and reticulations. RESULTS: CANO levels were increased in patients with early SSc compared to healthy controls (3.52 (2.94–4.09) versus 2.08 (1.6–2.6); p<0.001). Both SSc patients with SSc-ILD (3.56 (3.04–4.73), p<0.001) and SSc patients without SSc-ILD (2.98 (2.68-3.98), p<0.01) had higher CANO levels compared with healthy controls (2.08 (1.6–2.6)). CANO levels did not differ between SSc patients without SSc-ILD and SSc patients with SSC-ILD. CANO levels did not correlate to the extent of pulmonary fibrosis but were associated with the extent of ground glass opacities (rs=0.37, p<0.05) and reticulations (rs=0.37, p<0.05) on HRCT. CANO levels were not correlated to lung function tests. CONCLUSIONS: In patients with early SSc, alveolar NO is increased and may precede radiological changes of SSc-ILD. CANO may therefore be a marker of early lung involvement.

【 授权许可】

Unknown