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Rheumatology Advance Access originally published online on October 11, 2005
Rheumatology 2006 45(3):314-320; doi:10.1093/rheumatology/kei151
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© The Author 2005. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Levels of F2-isoprostanes in systemic sclerosis: correlation with clinical features

A. Volpe, D. Biasi, P. Caramaschi, W. Mantovani1, L. M. Bambara, S. Canestrini, M. Ferrari2, G. Poli3, M. Degan2, A. Carletto, S. Pieropan and P. Minuz2

Dipartimento di Medicina Clinica e Sperimentale, 1 Dipartimento di Medicina e Sanità Pubblica, 2 Dipartimento di Scienze Biomediche e Chirurgiche and 3 Dipartimento di Scienze Morfologico-Biomediche, Universita di Verona, Verona, Italy.

Correspondence to: P. Caramaschi, Dipartimento di Medicina Clinica e Sperimentale, Policlinico G.B. Rossi, P. le Scuro, 37134 Verona, Italy. E-mail: paola.caramaschi{at}azosp.vr.it

Objective. Oxidative stress may be one of the important complex pathogenetic mechanisms that lead to damage in scleroderma; free radicals may provoke endothelial injury, fibroblast proliferation and fragmentation of autoantigens favouring induction of autoantibodies. The present study investigates the oxidant status in scleroderma patients by measuring the urinary concentration of 8-isoprostaglandin-F2{alpha}, an F2-isoprostane, and a product of free radical-mediated peroxidation of arachidonic acid.

Methods. Forty-three scleroderma patients (42 women and 1 man, mean age 54.1 yr, mean disease duration 9.0 yr) underwent clinical evaluation and instrumental investigations in order to assess skin, vascular, lung and heart involvement. Von Willebrand factor was evaluated as marker of vascular dysfunction in 36 out of the 43 cases. The urinary level of 8-isoprostaglandin-F2{alpha} was measured in all scleroderma patients and in the 43 age- and sex-matched healthy controls.

Results. Urinary levels of 8-isoprostaglandin-F2{alpha} were higher in scleroderma patients than in the healthy control group (341.7 vs 147.6 pg/mg creatinine; P<0.001). Values of 8-isoprostaglandin-F2{alpha} were strongly correlated with the nailfold videocapillaroscopy pattern and lung involvement (P=0.002 and 0.003, respectively), showing increasing levels with the progression of pulmonary severity. Correlation between 8-isoprostaglandin-F2{alpha} level and von Willebrand factor narrowly failed to reach statistical significance (P=0.05). There was no correlation between 8-isoprostaglandin-F2{alpha} concentration and disease activity, vascular, skin and heart involvement, disease pattern or autoantibody profile.

Conclusions. Our study further supports the role of oxidant stress in the pathogenesis of scleroderma, showing a strong correlation between a marker of free radical damage with both the severity of lung involvement and the videocapillaroscopic patterns.

KEY WORDS: Systemic sclerosis, Oxidative stress, F2-isoprostanes


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