Severity of scleroderma lung disease is related to alveolar concentration of nitric oxide

¹ Université Paris Pierre et Marie Curie, Faculté de Médecine, Service de Médecine Interne, Hôpital Saint-Antoine, Assistance Publique Hôpitaux de Paris, 184 rue du faubourg Saint-Antoine, 75571 Paris Cedex 12
² Université Paris Descartes, Faculté de Médecine, EA 2511, Assistance Publique Hôpitaux de Paris, Service de Physiologie - Explorations Fonctionnelles, Hôpital Cochin, 27 rue du faubourg Saint-Jacques, 75679 Paris cedex 14
³ Université Paris Descartes, Faculté de Médecine, Service de Médecine Interne, Assistance Publique Hôpitaux de Paris, Hôpital Cochin, 27 rue du faubourg Saint-Jacques, 75679 Paris cedex 14

^* To whom correspondence should be addressed. E-mail: anh-tuan.dinh-xuan{at}cch.ap-hop-paris.fr.

	Abstract

Alveolar concentration of exhaled NO (CA_NO) is increased in systemic sclerosis (SSc) patients, but whether this increase is related to the severity of interstitial lung disease (ILD) in SSc has not yet been investigated.

Fifty eight SSc patients prospectively underwent pulmonary function tests (PFTs), echocardiogram, fibrosis scoring on pulmonary CT scan. Patients were subdivided into 2 groups according to the existence (or not) of ILD. Measurements of CA_NO were assessed in all SSc patients and compared with those obtained in 19 healthy volunteers. Relationships were sought between CA_NO, PFTs and CT scan fibrosis scores.

In overall, CA_NO was significantly increased in SSc patients (median, range: 6.2 ppb, 3.8-9.9) as compared with controls (2.0 ppb, 1.2-3.0; p<0.001). Among SSc patients, CA_NO was significantly higher in patients with ILD (n=33; 7.5 ppb, 5.2-11.9) as compared with patients without ILD (n=25; 4.9 ppb, 3.1-7.0 ppb; p<0.01). CA_NO was inversely related to total lung capacity (r= -0.34; p<0.01) and DLCO (r= -0.37; p<0.01) and was directly related to CT scan fibrosis scores (r=0.36; p<0.01).

Increased CA_NO could, at least in part, either reflect or contribute to the severity of lung disease and could be noninvasively used to assess the extent of ILD in SSc.

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