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

Tiev, Kiet; Cabané, J.; Aubourg, F.; Kettaneh, A.; Ziani, Mohamed; Mouthon, Luc; Duong‐Quy, Sy; Fajac, Isabelle; Guillevin, L.; Dinh-Xuan, Anh Tuan

doi:10.1183/09031936.00129806

Cited by 53 publications

(46 citation statements)

References 20 publications

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“…Elevated alveolar concentrations of NO have been a consistent finding in SSc. 17,30,31 Tiev et al 30 reported median CA NO values of 7.5, 4.9, and 2.0 ppb in SSc-ILD, SSc without ILD, and healthy controls, respectively. These investigators also showed an association with subsequent decrease in pulmonary function, 33 the presence of alveolitis defined by bronchoalveolar lavage fluid cellular differential, 34 and the clinical response to cyclophosphamide therapy, 35 suggesting that CA NO reflects alveolar inflammation.…”

Section: Discussionmentioning

confidence: 99%

Exhaled Nitric Oxide in Pulmonary Arterial Hypertension Associated with Systemic Sclerosis

et al. 2016

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Abstract:The fractional exhaled concentration of nitric oxide (FE NO ) has been shown to be reduced in idiopathic pulmonary arterial hypertension (PAH) but has not been adequately studied in PAH associated with systemic sclerosis (SSc). We measured FE NO at an expiratory flow rate of 50 mL/s in 21 treatment-naive patients with SSc-associated PAH (SSc-PAH), 94 subjects with SSc without pulmonary involvement, and 84 healthy volunteers. Measurements of FE NO at additional flow rates of 100, 150, and 250 mL/s were obtained to derive the flow-independent nitric oxide exchange parameters of maximal airway flux (J′aw NO ) and steady-state alveolar concentration (CA NO ). FE NO at 50 mL/s was similar (P = 0.22) in the SSc-PAH group (19 ± 12 parts per billion [ppb]) compared with the SSc group (17 ± 12 ppb) and healthy control group (21 ± 11 ppb). No change was observed after 4 months of targeted PAH therapy in 14 SSc-PAH group patients (P = 0.9). J′aw NO was modestly reduced in SSc group subjects without lung disease (1.2 ± 0.5 nl/s) compared with healthy controls (1.64 ± 0.9; P < 0.05) but was similar to that in the SSc-PAH group. CA NO was elevated in individuals with SSc-PAH (4.8 ± 2.6 ppb) compared with controls with SSc (3.3 ± 1.4 ppb) and healthy subjects (2.6 ± 1.5 ppb; P < 0.001 for both). However, after adjustment for the diffusing capacity of CO, there was no significant difference in CA NO between individuals with SSc-PAH and controls with SSc. We conclude that FE NO is not useful for the diagnosis of PAH in SSc. Increased alveolar nitric oxide in SSc-PAH likely represents impaired diffusion into pulmonary capillary blood.

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Section: Discussionmentioning

confidence: 99%

Exhaled Nitric Oxide in Pulmonary Arterial Hypertension Associated with Systemic Sclerosis

et al. 2016

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“…Currently, several biological markers, such as neutrophilic alveolitis surfactant A and D [14], or cytokines, such as tumour necrosis factor-a [15], and chemokines, such as interleukin-8 [16] and CCL2 [16][17][18], and alveolar concentration of nitric oxide [19,20], have been shown to be associated with the severity of ILD in SSc. Nevertheless, for each biomarker, long-term follow-up studies showing relevant prognostic value for progression are lacking.…”

Section: Discussionmentioning

confidence: 99%

Serum CC chemokine ligand-18 predicts lung disease worsening in systemic sclerosis

Tiev¹,

Hua-Huy²,

Kettaneh³

et al. 2011

Eur Respir J

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Elevated serum CC chemokine ligand (CCL)18 reflects lung fibrosis activity in systemic sclerosis (SSc) and could be an early marker of lung function worsening. Therefore, we sought to evaluate whether serum CCL18 levels at baseline could predict worsening of lung disease in SSc.In this prospective study, 83 SSc patients were analysed longitudinally over a 4-yr observation period for the risk of occurrence of combined deleterious events, defined as a 10% decrease from baseline of total lung capacity or forced vital capacity % predicted, or death, according to serum CCL18 at inclusion. Receiver operating characteristic (ROC) curve analysis was performed for prediction of events during the first year after inclusion. The best cut-off level of serum CCL18 for prediction of a combined event within the follow-up period was 187 ng?mL -1 , with 53% sensitivity and 96% specificity (area under the ROC curve 0.86; p,0.001). After a mean¡SD follow-up of 33.7¡10.8 months, a higher rate of disease progression occurred in the group with serum CCL18 levels .187 ng?mL -1 . The adjusted hazard ratio was 5.36 (95% CI 2.44-11.75; p,0.001). In summary, serum CCL18 is an accurate predictive biomarker for the identification of patients with a higher risk of subsequent scleroderma lung disease worsening.

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“…Variations of this method have since been used by several groups in patients with SSc [7,[26][27][28][29][30][31]. Ooi et al [29] evaluated correlation between HRCT findings and clinical markers of disease activity.…”

Section: Semi-quantitative Scoringmentioning

confidence: 99%

High Resolution Computed Tomography Scoring Systems for Evaluating Interstitial Lung Disease in Systemic Sclerosis Patients

Assayag¹,

Kaduri²,

Hudson³

2012

Rheumatology

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Interstitial lung disease commonly develops in patients with Systemic sclerosis (SSc). High resolution computed tomography (HRCT) has become the gold standard for detection and evaluation of lung involvement in SSc. Several HRCT scoring methods have been described and used to characterize and quantify the disease. This article reviews the different scoring systems and how they have been validated clinically and applied to prognosticate patients, assess disease progression and evaluate response to treatment.

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

Cited by 53 publications

References 20 publications

Exhaled Nitric Oxide in Pulmonary Arterial Hypertension Associated with Systemic Sclerosis

Exhaled Nitric Oxide in Pulmonary Arterial Hypertension Associated with Systemic Sclerosis

Serum CC chemokine ligand-18 predicts lung disease worsening in systemic sclerosis

High Resolution Computed Tomography Scoring Systems for Evaluating Interstitial Lung Disease in Systemic Sclerosis Patients

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