Hepatocyte growth factor in serum and bronchoalveolar lavage fluid versus exhaled nitric oxide in systemic lupus erythematosus

ABSTRACT

The present study tried to evaluate the clinical significance of hepatocyte growth factor [HGF] in the serum and bronchoalveolar lavage fluid [BALF] in systemic lupus erythematosus [SLE] patients and their relation to nitric oxide [NO] in exhaled air. Forty SLE patients were investigated along with ten apparently healthy individuals. The patients' group was divided into two groups group [A] Inactive SLE patients without pulmonary affection [n=14] and group [B] SLE patients with pulmonary affection [n=26]. The last group was further classified into 4 sub groups - B1= Active SLE patients without interstitial lung disease [ILD], B2= Active SLE patients with interstitial lung disease + Alveolitis [ILD +A], B3 Inactive SLE patients without ILD and B4= Inactive - SLE patients with ILD. All patient and control groups were evaluated for chest X-ray, pulmonary function tests and high-resolution computerized tomography [HRCT], along with systemic lupus erythematosus [SLE routine laboratory investigations. Measurement of HGF Levels in serum and BALF by Immunoassay and exhaled nitric oxide [NO] was measured by chemiluminescence. There were abnormal pulmonary function tests in 65% [26/40] of SLE patients and abnormal HRCT in the form of ILD in 32.5[13/40] of SLE patients. The exhaled NO showed a significant elevation in patients with activity especially those with evidence of active inflammation of the lung. There was no significant elevation of exhaled NO for patients with ILD without evidence of active inflammation. The level of HGF in serum and BALF showed a significant elevation in patients with activity especially with the presence of active lung inflammation. Also, there was a significant elevation of serum HGF and BALF-HGF for patients with ILD without evidence of inflammation. The level of HGF in serum and BALF showed significant elevation in patients as compared with control subjects. HGF levels in BALF of patients was more elevated than HGF levels in serum of patients groups. HGF in serum and BALF was increased in patients with pulmonary fibrosis and correlated with clinical parameters. Measurement of exhaled NO is a simple and non-invasive method to detect the presence of inflammatory lung disease