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Morphometric evaluation of nitric oxide synthase isoforms and their cytokine regulators predict pulmonary dysfunction and survival in systemic sclerosis
Parra, E.R.; Aguiar Junior, A.C.; Silva, L.O.; Souza, H.S.P.; Espinoza, J.D.; Capelozzi, V.L..
  • Parra, E.R.; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Patologia. Sao Paulo. BR
  • Aguiar Junior, A.C.; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Patologia. Sao Paulo. BR
  • Silva, L.O.; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Patologia. Sao Paulo. BR
  • Souza, H.S.P.; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Patologia. Sao Paulo. BR
  • Espinoza, J.D.; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Patologia. Sao Paulo. BR
  • Capelozzi, V.L.; Universidade de Sao Paulo. Faculdade de Medicina. Departamento de Patologia. Sao Paulo. BR
Braz. j. med. biol. res ; 46(10): 881-891, 24/set. 2013. tab, graf
Article in English | LILACS | ID: lil-688558
ABSTRACT
Because histopathological changes in the lungs of patients with systemic sclerosis (SSc) are consistent with alveolar and vessel cell damage, we presume that this interaction can be characterized by analyzing the expression of proteins regulating nitric oxide (NO) and plasminogen activator inhibitor-1 (PAI-1) synthesis. To validate the importance of alveolar-vascular interactions and to explore the quantitative relationship between these factors and other clinical data, we studied these markers in 23 cases of SSc nonspecific interstitial pneumonia (SSc-NSIP). We used immunohistochemistry and morphometry to evaluate the amount of cells in alveolar septa and vessels staining for NO synthase (NOS) and PAI-1, and the outcomes of our study were cellular and fibrotic NSIP, pulmonary function tests, and survival time until death. General linear model analysis demonstrated that staining for septal inducible NOS (iNOS) related significantly to staining of septal cells for interleukin (IL)-4 and to septal IL-13. In univariate analysis, higher levels of septal and vascular cells staining for iNOS were associated with a smaller percentage of septal and vascular cells expressing fibroblast growth factor and myofibroblast proliferation, respectively. Multivariate Cox model analysis demonstrated that, after controlling for SSc-NSIP histological patterns, just three variables were significantly associated with survival time septal iNOS (P=0.04), septal IL-13 (P=0.03), and septal basic fibroblast growth factor (bFGF; P=0.02). Augmented NOS, IL-13, and bFGF in SSc-NSIP histological patterns suggest a possible functional role for iNOS in SSc. In addition, the extent of iNOS, PAI-1, and IL-4 staining in alveolar septa and vessels provides a possible independent diagnostic measure for the degree of pulmonary dysfunction and fibrosis with an impact on the survival of patients with SSc.
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Full text: Available Index: LILACS (Americas) Main subject: Scleroderma, Systemic / Plasminogen Activator Inhibitor 1 / Lung Diseases, Interstitial / Nitric Oxide Synthase Type of study: Etiology study / Prognostic study / Risk factors Limits: Adult / Female / Humans Language: English Journal: Braz. j. med. biol. res Journal subject: Biology / Medicine Year: 2013 Type: Article / Project document Affiliation country: Brazil Institution/Affiliation country: Universidade de Sao Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Scleroderma, Systemic / Plasminogen Activator Inhibitor 1 / Lung Diseases, Interstitial / Nitric Oxide Synthase Type of study: Etiology study / Prognostic study / Risk factors Limits: Adult / Female / Humans Language: English Journal: Braz. j. med. biol. res Journal subject: Biology / Medicine Year: 2013 Type: Article / Project document Affiliation country: Brazil Institution/Affiliation country: Universidade de Sao Paulo/BR