Assessment of nitric oxide and prostaglandins levels in different pathological types of glomerular disease

ABSTRACT

The objective of this study was to evaluate plasma nitrite and nitrate as well as urinary nitrite levels in forty cases with different glomerular disorders. In addition, serum thromboxane A2 [TXA2] and prostacyclin 12 [PGI2] levels were evaluated in these cases in comparison to 20 healthy control subjects. The effect of steroid therapy on the above mentioned parameters was also evaluated. The results revealed that urinary nitrite level was significantly elevated among patients compared to control. The elevation was observed in diabetic nephropathy as well as proliferative forms of glomerular disease such as lupus nephritis and mesangioproliferative GN. However, plasma nitrite, nitrate and serum cGMP levels were similar in patients compared to the control levels. TXA2 level exhibited significant elevation in patients, whereas serum PGI2 showed significant decrease in its level among cases as compared to control subjects. Steroid therapy was demonstrated to have no effect on all of the studied parameters. The study concluded that the data indicated that NO might play a role in the pathogenesis of proliferative glomerular disease and diabetic nephropathy. The demonstration of normal level of urinary nitrite in non proliferative GN suggests that enhanced NO production is not the sole cause of proteinuria in these cases. Further studies are, therefore, needed to examine the exact role of NO in pathogenesis of glomerular injury. The significant elevation of TXA2 level together with the significant decrease in serum PGI2 should be thoroughly investigated regarding the renal hemodynamics, the extent of proteinuria and the thromboembolic tendency reported in these cases