25170266 - Lupus (2007) 16, 195200 http:/lup.sagepub.com...

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Lupus (2007) 16, 195–200 http://lup.sagepub.com CONCISE REPORT © 2007 SAGE Publications 10.1177/0961203306075802 Oxidative stress in systemic lupus erythematosus: relationship to disease activity and symptoms I Avalos 1 *, CP Chung 1 , A Oeser 1 , GL Milne 2 , JD Morrow 1,2 , T Gebretsadik 3 , A Shintani 3 ,C Yu 3 and CM Stein 1,2 1 Department of Medicine; 2 Department of Pharmacology; and 3 Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA Oxidative stress may play a role in the pathogenesis of systemic lupus erythematosus (SLE). We examined the hypothesis that oxidative stress was associated with indices of lupus disease activity and severity of symptoms. Urinary F 2 isoprostane excretion, a validated marker of oxidative stress, was measured in 95 patients with SLE and 103 healthy controls. Outcome measures included SLEDAI and SLICC scores, the modi±ed health assessment questionnaire, the fatigue severity scale (FSS), and visual analogue scales (VAS) for fatigue, pain and overall disease activity. F 2 isoprostane excretion was compared in patients and controls, and its relationship with clinical variables in SLE examined. F 2 isoprostane excretion did not differ signi±cantly among patients with lupus (2.7 6 2.3 ng/mg Cr) and control subjects (2.2 6 1.4 ng/mg Cr) ( P 5 0.70). In patients with lupus, F 2 isoprostane concentrations were independently associated with higher patient reported disease activity (VAS) (OR 5 1.52, P 5 0.01), fatigue (FSS, OR 5 1.52, P 5 0.03) and lower quality of life (OR 5 0.73, P 5 0.05), but not with objective markers or in²ammation or disease activity. In conclusion, F 2 isoprostane excretion is associated with patient-reported symptoms in SLE but not with measures of in²ammation, SLEDAI or SLICC. Oxidative stress may contribute to debilitating symptoms such as fatigue in SLE. Lupus (2007) 16 , 195–200. Key words: isoprostanes; oxidative stress; systemic lupus erythematosus Introduction Systemic lupus erythematosus (SLE) is a chronic autoimmune in²ammatory disease that causes increased morbidity and mortality. 1 The clinical manifestations of SLE re²ect multiorgan involvement, and oxidative stress has been implicated in its pathogenesis. 2 Increased oxidative stress results from an imbalance between products of oxidation such as reactive oxygen species and antioxidant defenses. Free radicals that are generated contribute to tissue damage. Oxidative stress has been assessed using different methods including measurement of total antioxidant capacity, lipid hydroperoxides, 3 oxidized glutathione, 4 4-hydroxy- nonenal and malondialdehyde concentrations. 5 Unfortunately, many of these methods do not accurately represent in vivo processes, and a more recent technique, measurement of F 2 isoprostanes, prostaglandin-like substances derived from lipid per- oxidation, provides a robust marker of oxidative stress in vivo . 6 F 2 isoprostane concentrations are increased in several conditions characterized by increased oxidative stress such as diabetes mellitus, 7 hyperhomocysteine- mia, 8 obesity, 9 hypercholesterolemia, 10 scleroderma 11 and smoking. 12
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This note was uploaded on 09/26/2010 for the course BIO BIO2110 taught by Professor Kwam during the Spring '10 term at 한동대학교.

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25170266 - Lupus (2007) 16, 195200 http:/lup.sagepub.com...

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