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

¹ Dept of Internal Medicine, Faculty of Medicine, Université Paris Pierre et Marie Curie, Hôpital Saint-Antoine, and Depts of ² Respiratory Physiology, and ³ Internal Medicine, Faculty of Medicine, Université Paris Descartes, Hôpital Cochin, Paris, France.

CORRESPONDENCE: A. T. Dinh-Xuan, Dept of Respiratory Physiology, Faculty of Medicine, EA 2511, Université Paris Descartes, Hôpital Cochin, 27, rue du faubourg Saint-Jacques, 75679, Paris Cedex 14, France. Fax: 33 158412345. E-mail: anh-tuan.dinh-xuan{at}cch.aphp.fr

Keywords: Exhaled nitric oxide, interstitial lung disease, nitric oxide, systemic sclerosis

Received: October 4, 2006
Accepted March 25, 2007

The alveolar concentration of exhaled nitric oxide (CA,_NO) is increased in patients with systemic sclerosis (SSc), but whether this increase is related to the severity of interstitial lung disease (ILD) in SSc has not yet been investigated.

In total, 58 SSc patients prospectively underwent pulmonary function tests (PFTs), echocardiogram and fibrosis scoring on pulmonary computed tomography (CT). Patients were divided into two groups according to the presence (or not) of ILD. Measurements of CA,_NO were assessed in all SSc patients and compared with those obtained in 19 healthy volunteers. Relationships were sought between CA,_NO PFTs and CT scan fibrosis scores.

Overall, CA,_NO was significantly increased in SSc patients (median (range) 6.2 (3.8–9.9) ppb) as compared with controls (2.0 (1.2–3.0) ppb). Among SSc patients, CA,_NO was significantly higher in patients with ILD compared with patients without ILD (n = 33, 7.5 (5.2–11.9) ppb versus n = 25, 4.9 (3.1–7.0) ppb, respectively). CA,_NO was inversely related to total lung capacity (r = –0.34) and the diffusing capacity of the lung for carbon monoxide (r = –0.37) and was directly related to CT scan fibrosis scores (r = 0.36).

An increased alveolar concentration of exhaled nitric oxide could, at least in part, either reflect or contribute to the severity of lung disease and could be used to noninvasively assess the extent of interstitial lung disease in systemic sclerosis.

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