Increased serum NG-hydroxy-L-arginine in patients with rheumatoid arthritis and systemic lupus erythematosus as an index of an increased nitric oxide synthase activity

doi:10.1136/ard.56.5.330

Annals of the Rheumatic Diseases 1997;56:330-332; doi:10.1136/ard.56.5.330

Ann Rheum Dis 1997;56:330-332 ( May )

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Increased serum N^G-hydroxy-L-arginine in patients with rheumatoid arthritis and systemic lupus erythematosus as an index of an increased nitric oxide synthase activity Rainer Wigand,^b Jens Meyer,^a Rudi Busse,^a Markus Hecker^c

^a Centre of Physiology , ^b and Department of Haematology, Centre of Internal Medicine , ^c Johann Wolfgang Goethe University Clinic, Frankfurt/Main, Germany Centre of Physiology and Pathophysiology, University of Göttingen, Germany

Correspondence to: Dr M Hecker, Zentrum Physiologie und Pathophysiologie, Universität Göttingen, Humboldtallee 23, D-37073 Göttingen, Germany.

Accepted for publication 5 February 1997

OBJECTIVES $---$ To determine the feasibility of monitoring the serum concentration of N^G-hydroxy-L-arginine (L-NHA) as an index of an increased nitricoxide (NO) synthase activity in patients with rheumatoid arthritis(RA) and systemic lupus erythematosus (SLE) compared with nitrate(NO₃), the major circulating metabolite of NO whose concentrationis influenced by dietaryintake.
METHODS $---$ The serum concentrations of L-NHA, L-arginine (L-Arg), and NO₃ were determined in 33 patients with RA, 25 patients with SLEand, 29 healthysubjects.
RESULTS $---$ Serum L-NHA was significantly increased in RA patients with high disease activity (287% of control, p<0.01), but not withlow disease activity (115%), as well as in patients with SLE (173%,p<0.01). In contrast, serum NO₃ did not differ significantly between either group of patientsand the respective controlgroup.
CONCLUSION $---$ NO synthase activity or expression, or both, is upregulated in RA patients with high disease activity and in patients withSLE. Serum L-NHA seems to be a more specific and reliable indexof an increased activity of this enzyme in patients with acuteor chronic inflammatory diseases than NO₃.

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