Extended report
Nerve growth factor and neuropeptides circulating levels in
systemic sclerosis (scleroderma)
M Matucci-Cerinica, R Giacomellic, A Pignonea, M L Cagnonia b, S Generinia, R Casaled, P Ciprianic, A Del Rossoa, P Tirassag, Y T Konttinene, B M Kahalehf, P-S Fanf, M Paolettih, C Marchesih, M Cagnonia b, L Aloeg
a Department
of Medicine, Division of Rheumatology, University of Florence, Italy, b Institute
of Dermatology, University of Florence, Italy, c Department of Internal Medicine and Public
Health, University of L'Aquila, Italy, d Department
of Neurophysiology, Foundation "S Maugeri" IRCCS, Rehabilitation
Institute of Montescano, Italy, e Department of Anatomy and Department of
Medicine, University of Helsinki, Finland, f Department of Medicine, Division of Rheumatology
and Immunology, Medical College of Ohio, USA, g Institute of Neurobiology, CNR, Rome,
Italy, h Department of Informatics, University of
Florence, Italy
Correspondence to: Dr M Matucci-Cerinic, Department of
Internal Medicine, University of Florence, Viale Pieraccini, 18
50139
Florence, Italy
cerinic{at}unifi.it
Accepted for publication 20 October
2000
OBJECTIVETo determine
the circulating levels of nerve growth factor (NGF), neuropeptide Y
(NPY), and vasoactive intestinal peptide (VIP) in systemic sclerosis
(SSc), and to correlate these levels with clinical and laboratory features.
METHODSForty four
patients with SSc were evaluated for circulating NGF (immunoenzymatic
assay), NPY and VIP (radioimmunoassay), anticentromere and
antitopoisomerase I autoantibodies, lung disease (pulmonary function
tests with carbon monoxide transfer factor (TLCO),
ventilation scintiscan with 99mTc DTPA radioaerosol, high
resolution computed tomography (HRCT), pulmonary pressure (echo colour
Doppler)), heart disease (standard and 24 ECG, echocardiography),
cutaneous involvement (skin score), joint involvement (evidence of
tender or swollen joints, or both), peripheral nervous system (PNS)
involvement (electromyography), rheumatoid factor, angiotensin
converting enzyme (fluorimetric method), von Willebrand factor (ELISA),
and erythrocyte sedimentation rate (ESR) (Westergren).
RESULTSCirculating
NGF levels in SSc were significantly increased compared with controls
(p<0.00001) and significantly higher in the diffuse than in the
limited subset of patients (p<0.01). Patients with articular disease
had significantly higher levels of NGF. A significant indirect
correlation between NGF levels and TLCO was detected
(p<0.01), but no correlation was found between NGF and HRCT, DTPA,
skin score, PNS involvement and angiotensin converting enzyme and von
Willebrand factor levels, antitopoisomerase or anticentromere
antibodies, and ESR. NGF levels increased progressively as the disease
worsened. Similarly, VIP circulating levels were significantly
increased in patients with SSc (p<0.001), whereas the increase of NPY
levels did not reach statistical significance. However, both
neuropeptides, following the same trend as NGF, increased as the
disease worsened (skin score and lung disease).
CONCLUSIONSThe
increase of NGF and VIP in patients with SSc, the former in the diffuse
subset of the disease, and in patients with prominent articular
disease, may suggest a link between neurotransmitters and the disease
pathogenesis. Neuropeptide circulating levels seem to increase only in
patients with the most severe disease.
© 2001 by Annals of the Rheumatic Diseases
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