Oxidative stress in systemic lupus erythematosus and allied conditions with vascular involvement

Objective. To evaluate the occurrence and clinical significance of lipid pe roxidation (oxidative stress) in rheumatic diseases characterized by vascul ar involvement. Patients and methods. Plasma 8-epi-PGF(2 alpha) (oxidative stress marker) w as measured by gas chromatography-mass spectrometry in 36 patients with sys temic lupus erythematosus (SLE), 13 with systemic sclerosis (SSc), 13 with systemic vasculitis [Wegener's granulomatosis (WG), n = 4; Churg-Strauss sy ndrome (CSS), n = 3; Behcet syndrome, rr = 6], 12 with rheumatoid arthritis (RA) and in 23 healthy controls (n = 23). Results. 8-epi-PGF(2 alpha) levels were higher in patients with SLE (P = 0. 007), SSc (P < 0.001) and vasculitis (P = 0.001) than in controls. In SLE, a positive Coombs' test and arterial hypertension independently predicted 8 -epi-PGF(2 alpha) concentrations (P = 0.004 and P = 0.001, respectively). S LE patients not taking prednisolone showed higher 8-epi-PGF(2 alpha) concen trations than SLE patients on prednisolone (P = 0.02). In the latter group, a dose-response relationship was noted between 8-epi-PGF(2 alpha) and ster oid dosage (I = 0.6, P = 0.0003). In WG and CSS, 8-epi-PGF(2 alpha) concent rations correlated with disease activity (r = 0.8, P = 0.01) and were highe r than in patients with Behcet disease (P = 0.003). Conclusions. Oxidative stress may be pathogenetically relevant in some auto immune rheumatic diseases with vascular involvement. Amelioration of some c linical manifestations of these diseases may be envisaged by targeting lipi d peroxidation with dietary or pharmacological antioxidants.