Ann Rheum Dis

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Ann Rheum Dis 2001;60:487-494 ( May )

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

OBJECTIVE---To 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.
METHODS---Forty 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).
RESULTS---Circulating 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).
CONCLUSIONS---The 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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