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Isoprostane in systemic sclerosis: A systematic review and meta-analysis
Paul R J Ames1,2, Mira Merashli3, Tommaso Bucci4
1a Immune Response and Vascular Disease Unit , CEDOC, Nova University Lisbon , Lisbon , Portugal.
Modern Rheumatology
|April 26, 2018
Summary
Systemic sclerosis (SSc) patients show increased isoprostane levels, indicating oxidative stress. Further research is needed to understand the prognostic value of this biomarker in SSc.
Area of Science:
- Biomedical Science
- Clinical Research
- Oxidative Stress Biomarkers
Background:
- Systemic sclerosis (SSc) is characterized by vasculopathy, with oxidative stress implicated as a contributing factor.
- Isoprostanes, derived from arachidonic acid, are recognized markers of oxidative stress and have been linked to vascular dysfunction.
- Understanding the role of isoprostanes in SSc is crucial for advancing knowledge of the disease's pathophysiology.
Purpose of the Study:
- To systematically review and meta-analyze existing studies on isoprostane levels in patients with systemic sclerosis.
- To determine if there is a significant difference in isoprostane levels between SSc patients and healthy controls.
- To explore potential heterogeneity in findings and identify factors influencing isoprostane measurements in SSc.
Main Methods:
- A systematic literature search was conducted in PubMed and EMBASE from January 1990 to December 2017.
- Studies measuring isoprostane levels in systemic sclerosis patients and controls were included, adhering to PRISMA guidelines.
- Random-effect meta-analysis was employed to synthesize data from 8 included studies (240 SSc patients, 192 controls).
Main Results:
- Meta-analysis revealed a significant overgeneration of isoprostanes in SSc patients compared to controls (p < .001), with substantial heterogeneity (I² = 75%).
- Subgroup analysis of urinary isoprostane showed increased excretion in SSc (p = .009, I² = 67%).
- Serum isoprostane analysis indicated overproduction in SSc (p < .0001) with no heterogeneity, though urinary results varied based on measurement units.
Conclusions:
- The findings provide evidence for isoprostane overgeneration in systemic sclerosis, supporting the presence of oxidative stress in the condition.
- Urinary isoprostane levels, particularly when expressed as pmol/mmol creatinine, are elevated in SSc.
- Further prospective studies are warranted to assess the prognostic significance of isoprostane as a biomarker in systemic sclerosis.
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