Abstract
BackgroundThere is a growing body of evidences indicating iNOS has involved in the pathogenesis of SLE. However, the role of iNOS in SLE is inconsistency. This systematic review was designed to evaluate the association between iNOS and SLE.ResultsSix studies were included, reporting on a total of 277 patients with SLE. The meta-analysis showed that SLE patients had higher expression of iNOS at mRNA level than control subjects (SMD = 2.671, 95%CI = 0.446–4.897, z = 2.35, p = 0.019), and a similar trend was noted at the protein level (SMD = 3.602, 95%CI = 1.144–6.059, z = 2.87, p = 0.004) and positive rate of iNOS (OR = 9.515, 95%CI = 1.915–47.281, z = 2.76, p = 0.006) were significantly higher in SLE group compared with control group. No significant difference was observed on serum nitrite level between SLE patients and control subjects (SMD = 2.203, 95%CI = -0.386–4.793, z = 1.64, p = 0.095). The results did not modify from different sensitivity analysis, representing the robustness of this study. No significant publication bias was detected from Egger’s test.ConclusionsThere was a positive correlation between increasing iNOS and SLE. However, the source of iNOS is unknown. Besides NO pathway, other pathways also should be considered. More prospective random studies are needed in order to certify our results.
Highlights
There is a growing body of evidences indicating inducible Nitric oxide synthase (NOS) (iNOS) has involved in the pathogenesis of Systemic lupus erythematosus (SLE)
The tissues used for evaluating inducible NOS (iNOS) expression were as follows: In studies of Belmont [32] and Kuhn [22] skin was evaluated, in studies of Gong [33] and Xu [34], peripheral blood was evaluated, and in the other 2 studies [35, 36] kidney was evaluated
Expression of iNOS The meta-analysis showed that SLE patients had higher expression of iNOS at mRNA level than the controls (SMD = 2.671, 95%CI = 0.446–4.897, z = 2.35, p = 0.019) (Fig. 2 and Additional file 5: Figure S5A)
Summary
There is a growing body of evidences indicating iNOS has involved in the pathogenesis of SLE. Free radical-mediated reactions have been implicated as contributions in a range of autoimmune diseases, including SLE [5, 6]. Nitric oxide (NO) is one of the most important and widely studied free radical molecules. It plays an (2020) 21:6 autoimmune attack. Accumulating evidence showed a positive association between RNS and SLE [14, 18]. It had been showed that NO production, such as nitrate and nitrite, as well as RNS-modified proteins, such as 3nitrotyrosine (3-NT) were elevated in SLE [20, 21]. Nitric oxide synthase (NOS) is the synthase catalyze Larginine to form NO
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