Changes of NADH Fluorescence from the Skin of Patients with Systemic Lupus Erythematosus

Abstract

Introduction. The blood circulation of the skin is an accessible and representative vascular bed for examining the mechanisms of microcirculatory function. Endothelial function is impaired in systemic lupus erythematosus (SLE), which implies disorders in cell metabolism dependent on blood circulation; however, noninvasive monitoring of metabolism at the tissue and cell level is absent in daily clinical practice. Objective. The aim of the study was to examine changes of NADH fluorescence from the epidermis of a forearm measured with the flow mediated skin fluorescence (FMSF) technique in patients with SLE and to investigate whether they are associated with clinical manifestation of the disease. Materials and Methods. The study enrolled 36 patients with SLE and 34 healthy individuals. Changes of NADH fluorescence were measured using FMSF on the forearm in response to blocking and releasing of blood flow. The results were represented as ischemic (IR max and IR auc) and hyperemic response maximum and area under the curve (HR max and HR auc). Results. IR max, IR auc, HR max, and HR auc were all lower in patients with SLE (p<0.05) compared with controls. All four parameters were negatively correlated (p<0.05) with patient age. No difference was found in NADH fluorescence between SLE patients with malar rash, discoid rash, photosensitivity, oral ulcers, nonerosive arthritis, renal disorder, hematologic disorder, or immunologic disorder and those without. No correlation was revealed between the SLEDAI score and NADH fluorescence. Conclusion. Changes of NADH fluorescence indicate the reduction in NADH restoration, observed especially during reperfusion, and suggest the occurrence of disorders in the microcirculation of the skin and/or at the mitochondrial level. Such changes of NADH during reperfusion in patients with SLE could be associated with their possible lower sensitivity to hypoxia and possibly with endothelial dysfunction.

Investigating the Ischaemic Phase of Skin NADH Fluorescence Dynamics in Recently Diagnosed Primary Hypertension: A Time Series Analysis

“…FMSF reflects dynamic mitochondrial function related to blood flow through skin microcirculation [ 9 , 10 , 11 ]. It has been used to study healthy individuals and athletes at rest and during various challenges (exercise, long-term training, repeated ischaemia and reperfusion to initiate preconditioning).…”

“…It has been used to study healthy individuals and athletes at rest and during various challenges (exercise, long-term training, repeated ischaemia and reperfusion to initiate preconditioning). FMSF has also been studied in patients with coronary artery disease [ 12 ], diabetes [ 13 ], obstructive pulmonary disease [ 14 ], and lupus [ 8 , 10 , 15 ]. Resting cellular NADH increases with age and in several cardiovascular diseases [ 9 , 13 ], obstructive pulmonary disease [ 14 ], and diabetes [ 13 ].…”

Arterial Blood Pressure Features of Hypertensive Patients with Typical and Atypical 460 nm Skin Fluorescence Response to Transient Ischaemia

“…The FMSF method has been used to investigate healthy people and athletes at rest and during various activities [ 4 ]. It has also been applied to patients with coronary artery disease [ 5 ], diabetes [ 6 ], obstructive pulmonary disease [ 7 ] and lupus [ 8 ].…”

Connexin 43 Expression in Cutaneous Biopsies of Lupus Erythematosus

“…38,44 More specifically, the flow-mediated skin fluorescence technique has allowed for the demonstration of disorders of cutaneous microcirculation in patients with LE. 45…”

“…38,44 More specifically, the flow-mediated skin fluorescence technique has allowed for the demonstration of disorders of cutaneous microcirculation in patients with LE. 45 Among the several mechanisms proposed as responsible for endothelial dysfunction in LE, impaired clearance of apoptotic cells, oxidative stress markers, several autoantibodies, cytokines, and B-cell and T-cell activity have been the most accepted candidates. 8 Several of these events (such as cell death or metabolism of toxics) are controlled by hemichannels and most specifically by Cx43.…”