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Association of the nitric oxide synthase (eNOS) gene polymorphism with increased risk for both lupus glomerulonephritis and rheumatoid arthritis in a single genetically homogeneous population

Laboratory of Internal Medicine, School of Health Sciences, University of Crete, Vassilika Vouton, 715 00 Heraklion, Crete, Greece

P. Sidiropoulos

Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Crete, Greece

G. Bertsias

Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Crete, Greece

E. Koutsounaki

Laboratory of Internal Medicine, School of Health Sciences, University of Crete, Vassilika Vouton, 715 00 Heraklion, Crete, Greece

E. Fragouli

Laboratory of Internal Medicine, School of Health Sciences, University of Crete, Vassilika Vouton, 715 00 Heraklion, Crete, Greece

A. Raptopoulou

Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Crete, Greece

H. Kritikos

Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Crete, Greece

D.T. Boumpas

Laboratory of Internal Medicine, School of Health Sciences, University of Crete, Vassilika Vouton, 715 00 Heraklion, Crete, Greece, Department of Rheumatology, Clinical Immunology and Allergy, University Hospital of Heraklion, Crete, Greece

G.N. Goulielmos

Laboratory of Internal Medicine, School of Health Sciences, University of Crete, Vassilika Vouton, 715 00 Heraklion, Crete, Greece, goulielmos{at}med.uoc.gr

Nitric oxide (NO), a short-lived gaseous free radical, synthesized from L-arginine by NO synthases (NOS), is a potent mediator of biologic responses involved in the pathogenesis of autoimmune rheumatic diseases, such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Most biological necessary NO is produced by the family of three NOS. To date, several functionally relevant genetic polymorphisms in the eNOS gene have been associated with various vascular, infectious and autoimmune diseases. To our knowledge, no study has explored these polymorphisms for both SLE and RA in the same population. The objective of this study was to investigate the influence of the eNOS gene intron 4 a/b VNTR polymorphism (a 27-base-pair tandem repeat-based polymorphism) on susceptibility to SLE and RA in patients living in the island of Crete, a genetically homogeneous population. A group of 145 healthy subjects and 190 SLE patients were included in this study. Similarly, a second group of 235 healthy controls and 202 RA patients were analysed. In both cases, patients and controls were sex- and age-matched. Herein we report that the presence of a/b genotype of the eNOS gene may act as a risk factor not for the presence of SLE but for the development of glomerulonephritis (OR 2.71, 95% CI: 1.4—5.2), while it may be a susceptibility gene for RA (OR: 2.005, 95% CI: 1.31—3.07). Thus, in our population, the a/b genotype of the eNOS gene represents a severity rather than a susceptibility genotype for SLE. Lupus (2007) 16, 867—874.

Key Words: endothelial nitric oxide synthase gene • eNOS polymorphism • nitric oxide (NO) • rheumatoid arthritis (RA) • systematic lupus erythematosus (SLE)

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