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Aspirin therapy and thromboxane biosynthesis in systemic lupus erythematosus
Ingrid Avalos
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA, ingrid.avalos{at}vanderbilt.edu
Cecilia P. Chung
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
Annette Oeser
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
Ginger L. Milne
Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA
Holly Borntrager
Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA
Jason D. Morrow
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA, Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA
Paolo Raggi
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
Joseph Solus
Department of Molecular Physiology and Biophysics, Vanderbilt University School of Medicine, Nashville, TN, USA
C. Michael Stein
Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA, Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA
Incomplete suppression of thromboxane biosynthesis during aspirin therapy is associated with increased cardiovascular risk. Since systemic lupus erythematosus (SLE) is associated with platelet activation and increased cardiovascular mortality, we compared thromboxane and prostacyclin biosynthesis in patients with SLE and control subjects, and measured inhibition of thromboxane excretion in aspirin-treated subjects. We measured the urinary excretion of 11-dehydro thromboxane B 2 (TXB2) and 2,3-dinor 6-ketoPGF1 (PGI-M), the stable metabolites of thromboxane A2 and prostacyclin, respectively, in 74 patients with SLE and 70 controls. In subjects who were not receiving aspirin, TXB2 excretion was higher in patients with SLE [0.40 ng/mg creatinine (0.26—0.64), median (interquartile range)] than controls [0.31 ng/mg creatinine (0.23—0.44)] (P = 0.04), and in these patients, TXB2 excretion correlated with disease activity (rho = 0.28, P = 0.03) and tumor necrosis factor alpha (rho = 0.48, P < 0.001). Aspirin therapy resulted in significantly lower TXB2 excretion in controls (P = 0.01), but not in patients with SLE (P = 0.10), compared with subjects not receiving aspirin. Prostacyclin biosynthesis did not differ among patients and controls, and was not affected by aspirin (P all >0.35). Thromboxane biosynthesis is increased in SLE and is associated with disease activity. Additionally, response to aspirin may be attenuated in some patients with SLE. Lupus (2007) 16, 981—986.
Key Words: systemic lupus erythematosus asprin resistance thromboxane prostacyclin oxidative stress
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Lupus, Vol. 16, No. 12,
981-986 (2007)
DOI: 10.1177/0961203307083313

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