Acta Pharmacologica Sinica (2009) 30: 1283–1288; doi: 10.1038/aps.2009.128

Acta Pharmacologica Sinica (2009) 30: 1283–1288; doi: 10.1038/aps.2009.128

Original Article

N-acetylcysteine infusion reduces the resistance index of renal artery in the early stage of systemic sclerosis

Edoardo ROSATO¹, Rosario CIANCI², Biagio BARBANO², Ginevra MENGHI¹, Antonietta GIGANTE², Carmelina ROSSI¹, Enrico M ZARDI³, Antonio AMOROSO⁴, Simonetta PISARRI¹, Felice SALSANO^1,^*

¹Sapienza University of Rome Department of Clinical Medicine, Clinical Immunology Unit-Scleroderma Center, Italy; ²Sapienza University of Rome Department of Clinical Medicine, Nefrology Unit, Italy; ³Department of Clinical Medicine, “Campus Bio-Medico” University, Rome, Italy; ⁴Sapienza University of Rome Department of Clinical Medicine, Italy

Aim: To evaluate resistance index (RI) changes in renal artery after N-acetylcysteine infusion in patients with systemic sclerosis.

Methods: In an open-label study 40 patients with systemic sclerosis (SSc) were treated with N-acetylcysteine (NAC) iv infusion over 5 consecutive hours, at a dose of 0.015 g ·kg ^-1·h^-1. Renal haemodynamic effects were evaluated by color Doppler examination before and after NAC infusion.

Results: NAC infusion significantly reduced RI in a group of sclerodermic patients with early/active capillaroscopic pattern, modified Rodnan Total Skin Score (mRTSS) <14 and mild-moderate score to the vascular domain of Medsger Scleroderma Disease Severity Scale (DSS). RI increased after NAC infusion in patients with late capillaroscopic pattern, mTRSS>14 and severe-end stage score to the vascular domain of DSS. In patients with reduction of RI after NAC infusion, diffusion capacity for carbon monoxide mean value was significantly higher than in those patients with an increase of RI. No significant differences in renal blood flow were found between patients with different subsets of SSc.

Conclusion: In patients with low disease severity NAC ameliorates vascular renal function.

Keywords: systemic sclerosis; N-acetylcysteine; color Doppler sonography; renal blood flow; resistance index

* To whom correspondence should be addressed.
Emal felice.salsano@uniroma1.it
Received 2009-05-15 Accepted 2009-07-16

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