Premium
124
Venous Ulcer Healing Predicted by Urine Nitrate Assay: A Retrospective Study
Author(s) -
Boykin J.V.,
Baylis C.,
Yager D.,
Cohen I.K.,
Sommer V.,
Shawler L.,
Watkins M.,
Young J.,
Crossland M.
Publication year - 2004
Publication title -
wound repair and regeneration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.847
H-Index - 109
eISSN - 1524-475X
pISSN - 1067-1927
DOI - 10.1111/j.1067-1927.2004.0abstractdr.x
Subject(s) - nitric oxide , urine , medicine , gastroenterology , asymmetric dimethylarginine , excretion , arginine , platelet , wound healing , venous blood , endocrinology , surgery , chemistry , biochemistry , amino acid
Chronic venous stasis ulcerations (VSU) are associated with significant platelet and leukocyte activation with secondary superoxide anion and ROS production that may severely degrade nitric oxide (NO) production. This study was designed to document the possible association between NO production and the impaired healing of VSU patients. Twenty‐four subjects were used for the study. Group C (n = 8) the control group, consisted of healthy adults without history of VSU. Group HU (n = 8) the healed ulcer group, consisted of adults with documented VSU whose ulcers healed with routine wound care and compression therapy in 20 weeks or less. Group UU (n = 8) the unhealed ulcer group, consisted of adults with documented VSU without healing within 20 weeks. All groups had normal renal function and were hospitalized for 24 hours on bed rest with a low arginine and low nitrate diet. Fasting samples were obtained for plasma and urine nitrate (NOx) and plasma arginine, asymmetric dimethylarginine (ADMA) and isoprostane determinations. At 24‐hrs, group HU demonstrated the highest plasma NOx levels (33.25 ± 11.69 μM) as compared to group C (19.45 ± 2.63 μM) or group UU (27.17 ± 3.67 μM); urine NOx excretion of group UU (51.46 ± 11.77 μM) was significantly lower (p < 0.05; Kruskal‐Wallis) as compared to group HU (135 ± 38.29 μM) or group C (164.3 ± 38.58 μM). ADMA and arginine were not significantly different between groups. Ratios of NOx to isoprostane were disproportionate between groups. These results suggest, for the first time, a significant relationship between impaired VSU healing and deficient NO production. Furthermore, these findings establish the clinical value of measurements of NO production and bioavailability as effective predictivebiological markers for the healing of VSU.