Iloprost infusion reduces serological cytokines and hormones of hypoxia and inflammation in systemic sclerosis patients

Introduction Systemic sclerosis (SSc) is characterized by microvascular damage of skin and internal organs with chronic hypoxia and release of cytokines and hormones such as neutrophil gelatinase-associated lipocalin (NGAL), fibroblast growth factor-23 (FGF-23) and Klotho. Aim of the study was to evaluate FGF-23, Klotho and NGAL serum levels in SSc patients and healthy controls (HC) and to evaluate serum levels changes of FGF-23, Klotho and NGAL after Iloprost. Methods Twenty-one SSc patients and 20 HC were enrolled. In SSc patients, peripheral venous blood samples were collected at the first day before the autumn Iloprost infusion (t0), 60 min (t1) and 14 days after Iloprost infusion (t2). Results SSc patients had higher serum level of FGF-23 [18.7 +/- 6.4 pg/ml versus 3.6 +/- 2.2 pg/ml, p < 0.001], Klotho [5.1 +/- 0.8 pg/ml versus 2.3 +/- 0.6 pg/ml, p < 0.001] and NGAL [20.9 +/- 2.6 pg/ml versus 14.5 +/- 1.7 pg/ml, p < 0.001] than HC. Iloprost infusion reduces serum level of FGF-23 (18.7 +/- 6.4 pg/ml versus 10.4 +/- 5.5 pg/ml, p < 0.001), Klotho (5.1 +/- 0.8 pg/ml versus 2.5 +/- 0.6 pg/ml, p < 0.001) and NGAL (20.9 +/- 2.6 pg/ml versus 15.1 +/- 2.3 pg/ml, p < 0.001) between t0 and t1. The Iloprost infusion reduces serum level of FGF-23 (18.7 +/- 6.4 pg/ml versus 6.6 +/- 5.1 pg/ml), Klotho (5.1 +/- 0.8 pg/ml versus 2.3 +/- 0.4 pg/ml) and NGAL (20.9 +/- 2.6 pg/ml versus 15.5 +/- 1.9 pg/ml) between t0 and t2. Results SSc patients had higher serum level of FGF-23 [18.7 +/- 6.4 pg/ml versus 3.6 +/- 2.2 pg/ml, p < 0.001], Klotho [5.1 +/- 0.8 pg/ml versus 2.3 +/- 0.6 pg/ml, p < 0.001] and NGAL [20.9 +/- 2.6 pg/ml versus 14.5 +/- 1.7 pg/ml, p < 0.001] than HC. Iloprost infusion reduces serum level of FGF-23 (18.7 +/- 6.4 pg/ml versus 10.4 +/- 5.5 pg/ml, p < 0.001), Klotho (5.1 +/- 0.8 pg/ml versus 2.5 +/- 0.6 pg/ml, p < 0.001) and NGAL (20.9 +/- 2.6 pg/ml versus 15.1 +/- 2.3 pg/ml, p < 0.001) between t0 and t1. The Iloprost infusion reduces serum level of FGF-23 (18.7 +/- 6.4 pg/ml versus 6.6 +/- 5.1 pg/ml), Klotho (5.1 +/- 0.8 pg/ml versus 2.3 +/- 0.4 pg/ml) and NGAL (20.9 +/- 2.6 pg/ml versus 15.5 +/- 1.9 pg/ml) between t0 and t2. Conclusions SSc patients had higher FGF-23, Klotho and NGAL than HC. Iloprost reduces serum levels of FGF-23, Klotho and NGAL.