Objectives Raynaud's phenomenon (RP) can be the first manifestation of systemic sclerosis (SSc) or other connective tissue diseases (CTDs), often preceding an overt disease by years. It is not known if markers of endothelial damage are detectable in those RP patients who subsequently develop a CTD. Methods We studied 82 RP patients at their first evaluation to correlate the levels of endothelial markers with the subsequent development of an overt disease 36 months later. We measured plasma levels of tissue-type plasminogen activator (t-PA) and von Willebrand factor (vWF), two markers of endothelial damage, and interleukin-6 (IL-6), a pro-inflammatory cytokine. Thirty sex- and age-matched healthy subjects (HS) served as controls. Results At baseline, 67 patients showed capillaroscopic normal pattern (CNP) and 15 patients, of which 11 were very early SSc, had capillaroscopic scleroderma pattern (CSP). Plasma levels of t-PA, vWF and IL-6 were higher in patients with CNP (p = 0.0001) than in HS and even much higher in patients with CSP (p = 0.0001). In patients with CNP and RP of recent onset (< 18 months), vWF plasma levels were higher when autoantibodies were present (p = 0.020). After 36 months, among 48 RP patients with CNP who remained in follow-up, 24 were diagnosed as primary and 24 as secondary RP. In secondary RP, basal levels of t-PA, IL-6 and particularly vWF were higher than in primary RP (p = 0.005, p = 0.004, p = 0.0001 respectively) and HS (p = 0.0001 for all). Conclusions Our findings indicate that markers of endothelial damage are elevated in RP patients who subsequently develop SSc or other CTDs, even in the absence of capillaroscopic abnormalities.
Detection of early endothelial damage in patients with Raynaud's phenomenon / R. Gualtierotti, F. Ingegnoli, S. Griffini, E. Grovetti, M.O. Borghi, P. Bucciarelli, P.L. Meroni, M. Cugno. - In: MICROVASCULAR RESEARCH. - ISSN 0026-2862. - 113(2017), pp. 22-28.
|Titolo:||Detection of early endothelial damage in patients with Raynaud's phenomenon|
GUALTIEROTTI, ROBERTA (Primo)
INGEGNOLI, FRANCESCA ANNA (Secondo)
CUGNO, MASSIMO (Corresponding)
|Parole Chiave:||Autoantibodies; Capillaroscopy; Endothelial damage; Interleukin-6; Raynaud's phenomenon; Systemic sclerosis; Tissue-type plasminogen activator; Very early systemic sclerosis; von Willebrand factor; Biochemistry; Cardiology and Cardiovascular Medicine; Cell Biology|
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
Settore MED/16 - Reumatologia
|Data di pubblicazione:||2017|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.mvr.2017.04.004|
|Appare nelle tipologie:||01 - Articolo su periodico|