CONNECTIVE TISSUE DISEASES: FOCUS ON MICROCIRCULATORY BED
Background. A microcirculatory bloodstream is a target, source and reason of the pathological process in patients with systemic connective tissue diseases.
Objectives. This study is focused on meta-analyses of biopsy material of skin flaps harvested from patients’ fingers to identify specific morphological changes.
Methods. A retrospective analysis of the medical records of 39 examinees with systemic sclerosis (SSc), 45 with Systemic Lupus Erythematosus (SLE), and 45 with rheumatoid arthritis (RA) was performed. The condition of peripheral hemodynamics was examined with longitudinal rheovasography of arms and legs. Endothelin-1 (ЕТ1) concentration was evaluated by immunoenzymatic method. We assessed other results of clinical and laboratory tests to compare them with morphological changes of the microcirculatory bed.
Results. Most patients involved suffered from abnormal peripheral hemodynamics. It was revealed that kidneys, lungs or heart were damaged more frequently in the patients with peripheral blood circulation disorders, which were the most significant in the patients with SSc (p<0.05). Disorders of peripheral blood flow were exacerbated in case of lengthening of the disease course. Concentration of ЕТ1 was relevantly higher in the patients with peripheral blood flow disorders. Number of pathologic capillaries was the highest in the SSc patients.
Conclusions. In terms of integral estimation, extremely significant changes of microcirculatory bloodstream were evidenced in the patients with SSc. However, some morphometric peculiarities were revealed in the patients without peripheral blood flow disorders. Thus, normal rheovasography did not exclude any microcirculation disorders.
Bărbulescu AL, Vreju AF, Bugă AM, Sandu RE, Criveanu C, Tudoraşcu DR, Gheonea IA, Ciurea PL. Vascular endothelial growth factor in systemic lupus erythematosus-correlations with disease activity and nailfold capillaroscopy changes. Rom J Morphol Embryol. 2015 Jan 1;56(3):1011-6.
Kuryliszyn-Moskal A, Klimiuk PA, Sierakowski S, Ciolkiewicz M. Vascular endothelial growth factor in systemic lupus erythematosus: relationship to disease activity, systemic organ manifestation, and nailfold capillaroscopic abnormalities. Arch. Immunol. Ther. Exp. 2007;55:179-85.
Kuryliszyn-Moskal A, Klimiuk PA, Sierakowski S, Ciolkiewicz M. A study on vascular endothelial growth factor and endothelin-1 in patients with extra-articular involvement of rheumatoid arthritis. Clinical Rheumatology. 2006; 25(3):314-9.
Maurizio Cutolo M, Sulli A, Smith V. Assessing Microvascular Changes in Systemic Sclerosis Diagnosis and Management. Nat Rev Rheumatol. 2010;6(10):578-87.
Mihail C, Tervaert JWC. Anti-endothelial cell antibodies in systemic sclerosis. BMJ journals Annals of Rheumatic Diseases.2010;69(2):319-24.
Chojnowski MM, Felis-Giemza A, Olesinska M. Capillaroscopy - a role in modern rheumatology. Reumatologia. 2016;54(2):67-72.
Ragab O, Ashmawy A, Abdo M, Mokbel A. Nailfold capilloroscopy in systemic lupus erythematosus. The Egyptian Rheumatologist. 2011; 33(1):61-7.
Etehad Tavakol M, Fatemi A, Karbalaie A, Emrani Z, Erlandsson BE. Nailfold capillaroscopy in rheumatic diseases: which parameters should be evaluated? BioMed research international, 2015. Article ID 974530. 17 pages.
Ciolkiewicz M, Kuryliszyn-Moskal A, Klimiuk PA. Analysis of correlations between selected endothelial cell activation markers, disease activity, and nailfold capillaroscopy microvascular changes in systemic lupus erythematosus patients. Clin Rheumatol. 2010;29(2):175-80.
Dimitrijevic J, Brajuckovic G, Cerovic S, Popovic Z, Bogdanovic R, Jovanovic D, et al. Morphology of autoimmune diseases. Arch oncol. 2004;12:27-9.
Holovach IYu, Egudina ED. Systemic scleroderma: modern view on pathogenesis, course, diagnosis and treatment. Semeynaya Meditsina. 2019;3:7-16. http://nbuv.gov.ua/UJRN/simmed_2019_3_3. (In Russian).
Sinyachenko OV, Egudina ED, Khaniukov AA, Ermolaeva MB, Gulmamedova MF, Potapov YuA. Specific course of angiopathy in systemic autoimmune rheumatic diseases. 2017;2:33-9.
Copyright (c) 2020 International Journal of Medicine and Medical Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who sent their manuscript to International Journal of Medicine and Medical Research agree to the following terms:
1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License CC-BY-NC that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
2. Authors able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).