Objective. To evaluate the use of color-flow Doppler ultrasonography, a direct, noninvasive technique, for measurement of kidney blood flow in patients with systemic sclerosis (SSc).Methods. Twenty-five normal volunteers and 25 SSc patients (median disease duration 8 years, range 2-21 years) were studied. All were free of clinical symptoms of renal damage. The resistance index (RI) was determined on main, interlobar, and cortical vessels.Results. In SSc patients, the RI was significantly increased at every sampling site examined ( P C 0.001). RI values were strongly correlated with disease duration (main artery r = 0.56, P C 0.04; interlobar artery r = 0.63, P < 0.02; cortical artery r = 0.75, P C 0.002). Regression analysis showed no relationship between RI and creatinine clearance values.Conclusion. Color-flow Doppler ultrasonography is a sensitive and noninvasive technique for evaluating vascular damage of the kidney in patients with SSc.

SUMMARYThe aim of the present study was to analyse the in vitro proliferation and cytokine production by alloantigen-stimulated peripheral blood mononuclear cells (PBMC) obtained from patients affected by systemic sclerosis (SSc) and patients with Raynaud's phenomenon (RP). In SSc patients the proliferation of PBMC stimulated in vitro with alloantigens was significantly increased compared with healthy subjects, while no differences were observed for RP patients. Lymphocytes from SSc patients also produced larger amounts of IFN-g compared with healthy controls. However, patients with clinically active disease had lower IFN-g levels than those found in clinically stable patients. Patients affected by RP showed significantly higher levels of IFN-g than healthy subjects. Analysis at the clonal level of the lymphocyte subsets involved in alloantigen stimulation in one patient affected by active SSc, and one subject with RP confirmed the results obtained using PBMC. In particular, in the RP patient but not in the SSc patient, we observed a population of CD4 þ T cells which proliferated to alloantigens in vitro and produced high levels of IFN-g. We suggest that T lymphocytes producing high levels of IFN-g might play a protective role in RP patients and in established scleroderma.