Effects of treatment with rituximab on microcirculation in patients with long-term systemic sclerosis

Abstract

ObjectiveTo investigate the effect of rituximab on microcirculation in long-term SSc.ResultsFour patients with diffuse SSc over 3 years of disease received rituximab cycles of two 1-g infusions every 6 months for 2 years. Videocapillaroscopy was performed at baseline, 12 months, and 24 months and semi-quantitative scoring of videocapillaroscopy abnormalities was performed and the microangiopathy evolution score (MES: range 0–9) was calculated. The mean disease duration was 5 years (range 3–15). On videocapillaroscopy, giant capillaries and hemorrhages remained stable from baseline to 24 months. Capillary loss, abnormally-shaped capillaries, and MES stabilized at 12 months and increased by 24.5% and 28% at 24 months. Rituximab improves microcirculation in long-term SSc. Stabilization and reduced progression of microcirculation abnormalities were achieved at 12 and 24 months, respectively.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3994-1) contains supplementary material, which is available to authorized users.

Bi-directional communication: Conversations between fibroblasts and immune cells in systemic sclerosis

“…Rituximab appears to have general anti-fibrotic effects, exerting influence on the vasculature through stabilization and generation of capillaries [183] and acting directly on dermal myofibroblasts to downregulate the expression of the PDGF receptor [184].…”

Esophageal Dysfunction in Systemic Sclerosis: An Update

“…Targeting vascular injury Statins have been used in patients with SSc because statins can significantly regulate the blood-vessel wall [66] and they reduce the levels of inflammatory cytokines and increase circulating endothelial precursors in a dose-dependent manner [66][67][68]. Statins have been shown to improve Raynaud's phenomenon in some clinical trials, leading us to speculate that they could improve Being studied in patients with skin and joint involvement [80] Tocritizumab Anti-IL-6 d receptor antibody Ability to affect fibroblasts early [81][82][83] Belimumab/ Rituximab Specific inhibitor of B lymphocyte stimulating factor Improvement of fibrosis and microcirculation [84][85][86] Abaproxil Prevent T lymphocyte activation Improvement of the skin thickness of patients [87] a The RhoA/Rho kinase pathway is an important pathway in many cell functions and is related to oxidative stress and vascular damage b PDGF (platelet-derived growth factor) promotes the chemotaxis of fibroblasts in tissue repair and is associated with pathological fibrosis c c-Abl (cellular Abelson) is ,a non-receptor tyrosine kinase d IL-6 (interleukin 6) is an interleukin that acts as both a pro-inflammatory and anti-inflammatory cytokine esophageal vascular damage [68,69]. a2-Adrenergic receptors and the RhoA/Rho kinase pathway are potential therapeutic targets.…”

“…In addition, for B cells and T cells that play an important role in the immune process, researchers have also carried out related studies. Belimumab and rituximab have also been used in patients with SSc, and these drugs have been found to improve the patient's microcirculation and affect fibrosis genes and pathways [84][85][86]. However, there are very few relevant clinical trials providing clear evidence.…”

Nail is Systemic Disorders: Main Signs and Clues

“…61 Some studies have described an improvement in nailfold capillaroscopy abnormalities under systemic treatment. 62,63 In dermatomyositis, the scleroderma-like pattern is observed with usually a more anarchic picture with a higher capillary density (no capillary dropout), more neo-formed capillaries (ramified capillaries) and capillary disorganisation. 64 Some authors report a normalization of the nailfold capillaries under immunosuppressive treatment, especially rituximab.…”