Impaired skeletal muscle microcirculation in systemic sclerosis

Abstract

IntroductionMuscle symptoms in systemic sclerosis (SSc) may originate from altered skeletal muscle microcirculation, which can be investigated by means of blood oxygenation level dependent (BOLD) magnetic resonance imaging (MRI).MethodsAfter ethics committee approval and written consent, 11 consecutive SSc patients (5 men, mean age 52.6 years, mean SSc disease duration 5.4 years) and 12 healthy volunteers (4 men, mean age 45.1 years) were included. Subjects with peripheral arterial occlusive disease were excluded. BOLD MRI was performed on calf muscles during cuff-induced ischemia and reactive hyperemia, using a 3-T whole-body scanner (Verio, Siemens, Erlangen, Germany) and fat-suppressed single-short multi-echo echo planar imaging (EPI) with four different effective echo times. Muscle BOLD signal time courses were obtained for gastrocnemius and soleus muscles: minimal hemoglobin oxygen saturation (T2*min) and maximal T2* values (T2*max), time to T2* peak (TTP), and slopes of oxygen normalization after T2* peaking.ResultsThe vast majority of SSc patients lacked skeletal muscle atrophy, weakness or serum creatine kinase elevation. Nevertheless, more intense oxygen desaturation during ischemia was observed in calf muscles of SSc patients (mean T2*min -15.0%), compared with controls (-9.1%, P = 0.02). SSc patients also had impaired oxygenation during hyperemia (median T2*max 9.2% vs. 20.1%, respectively, P = 0.007). The slope of muscle oxygen normalization was significantly less steep and prolonged (TTP) in SSc patients (P<0.001 for both). Similar differences were found at a separate analysis of gastrocnemius and soleus muscles, with most pronounced impairment in the gastrocnemius.ConclusionsBOLD MRI demonstrates a significant impairment of skeletal muscle microcirculation in SSc.

Assessment of T Regulatory Cells and Expanded Profiling of Autoantibodies May Offer Novel Biomarkers for the Clinical Management of Systemic Sclerosis and Undifferentiated Connective Tissue Disease

“…However, the presence of anti-SRP antibodies has been occasionally reported in patients with other immunologic disorders, including SSc, however in the absence of an evident myopathy [24]. Nevertheless, skeletal muscle involvement represents a well-recognized characteristic of SSc [25–28]. Anti-PL-7, threonyl-tRNA synthetase, and anti-PL-12, alanyl-tRNA synthetase, antibodies have been previously implicated in the pathogenesis of the antisynthetase syndrome, a disease characterized by varying degrees of interstitial lung disease, myositis, arthropathy, fever, Raynaud's phenomenon, and mechanic's hands [29].…”

Correlation of skeletal muscle blood oxygenation level‐dependent MRI and skin laser doppler flowmetry in patients with systemic sclerosis

“…The here used muscle BOLD data has been published previously and used for correlation analysis with TcPO 2 measurements . Muscle BOLD MRI was performed on a 3 Tesla (T) whole‐body scanner (Verio, Siemens Medical Solutions, Erlangen, Germany) using a peripheral angiography array coil.…”

Skeletal muscle quantitative nuclear magnetic resonance imaging and spectroscopy as an outcome measure for clinical trials (part II)

“…Несколько состояний, влияющих на скелетные мышцы, были исследованы с помощью функциональ-ной томографии, в частности острая и хроническая ишемия [149][150][151][152], диабет [153], прогрессирующий системный склероз (склеродермия) [154] и синдром длительного сдавления [155].…”