Impairment of microcirculation in juvenile idiopathic arthritis - studies by nailfold videocapillaroscopy and correlation with serum levels of sICAM and VEGF.

Abstract

Impairment of vascular endothelium plays a key role in the pathogenesis of inflammatory diseases including juvenile idiopathic arthritis (JIA) and atherosclerosis. We hypothesized that structural abnormalities of the smallest blood vessels (capillaries) might exist and reflect endothelial dysfunction in children with JIA. Microcirculation was studied, by means of nailfold videocapillaroscopy with computer-associated image analysis, in 43 patients with JIA and compared with 20 healthy children. Moreover, capillaroscopic findings were correlated with the activity of the disease and the levels of serum biomarkers of endothelial injury, namely soluble intercellular adhesion molecule (sICAM) and vascular endothelial growth factor (VEGF). We found that in JIA patients capillaries were significantly wider and longer than in healthy controls. Moreover, irregular capillaries and dilated subpapillary venous plexus were found significantly more frequently in JIA in comparison with the control group. Serum levels of sICAM and VEGF were significantly higher in JIA patients with capillary abnormalities than in JIA patients with normal capillaroscopy. Our study indicates that there are structural changes in the microcirculation of patients with JIA and that these changes might reflect endothelial injury. Whether capillaroscopy might have a role in early identification of JIA patients being at higher risk of atherosclerosis requires further studies.

Microvascular abnormalities in capillaroscopy correlate with higher serum IL-18 and sE-selectin levels in patients with type 1 diabetes complicated by microangiopathy

“…Nailfold capillaroscopy (NC) has been used as a non-invasive and sensitive technique for evaluating microvascular involvement, mainly in connective tissue diseases, including scleroderma-spectrum disorders [14], systemic lupus erythematosus [8], juvenile idiopathic arthritis [15] and other connective tissue diseases [16].…”

Value of nailfold videocapillaroscopy and high-sensitivity C-reactive protein test in diagnosis of microangiopathy in adolescents with Raynaud’s phenomenon

“…endothelins and E-selectins) as well as reduced production of myorelaxing and anti-thrombotic factors (nitric oxide, prostacyclin) [5,6]. This has been confirmed in studies of biochemical markers of inflammation and endothelial dysfunction, including adhesions and chemokines in autoimmune diseases and many peripheral vascular disorders (atherosclerosis, hypertension, diabetic microangiopathy) [7][8][9][10][11].…”

Soluble molecules of immunoglobulins superfamily in rheumatoid arthritis

“…Even in juvenile rheumatoid arthritis, correlation of PECAM-1, ICAM-1 and vascular endothelial growth factor with number of circulating leucocytes and platelets was observed [2,12]. But, possible association of mediators of intercellular interaction with deviations in cellular composition of blood in RA was not shared by all the researchers [7].…”