Microcirculatory Functions in Systemic Sclerosis: Additional Parameters for Therapeutic Concepts?

Albrecht, Hans; Hiller, D.; Hornstein, O. P.; Bühler-Singer, Susanne; Mück, Michael; Gruschwitz, Matthias S.

doi:10.1111/1523-1747.ep12363834

Cited by 25 publications

(13 citation statements)

References 27 publications

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“…Over the fore¬ arm, which scleroderma often affects in a variable way, normal perfusion persists.23 in contrast, investigators con¬ sistently describe decreased flow over the finger¬ tip16,21"23 but increased flow over the dorsal aspect of the hand 15,16,24 Studies by Kristensen23 and Kristensen and Henrik-sen26 countered the notion that increased blood flow ac¬ tively compensates for capillary obstruction and hypoxia in scleroderma, demonstrating that, instead, there is a fixed dilatation of arterioles that results passively from defective regulation of vascular smooth muscle. Both stud¬ ies2326 demonstrated that when the sclerodermatous hand was elevated or lowered, arteriolar tone was conspicu¬ ously absent, allowing perfusion pressure to dictate flow.…”

Section: Two-dimensional Blood Flow Mappingmentioning

confidence: 99%

“…We obtained serial durometer measurements at 2-cm intervals over the arms of four patients with scleroderma, correlating them with blinded assessments of skin score. Third, we produced two-dimensional laser Doppler maps of cutaneous blood flow over the dorsal aspect of the hands of 10 patients with scleroderma and 16 controls and, with software, we determined the mean red blood cell flux, density of arteriolar islands, and percentage of avascular area at each measured site.…”

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confidence: 99%

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Reproducible Measurements to Quantify Cutaneous Involvement in Scleroderma

Aghassi

Monoson²,

Braverman³

1995

Arch Dermatol

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Section: Two-dimensional Blood Flow Mappingmentioning

confidence: 99%

mentioning

confidence: 99%

Reproducible Measurements to Quantify Cutaneous Involvement in Scleroderma

Aghassi

Monoson²,

Braverman³

1995

Arch Dermatol

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“…For example, abnormal microvascular responses are localized to both small and large vessels of the digits [182]. Functional capacity of the microcirculation is impaired in scleroderma when measuring reactivity following arterial occlusion and local heat exposure [183,184]. Endothelium-dependent and -independent vasodilatation is found impaired in patients with Raynaud's phenomenon secondary to scleroderma [185].…”

Section: Vascular Reactivitymentioning

confidence: 99%

Vascular Disease in Scleroderma

Wigley

2008

Clinic Rev Allerg Immunol

113

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Although scleroderma is generally considered a fibrosing disease of the tissues, it is now recognized that the underlying vascular disease is playing a fundamental role in its pathogenesis and associated tissue injury. The exact mechanism for the widespread scleroderma vascular disease is still unknown, but endothelial cell injury induced by infection, immune-mediated cytotoxicity, antiendothelial antibodies, and/or ischemia-reperfusion have all been implicated. The downstream effects of blood vessel perturbation produce "biomarkers" of vascular damage that reflect disease and may predict clinical outcomes. A complex interaction between endothelial cells, smooth muscle cells, extracellular matrix, and intravascular circulating factors is now recognized to contribute to the vascular reactivity, remodeling, and occlusive disease of scleroderma. Understanding the mechanisms underlying these processes provides rationale of novel therapeutic strategies and specific targeted therapy. This review will outline some of the evidence for the causes and consequences of scleroderma vascular disease.

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“…Capillary microscopy, the preferred method of assessing capillary blood flow [11], has been coupled with videophotometric systems and software to analyze capillary blood cell velocity [12]. This unique technique has been applied to evaluate dynamic microcirculatory status in peripheral vascular disorders, including arterial occlusive diseases [11], collagen vascular diseases [13], and congenital heart disease [14]. …”

Section: Introductionmentioning

confidence: 99%

Deterioration of cutaneous microcirculatory status of Kawasaki disease

Huang

et al. 2012

Clin Rheumatol

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Kawasaki disease (KD) is associated with generalized vasculitis with a predilection for coronary artery leading to ectasia and aneurysm in some cases. The aim of this study was to noninvasively assess the cutaneous microcirculation and correlate it with the coronary artery diameter in these patients. Laser Doppler flowmetry and dynamic capillaroscopy were performed at the nailbeds to assess total cutaneous blood flow and microcirculation in children with KD, both in the afebrile phase (after the resolution of fever) and convalescent phases, in comparison to controls. The 100 subjects analyzed in this study included 64 patients with KD (33 in afebrile phase and 31 in convalescent phase) and 36 normal controls. In KD, the capillary morphology was abnormal when compared to controls, with a larger diameter of the arterial and venous limbs, a higher intercapillary distance and a decrease in the loop numbers. Significantly decreased capillary blood cell velocity was noted in afebrile phase but not in convalescent phase. In the afebrile phase, a decreased capillary blood cell velocity significantly correlated with an increased coronary artery diameter. In conclusion, KD patients, both in the afebrile and convalescent phases, exhibited morphologic alterations in the microcirculation when compared to the controls. The results indicate the potential role of dynamic capillaroscopy for the noninvasive survey of microcirculation abnormalities in patients with KD.

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Microcirculatory Functions in Systemic Sclerosis: Additional Parameters for Therapeutic Concepts?

Cited by 25 publications

References 27 publications

Reproducible Measurements to Quantify Cutaneous Involvement in Scleroderma

Reproducible Measurements to Quantify Cutaneous Involvement in Scleroderma

Vascular Disease in Scleroderma

Deterioration of cutaneous microcirculatory status of Kawasaki disease

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