Longterm Treatment with Endothelin Receptor Antagonist Bosentan and Iloprost Improves Fingertip Blood Perfusion in Systemic Sclerosis

被引：53

作者：

Cutolo, Maurizio ^{[1
]}

Ruaro, Barbara ^{[1
,2
]}

Pizzorni, Carmen ^{[1
,2
]}

Ravera, Francesca ^{[1
,2
]}

Smith, Vanessa ^{[3
]}

Zampogna, Giuseppe ^{[1
,2
]}

Paolino, Sabrina ^{[1
,2
]}

Seriolo, Bruno ^{[1
,2
]}

Cimmino, Marco ^{[1
,2
]}

Sulli, Alberto ^{[1
,2
]}

机构：

[1] Univ Genoa, Res Lab, I-16132 Genoa, Italy

[2] Univ Genoa, Acad Div Clin Rheumatol, Dept Internal Med, I-16132 Genoa, Italy

[3] Ghent Univ Hosp, Dept Rheumatol, Ghent, Belgium

来源：

JOURNAL OF RHEUMATOLOGY | 2014年 / 41卷 / 05期

关键词：

SYSTEMIC SCLEROSIS; RAYNAUD PHENOMENON; LASER DOPPLER FLOWMETRY; NAILFOLD VIDEOCAPILLAROSCOPY; ENDOTHELIN-1; ANTAGONIST; ILOPROST; RAYNAUDS-PHENOMENON; NAILFOLD VIDEOCAPILLAROSCOPY; CAPILLAROSCOPIC ANALYSIS; MICROVASCULAR CHANGES; DISEASE; MANAGEMENT; SEVERITY; DAMAGE;

D O I：

10.3899/jrheum.131284

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective. To evaluate the longterm effects of endothelin-1 (ET-1) antagonism on peripheral blood perfusion (PBP) in patients with systemic sclerosis (SSc). Methods. Twenty-six patients with SSc already receiving cyclic intravenous iloprost (ILO) for severe Raynaud phenomenon were enrolled. Thirteen patients continued the treatment for a further 3 years (ILO group) and 13 patients, because of the appearance of digital ulcers, received in addition bosentan (BOS; 125 mg twice/day) for 3 years (ILO + BOS group). Both PBP at fingertips and nailfold microangiopathy were evaluated yearly by laser Doppler flowmetry and nailfold videocapillaroscopy, respectively. Results. A progressive significant increase of PBP was observed in the ILO + BOS group during the 3 followup years (p = 0.0007, p = 0.0002, p = 0.01, respectively). In contrast, an insignificant progressive decrease of PBP was observed in the ILO group. Difference of perfusion between the PBP evaluations at basal temperature and at 36 degrees C (to test capillary dilation capacity), was found progressively decreased during the 3-year followup only in the ILO group (p = 0.05, p = 0.26, p = 0.09, respectively). A progressive increase of nailfold capillary number was observed only in the ILO + BOS group after 2 and 3 years of followup (p = 0.05). Conclusion. Longterm treatment of SSc patients with ET-1 antagonism, in combination with ILO, seems to increase fingertip blood perfusion, as well as both capillary dilation capacity and number.

引用

页码：881 / 886

页数：6

共 18 条

[1] Scleroderma patients nailfold videocapillaroscopic patterns are associated with disease subset and disease severity [J].