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
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
收藏
页码:881 / 886
页数:6
相关论文
共 18 条
[11]   Bosentan Improves Skin Perfusion of Hands in Patients with Systemic Sclerosis with Pulmonary Arterial Hypertension [J].
Rosato, Edoardo ;
Molinaro, Ilenia ;
Borghese, Federica ;
Rossi, Carmelina ;
Pisarri, Simonetta ;
Salsano, Felice .
JOURNAL OF RHEUMATOLOGY, 2010, 37 (12) :2531-2539
[12]   Endothelin and scleroderma lung disease [J].
Silver, R. M. .
RHEUMATOLOGY, 2008, 47 :V25-V26
[13]   Nailfold capillaroscopy for day-to-day clinical use: construction of a simple scoring modality as a clinical prognostic index for digital trophic lesions [J].
Smith, Vanessa ;
De Keyser, Filip ;
Pizzorni, Carmen ;
Van Praet, Jens T. ;
Decuman, Saskia ;
Sulli, Alberto ;
Deschepper, Ellen ;
Cutolo, Maurizio .
ANNALS OF THE RHEUMATIC DISEASES, 2011, 70 (01) :180-183
[14]   Reliability of the qualitative and semiquantitative nailfold videocapillaroscopy assessment in a systemic sclerosis cohort: a two-centre study [J].
Smith, Vanessa ;
Pizzorni, Carmen ;
De Keyser, Filip ;
Decuman, Saskia ;
Van Praet, Jens T. ;
Deschepper, Ellen ;
Sulli, Alberto ;
Cutolo, Maurizio .
ANNALS OF THE RHEUMATIC DISEASES, 2010, 69 (06) :1092-1096
[15]   Digital ulcers: overt vascular disease in systemic sclerosis [J].
Steen, V. ;
Denton, C. P. ;
Pope, J. E. ;
Matucci-Cerinic, M. .
RHEUMATOLOGY, 2009, 48 :19-24
[16]   Scoring the nailfold microvascular changes during the capillaroscopic analysis in systemic sclerosis patients [J].
Sulli, A. ;
Secchi, M. E. ;
Pizzorni, C. ;
Cutolo, M. .
ANNALS OF THE RHEUMATIC DISEASES, 2008, 67 (06) :885-887
[17]   Correlations between nailfold microangiopathy severity, finger dermal thickness and fingertip blood perfusion in systemic sclerosis patients [J].
Sulli, A. ;
Ruaro, B. ;
Alessandri, E. ;
Pizzorni, C. ;
Cimmino, M. A. ;
Zampogna, G. ;
Gallo, M. ;
Cutolo, M. .
ANNALS OF THE RHEUMATIC DISEASES, 2014, 73 (01) :247-251
[18]   Progression of Nailfold Micro Vascular Damage and Antinuclear Antibody Pattern in Systemic Sclerosis [J].
Sulli, Alberto ;
Ruaro, Barbara ;
Smith, Vanessa ;
Pizzorni, Carmen ;
Zampogna, Giuseppe ;
Gallo, Maurizio ;
Cutolo, Maurizio .
JOURNAL OF RHEUMATOLOGY, 2013, 40 (05) :634-639