Evaluation of vascular lesion serum markers and anatomic and functional microcirculation changes in patients with primary and secondary Raynaud's phenomenon

• Grant number: 10/12613-9
• Support Opportunities: Scholarships in Brazil - Master
• Start date: March 01, 2011
• End date: February 28, 2013
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Cristiane Kayser
• Grantee: Cintia Zumstein Camargo
• Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil

Abstract

Raynaud's phenomenon (RP) is a relatively common disease in the general population. It is benign and not associated with disease (primary RP) in most of cases. It can be also secondary to local or systemic conditions, like the rheumatic autoimmune diseases (RAID). It's known that 10% of patients with primary RP develop RAID. However, the pathogenesis and mechanisms involved in the expression of systemic sclerosis (SS) spectrum diseases with RP are not totally comprehended. Anatomic (nailfold capillaroscopy and videocapillaroscopy) and functional (laser Doppler imaging) methods of microcirculation evaluation can be used for the evaluation of RP patients' microcirculation. In addition, the study of serum biomarkers of vascular injury is also relevant. In the present study, we intend to evaluate in a large population of patients with RP, with defined or pre-clinic disease, different serum markers of endothelial activation, platelet activation, oxidative stress, inflammation, angiogenesis and fibrosis involved in RP and SS spectrum diseases pathogenesis, and correlate them with clinical data and anatomic/functional microcirculation changes using nailfold capillaroscopy, videocapillaroscopy and laser Doppler imaging. 50 patients with primary RP, 50 patients with suspected secondary RP (undifferentiated connective tissue disease), 50 patients with systemic sclerosis and 50 healthy controls will be studied. Endothelin-1 (ET-1), vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-²) and von Willebrand factor (vWF) plasma levels will be measured by ELISA, C reactive protein (CRP) by turbidimetry, and thiobarbituric acid reactive substances (TBARS) using hot acid reaction. ELISA and TBARS reactions will be read by spectrophotometry. The panoramic nailfold capillaroscopy view will be held using a stereomicroscope with magnification of 10 to 25 times. The videocapillaroscopy will be performed under magnification of 200 times, with computerized equipment and the video system Videocap 8.14 (DS-Medica, Italy). Hand blood flow will be measured with laser Doppler imaging, before and after cold stimulus. Serum markers will be correlated with clinical and morphologic variables, with comparison of different parameters between the studied groups. The present study will allow a large approach of mechanisms involved in primary and secondary RP. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

CAMARGO, C. Z.; SEKIYAMA, J. Y.; ARISMENDI, M. I.; KAYSER, C.. Microvascular abnormalities in patients with early systemic sclerosis: less severe morphological changes than in patients with definite disease. SCANDINAVIAN JOURNAL OF RHEUMATOLOGY, v. 44, n. 1, p. 48-55, 2015. (10/51667-7, 10/12613-9)