ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1909

Nailfold Capillaroscopic Assessment and Vascular Biomarkers in Systemic Sclerosis: Low CD40L Levels in Patients with Late Scleroderma Patterns

Yasemin Yalcinkaya1, Suzan Cinar2, Sevil Kamali3, Ozlem Pehlivan4, Lale Ocal1, Gunnur Deniz2 and Murat Inanc3, 1Istanbul Medical Faculty, Department of Internal Medicine, Division of Rheumatology, Istanbul University, Istanbul, Turkey, 2Department of Immunology, Istanbul University, Institute of Experimental Medicine (DETAE), Istanbul, Turkey, 3Department of Internal Medicine, Division of Rheumatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey, 4Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Rheumatology, Istanbul University, Istanbul, Turkey

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: ,

Session Information

Date: Monday, November 9, 2015

Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Pathogenesis, Animal Models and Genetics Poster I

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: To determine the relationship between vascular biomarkers reflecting the vascular   injury and neoangiogenesis with nailfold capillaroscopic changes in systemic sclerosis (SSc).

Methods: Seventy-two SSc patients (66 female) fulfilling Leroy and Medsger classification criteria were evaluated, including clinical findings, nailfold videocapillaroscopy (NVC) was performed qualitatively (early, active and late scleroderma patterns) in all patients (Cutolo M, et al. J Rheumatol 2000). Serum samples of patients were collected for flow-cytometric analysis of  CD40L,  tPA,  MCP-1,  sE-selectin,  IL-8,  IL-6, VEGF,  sP-selectin,  TGF-β1  and  VCAM levels ( Bender  MedSystems,  Vienna,  Austria )  at  the  same  time  with  NVC.  Results were  compared  with  Pearson  chi-square / Fischer’s, Mann Withney U ve Kruskal Wallis tests. 

Results: The mean age of the patients was 44.9 and disease duration from the appearance of Raynaud’s and non-Raynaud symptoms were 5.8±5.9 and 3.2±2.4 years.  Of the patients 23 (%32)  had diffuse and 49 (%68) limited cutaneous involvement, 15(%21) were anti-centromere(+) and 34(%47) were anti-Scl70(+).

When we compared with healthy subjects; tPA (p=0.02), MCP-1 (p=0.001), sE-selectin (p=0.008) and TGF-β1(p=0.001) levels were significantly higher,  sP-selectin (p=0.011) ve IL-8(p=0.001) levels were lower in SSc patients (table-1)(figure-1). SSc patients grouped according to NVC patterns as ‘early’(n=10), ‘active’(n=37)  and ‘late’(n=25). Between groups according to NVC patterns, only sCD40L(pg/ml) levels were significantly lower in the ‘late’ group (p=0.043), higher in patients with limitted cutaneus involvement (p=0.01) and smoking history (n=32,%44) (p=0.033). The other markers were similar between NVC groups.

Table-1: Vascular Biomarkers in Healthy Controls, Systemic Sclerosis and NVC patterns

Biomarker Levels  (mean±SD)                                                        

 

Healthy

  Controls 

(n=20)

 

Systemic

Sclerosis

(n=72)

NVC

Early

 (n=10)

   NVC

   Active

   (n=37)

NVC

       Late       

(n=25)

sCD40L  (pg/ml)

24620±13051

27847±33315

27584±14694

34656±42750

17877±16911

tPA  (pg/ml)

2415±1279*

4036±6961

3173±1364

4835±9577

3199±1742

MCP-1  (pg/ml)

907±300**

1302±550

1096±433

1372±636

1282±437

sE-selectin  (ng/ml)

205±78**

269±106

212±69

283±110

272±107

IL-8  (pg/ml)

49±73**

22±80

7±14

22±82

30±93

IL-6  (pg/ml)

0

0.6±2.8

17.9

13.3

9.3/2.8

VEGF  (pg/ml)

704±363

776±591

996±904

745±570

733±464

sP-selectin  (ng/ml)  

364±137*

287±86

316±83

292±98

267±62

TGF-β1 (pg/ml)

  2421±4785**

8277±8592

12115±9511

8128±9140

6964±7155

VCAM  (pg/ml)

3231±1435

3945±1754

3951±1062

4091±1771

3727±1973

*p<0.05, **p<0.01 When healthy controls and sytemic sclerosis patients were compared with  Mann-Whitney tests, ¶ p<0.05 When early, active and late NVC patterns in systemis sclerosis patients were compared with Kruskal-Wallis test

Conclusion: There was lower sCD40L serum levels in patients with late NVC patterns, although the levels were similar to healthy controls in patients with early, active NVC patterns. CD40L may be a key molecule in the early/active phase of vascular involvement. Higher concentrations of sCD40L in patients with limited cutaneous disease and smoking history might be related to its role in vascular pathology. NVC is a useful method for investigating the vascular pathogenesis in SSc.

Disclosure: Y. Yalcinkaya, None; S. Cinar, None; S. Kamali, None; O. Pehlivan, None; L. Ocal, None; G. Deniz, None; M. Inanc, None.

To cite this abstract in AMA style:

Yalcinkaya Y, Cinar S, Kamali S, Pehlivan O, Ocal L, Deniz G, Inanc M. Nailfold Capillaroscopic Assessment and Vascular Biomarkers in Systemic Sclerosis: Low CD40L Levels in Patients with Late Scleroderma Patterns [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/nailfold-capillaroscopic-assessment-and-vascular-biomarkers-in-systemic-sclerosis-low-cd40l-levels-in-patients-with-late-scleroderma-patterns/. Accessed .

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