Session Information
Date: Monday, November 9, 2015
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.
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 .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/nailfold-capillaroscopic-assessment-and-vascular-biomarkers-in-systemic-sclerosis-low-cd40l-levels-in-patients-with-late-scleroderma-patterns/