Abstract
IntroductionWe sought to assess whether nailfold videocapillaroscopy (NVC) patterns are associated with levels of angiogenic factors in systemic sclerosis (SSc).MethodsCirculating endothelial progenitor cells (EPCs) and circulating endothelial cells (CECs) were measured in the peripheral blood of 60 consecutive SSc patients. Serum levels of eight endothelial markers were measured first in these 60 patients, and then in an independent replication cohort of 43 SSc patients in case of association with NVC patterns. NVC patterns were determined by four independent investigators blinded to vascular markers.ResultsPatients with the late-NVC pattern exhibited lower EPC levels (P < 0.0001) and higher VEGF levels (P = 0.03). Higher VEGF levels were confirmed to be associated with the late-NVC pattern in the replication cohort (P = 0.01). By multivariate analysis focused on biomarkers, lower EPC (P = 0.03) and higher VEGF levels (P = 0.001) were independently associated with the late-NVC pattern. In an alternate multivariate model including these two factors and SSc-related disease characteristics, lower EPC counts (P = 0.005), higher VEGF levels (P = 0.01), a history of digital ulcers (P = 0.04), and a modified Rodnan skin score > 14 (P < 0.0001) were independently associated with the late-NVC pattern.ConclusionOur data revealed decreased EPC counts and increased VEGF levels in patients with the late-NVC pattern. Further studies are now needed to determine the role of VEGF and EPCs in endothelial injury and repair in SSc.
Highlights
We sought to assess whether nailfold videocapillaroscopy (NVC) patterns are associated with levels of angiogenic factors in systemic sclerosis (SSc)
Reduced endothelial progenitor cell (EPC) numbers in the late-NVC pattern suggest that deficient vasculogenesis may contribute to the severe loss of capillaries observed in this pattern
We found that the lateNVC pattern was associated in univariate analysis with more-severe vascular manifestations or with the presence of markers of a more-diffuse SSc subset
Summary
We sought to assess whether nailfold videocapillaroscopy (NVC) patterns are associated with levels of angiogenic factors in systemic sclerosis (SSc). And diffuse microvascular alterations are key features of SSc, with outcome depending on the extent and severity of vascular lesions. Endothelial cell injury results in disorganization of endothelial layer favoring early impaired capillary architecture and loss of capillaries [7]. These features can be detected on nailfold videocapillaroscopy (NVC), which shows a variety of (PlGF) and soluble vascular cell-adhesion molecule (sVCAM) have been recently shown to predict the occurrence of ischemic digital ulcers and cardiovascular events, complications that directly relate to microvascular complications [18]
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