The influence of Multiwave Locked System (MLS) laser therapy on clinical features, microcirculatory abnormalities and selected modulators of angiogenesis in patients with Raynaud's phenomenon.

Anna Kuryliszyn-Moskal,Ewa Jabłońska,Piotr Adrian Klimiuk,Sylwia Chwieśko-Minarowska,Agnieszka Dakowicz,Diana Moskal,Jacek Kita,Bożena Kosztyła-Hojna

doi:10.1007/s10067-014-2637-8

Anna Kuryliszyn-Moskal, Ewa Jabłońska + Show 6 more

Open Access

https://doi.org/10.1007/s10067-014-2637-8

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Journal: Clinical rheumatology	Publication Date: May 13, 2014
Citations: 41	License type: CC BY 4.0

Affiliation: Medical University of Białystok

Abstract

The aim of this study was to investigate the influence of the Multiwave Locked System (MLS) laser therapy on clinical features, microvascular changes in nailfold videocapillaroscopy (NVC) and circulating modulators releasing as a consequence of vascular endothelium injury such as vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang-2) in patients with primary and secondary Raynaud’s phenomenon. Seventy-eight RP patients and 30 healthy volunteers were recruited into the study. All patients with RP received MLS laser irradiation for 3 weeks. Clinical, NVC and laboratory investigations were performed before and after the MLS laser therapy. The serum concentration of VEGF and Ang-2 were determined by an enzyme-linked immunosorbent assay (ELISA). After 3 weeks of MLS laser therapy, the clinical improvement manifested by decreasing of the number of RP attacks, mean duration of Raynaud’s attack and pain intensity in RP patients was observed. After MLS laser therapy in 65 % of patients with primary and in 35 % with secondary RP, an increase in the loop number and/or a reduction in avascular areas in NVC were observed. In comparison with a control group, higher serum concentration of VEGF and Ang-2 in RP patients was demonstrated. After MLS laser therapy, a reduction of Ang-2 in both groups of RP patients was found. Our results suggest that NVC may reflect microvascular changes associated with clinical improvement after MLS laser therapy in patients with primary and secondary RP. Ang-2 serum levels may be a useful marker of microvascular abnormalities in RP patients treated with MLS laser therapy.

Highlights

Raynaud’s phenomenon (RP) is a vascular disorder characterized by recurrent vasospastic response of the fingers and toes to cold or emotional stimuli
Before the Multiwave Locked System (MLS) laser therapy, no significant differences in age, sex, the duration of symptoms and the pain intensity assessed by visual analogue scale (VAS) between two groups of patients with primary and secondary RP were seen
After the MLS laser therapy, the number of RP attacks, their duration and intensity measured by VAS scale was significantly reduced in the both groups of RP patients (p

Summary

Introduction

Raynaud’s phenomenon (RP) is a vascular disorder characterized by recurrent vasospastic response of the fingers and toes to cold or emotional stimuli. The pathogenesis of RP is poorly understood, current data points to three main pathophysiological mechanisms: vascular abnormalities, disturbances in the neural control of vascular tone and intravascular factors including circulating mediators and they influence on the balance between vasoconstriction and vasodilatation [2]. Angiogenic factors such as vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2) are the main regulators of angiogenesis, playing an essential role in vascular remodelling [3, 4]. It has been shown that VEGF and Ang-2 reflected the dysregulation of endothelium, leading to the development of the main clinical manifestations in patients with systemic sclerosis [7]

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