Primary Raynaud's Syndrome Research Articles

Helicobacter pylori infection in connective tissue disorders is associated with high levels of antibodies to mycobacterial hsp65 but not to human hsp60.

To investigate whether the Helicobacter pylori status influences levels of antibodies against mycobacterial heat shock protein (hsp) 65 and human hsp60 in systemic autoimmune diseases and to study the concentration of anti-H. pylori antibodies in autoimmune patients and healthy controls. Antibodies against human heat-shock protein hsp60, mycobacterial heat-shock protein hsp65 were analyzed by ELISA. Anti-Helicobacter antibodies were determined by enzyme immunoassay. There was a markedly higher prevalence of H. pylori infection in undifferentiated connective tissue disease (82%) (n = 33) and systemic sclerosis (78%) (n = 55) but not in systemic lupus erythematosus (n = 49), polymyositis/dermatomyositis (n = 14), rheumatoid arthritis (n = 21) or primary Raynaud's syndrome (n = 26) compared with controls (59%) (n = 349). In autoimmune diseases H. pylori infection was associated with elevated levels of antihsp65 (p =.008) but not of antihsp60. Anti-hsp65 levels were significantly higher in H. pylori-infected (n = 129) than in uninfected patients (n = 69) (p =.0007). These findings indicate that in autoimmune diseases the infection with the H. pylori bacterium is associated with increased concentration of antimycobacterial hsp65.

Ambulante low-dose Iloprost-Therapie des Raynaud-Syndroms**

Iloprost ist ein Prostazyklin-Derivat mit starker vasodilatatorischer und rheologischer Wirkung. Es wird zur Therapie okklusiver Gefäßerkrankungen wie der Thrombangiitis obliterans, der peripheren arteriellen Verschlusskrankheit oder im Rahmen von Heilversuchen bei der pulmonalen Hypertension oder beim Raynaud-Syndrom eingesetzt. Derzeit steht Iloprost lediglich für die parenterale Applikation zur Verfügung. Die ambulante Anwendung wird dadurch erheblich eingeschränkt. Die vorliegende Arbeit berichtet über erste Erfahrungen mit einem ambulanten Therapiekonzept an 7 Patientinnen mit primärem oder sekundärem Raynaud-Syndrom. Über 4 Wochen wurden an jedem Wochentag 25 µg Iloprost (max. 2,0 ng/kg KG/min) in 250 ml physiolog. NaCl-Lösung i. v. infundiert. Alle Patienten profitierten bei überwiegend guter Verträglichkeit von diesem Vorgehen. Gemäß unserer Erfahrung eignet sich diese Vorgehensweise bei sachgerechter Anwendung und sorgfältiger Patientenauswahl sowie -kontrolle für eine ambulante Therapie.

Levels of antibodies against C1q and 60 kDa family of heat shock proteins in the sera of patients with various autoimmune diseases

Previously a strong positive correlation was found between antibodies to C1q (C1qAb) and antibodies against human heat shock protein (hsp60) and mycobacterial hsp65 in HIV infected patients. Here the levels of these antibodies were measured in the sera of patients with different autoimmune diseases (122 systemic lupus erythematosus (SLE), 55 systemic sclerosis, 33 undifferentiated connective tissue disease (UCTD), 27 primary Raynaud syndrome, 21 rheumatoid arthritis (RA), 14 polymyositis/dermatomyositis (PM/DM), and 192 healthy blood donors. The prevalence of IgG C1qAb was found to be high ( P<0.0001 as compared to the healthy controls) only in the SLE group. The levels of the anti-hsp60 ( P=0.0094) and anti-hsp65 ( P=0.0108) antibodies were high only in the UCTD patients. No correlation was found between the C1qAb and anti-hsp antibodies in any group except a significant ( P=0.011) positive correlation between C1qAb and hsp65 antibodies in the patients with UCTD. These findings indicate that the autoantibodies against C1q are heterogeneous: in different diseases different types of C1qAb may dominate.

Effect of nitric-oxide-generating system on microcirculatory blood flow in skin of patients with severe Raynaud's syndrome: a randomised trial

Patients with Raynaud's syndrome have abnormal digital vasoconstriction, which may be secondary to impaired synthesis of, or impaired sensitivity to, nitric oxide. We studied the effect on microcirculation of a nitric-oxide-generating system applied topically to the finger and forearm of healthy volunteers and patients with primary Raynaud's syndrome. We did a single-blind, randomised, placebo controlled, cross-over study of the microcirculatory response to topical application of a nitric-oxidegenerating gel in 20 patients with severe Raynaud's syndrome, and ten healthy volunteers. We prepared the nitric-oxide-generating system by mixing a solution of KY jelly and sodium nitrite (5% weight/volume), with a solution of KY jelly and ascorbic acid (5% weight/volume). About 0.5 mL of each solution was separately applied to the skin of the forearm (3 cm2), and then mixed with a sterile cotton bud. A similar procedure was done simultaneously on the other arm with KY jelly only (placebo). The procedure was then repeated on the finger pulps. Changes in skin microcirculatory volume and flux were measured bilaterally by infrared photoplethysmography and laser doppler fluxmetry, respectively. In the forearm, blood flow increased significantly after application of the active gel both in patients with Raynaud's syndrome (microcirculatory volume from mean area under the curve 98 [SE 14] to 1024 [130]; microcirculatory flux from 5060 [462] to 74,800 [3940]) and in healthy controls (volume from 85 [19] to 1020 [60]; flux from 4420 [435] to 84,500 [7000]). In the fingers, although baseline blood flow was lower in patients than in controls, both groups showed increases with application of active gel (volume from 1100 [194] to 3280 [672] and 2380 [441] to 6160 [1160], respectively; flux from 33,400 [4200] to 108,000 [13,600] and 52,000 [8950] to 185,000 [19,500]). Increases in blood flow with placebo gel were not significant. No adverse effects were reported. In primary Raynaud's syndrome, topical application of a nitric-oxide-generating system can stimulate an increase in both microcirculatory volume and flux.

Is acupuncture effective in the treatment of primary Raynaud's syndrome?

Is acupuncture effective in the treatment of primary Raynaud's syndrome?

Detection of serum interleukin 10 levels in patients with dermato-polymyositis, scleroderma and primary Raynaud's syndrome

Detection of serum interleukin 10 levels in patients with dermato-polymyositis, scleroderma and primary Raynaud's syndrome

Detection of serum interleukin 10 levels in patients with dermato-polymyositis, scleroderma and primary Raynaud's syndrome

Detection of serum interleukin 10 levels in patients with dermato-polymyositis, scleroderma and primary Raynaud's syndrome

Cold and the airways.

Physiological and pathological respiratory responses are triggered by various conditions of exposure to cold climates. Beside airway smooth muscle, both the pulmonary and the tracheobronchial vasculatures are major effectors of respiratory responses to cold. General exposure to cold causes pulmonary vasoconstriction known as "Raynaud's phenomenon of the lung" in subjects with primary Raynaud syndrome and favors acute pulmonary oedema in subjects with congestive heart failure. In healthy subjects acute hyperventilation of very cold air has led to acute respiratory failure closely similar to hypoxic pulmonary oedema. In outdoor exercising people years long repetition of hyperventilation of subfreezing air causes "eskimo lung" made of obstructive lung disease and increased wall thickness of pulmonary arteries. At a lesser degree hyperventilation of dry air cools the central airways and triggers subclinical bronchial obstruction in healthy subjects. In asthmatic subjects hyperventilation of dry air causes asthma attacks. Results of recent animal and human experiments point to a key role of mucosal vessels in thermal balance of the airways. Simultaneously, there is increasing evidence that hyperventilation-induced asthma is triggered by a thermal stimulus.

Raynaud's Syndrome

This is a comprehensive, well-organized, and detailed book regarding the pathophysiologic characterstics, diagnosis, and management of disturbances in the microcirculation of patients with primary Raynaud's disease and secondary Raynaud's syndrome. This is the best contemporary reference available for students, residents, and practicing physicians seeking up-to-date information about this disease complex. Descriptions of the immunologic, physiologic, technologic, and pharmacologic aspects of the disease complex are combined in a cogent format that includes extensive documentation. This text should be part of the reference library for physicians treating vascular diseases in the 1990s.

Capillary blood cell velocity in finger nailfold: Characteristics and reproducibility of the local cold response

The characteristics and reproducibility of nailfold capillary blood cell velocity (CBV) of the local cold response was evaluated in 30 cases by video-microscopy using a flying-spot technique. CBV, as well as flow stop duration during cooling, from a first and second test was significantly ( P < 0.05) reproducible, whether or not the test was repeated after 60 min or after an interval of 12 weeks. Because of interindividual variations in rest CBV, and a better reproducibility of the flow stop duration, this last parameter is more useful in clinical practice for follow-up evaluations of the local cold response test. The usefulness of the flying-spot generator for rapid and accurate measurement of CBV in finger nailfold capillaries is demonstrated in normal subjects and patients with primary Raynaud syndrome during a local cooling test.

Raynaud syndrome in childhood

Twenty-seven patients with Raynaud syndrome (mean age at onset 11.7 years) were studied to determine the prevalence of primary Raynaud syndrome and to assess the predictive role of antinuclear antibody, nail-fold capillary microscopy, and photoelectric plethysmography in this population. Fourteen patients (52%) had a connective tissue disease, four (15%) had a probable connective tissue disease, and nine (33%) had primary Raynaud syndrome. In all patients with either a connective tissue disease or a probable connective tissue disease, there was a positive reaction to antinuclear antibody, in contrast to patients with primary Raynaud syndrome, in whom antinuclear antibody was not detected. Nail-fold capillary microscopy scores differed significantly between patients with either a connective tissue disease or a probable connective tissue disease and those with primary Raynaud syndrome for both enlarged loop score (p less than 0.025 and less than 0.05, respectively) and avascular score (p less than 0.005 and less than 0.01, respectively). Photoelectric plethysmography scores were reduced in all groups but did not differ significantly between groups. Our findings suggest that in children with Raynaud syndrome, the primary type is more common than was originally suspected, and that both antinuclear antibody and nail-fold capillary microscopy, but not photoelectric plethysmography, can distinguish patients with primary Raynaud syndrome from those with either a connective tissue disease or a probable connective tissue disease.