Capillaroscopic patterns in patients with systemic sclerosis, psoriasis and alopecia and their correlations with serum concentrations of several angiogenic markers
DOI:
https://doi.org/10.1515/pjph-2015-0024Keywords:
capillaroscopy, nailfold videocapillaroscopy, angiogenesis, systemic scleroderma, psoriasis, psoriatic arthritis, alopecia areata, androgenetic alopeciaAbstract
Introduction. Capillaroscopy is a non-invasive imaging method that allows cutaneous microcirculation to be analyzed. During the last decades, a diagnostic and prognostic potential of nailfold capillaroscopy (NVC) has been gaining increasing appreciation. The main indications include Raynaud phenomenon and scleroderma spectrum diseases, however the usefulness of this technique is also suggested in a variety of non-rheumatic diseases.
Aim. To assess capillaroscopic patterns in systemic scleroderma (SSc), psoriasis (PV), psoriatic arthritis (PsA), alopecia areata (AA) and androgenetic alopecia. To evaluate serum levels of several endothelial and angiogenic markers, and their relation to capillaroscopic pattern.
Material and methods. There were evaluated 295 patients with systemic scleroderma (SSc), psoriasis (PV), psoriatic arthritis (PsA), alopecia areata (AA) and androgenetic alopecia, as well as age- and sex-matched controls, were examined. In each subject, NVC was performed and serum concentration levels of several angiogenic markers.
Results. In SSc three NVC patterns: early, active and late were distinguished. Angiopoietin-2 concentrations were higher and andothelial microparticles were lower in patients with late NVC pattern. We found several differences between the NVC pattern in PV and PsA. No correlations between NVC pattern and serum levels of angiogenic markers were revealed. In AA, we distinguished both normal and abnormal NVC patterns, although the normal patterns were more frequent. Branching capillaries and features of neoformation were often present in patients with the abnormal pattern. In androgenetic alopecia, the normal NVC pattern was most frequently present, however, we found several statistically significant capillarosopic alterations, like branching capillaries, features of neoformation and altered distribution of capillaries.
Discussion and Conclusions. Serum levels of Ang-2 and EMPs may reflect capillary damage in SSc. NVC pattern varies between PV and PsA patients. The presence of abnormal NVC patterns in alopecia patients might show the role of disturbances in microcirculation in the diseases. Further studies are required to confirm the hypothesis.
References
1. Cutolo M. Atlas of Capillaroscopy in rheumatic diseases. 1st ed. Milano: Elsevier; 2010.
2. Gallucci F, Russo R, Buono R, et al. Indications and results of videocapillaroscopy in clinical practice. Adv Med Sci. 2008;53(2):1-9. [Web of Science]
3. Jimenez JJ, Jy W, Mauro LM, et al. Endothelial microparticles (EMP) as vascular disease markers. Adv Clin Chem. 2005;39:131-57. [PubMed] [CrossRef]
4. Bernal-Mizrachi L, Jy W, Fierro C, et al. Endothelial microparticles correlate with high-risk angiographic lesions in acute coronary syndromes.Int J Cardiol. 2004;97(3):439-46. [CrossRef]
5. Michalska-Jakubus M, Kowal-Bielecka O, Chodorowska G, et al. Angiopoietins-1 and -2 are differentially expressed in the sera of patients with systemic sclerosis: high angiopoietin-2 levels are associated with greater severity and higher activity of the disease. Rheumatol. 2011;50(4):746-55.
6. Gerkowicz A, Krasowska D, Pietrzak A, et al. Videocapillaroscopic alterations in alopecia areata. Biomed Rese Int. 2013;2013:160203.
7. Brown GE, O’Leary PA. Skin capillaries in scleroderma. Arch Intern Med. 1925;36:73-88. [CrossRef]
8. Maricq HR, LeRoy EC. Patterns of finger capillary abnormalities in connective tissue disease by “wide-field” microscopy. Arthritis Rheum. 1973;16(5):619-28. [PubMed] [CrossRef]
9. Cutolo M, Sulli A, Pizzorni C, Accardo S. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis. J Rheumatol. 2000;27(1):155-60. [PubMed]
10. Minier T, Guiducci S, Bellando-Randone S, et al. Preliminary analysis of the very early diagnosis of systemic sclerosis (VEDOSS) EUSTAR multicentre study: evidence for puffy fingers as a pivotalsign for suspicion of systemic sclerosis. Ann Rheum Dis. 2014;73(12):2087-93. [Web of Science] [CrossRef] [PubMed]
11. van den Hoogen F, Khanna D, Fransen J, et al. 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/ European League against Rheumatism collaborative initiative. Arthritis Rheum. 2013;65(11):2737-47.
12. Sebastiani M, Manfredi A, Colaci M, et al. Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. Arthritis Rheum. 2009;61(5):688-94. [PubMed] [Web of Science] [CrossRef]
13. Riccieri V, Vasile M, Iannace N, et al. Systemic sclerosis patients with and without pulmonary arterial hypertension: a nailfold capillaroscopy study. Rheumatology. 2013;52(8):1525-8. [CrossRef]
14. Castellví I, Simeón-Aznar CP, Sarmiento M, et al. Association between nailfold capillaroscopy findings and pulmonary function tests in patients with systemic sclerosis. J Rheumatol. 2015;42(2):222-7. [PubMed] [CrossRef]
15. Yancopoulos GD, Davis S, Gale NW, et al. Vascular-specific growth factors and blood vessel formation. Nature. 2000;407:242-8.
16. Dignat-George F, Boulanger CM. The many faces of endothelial microparticles. Arterioscler Thromb Vasc Biol. 2011;31(1):27-33. [Web of Science] [CrossRef]
17. Braverman IM, Yen A. Ultrastructure of the capillary loops in the dermal papillae. J Invest Dermatol. 1977;68:53-60. [CrossRef] [PubMed]
18. Micali G, Lacarrubba F, Musumeci ML, et al. Cutaneous vascular patterns in psoriasis. Int J Dermatol. 2010;49:249-56. [CrossRef]
19. Liew SC, Das-Gupta E, Chakravarthi S, et al. Differential expression of the angiogenesis growth factors in psoriasis vulgaris. BMC Res Notes. 2012;5:201. [CrossRef] [PubMed]
20. Batycka-Baran A, Krawczenko A, Paprocka M, et al. The soluble vascular endothelial growth factor receptor-1 (sVEGFR-1) in patients with plaque psoriasis - does it play any role? Cytokine. 2013;61(2):688-9. [CrossRef] [Web of Science]
21. Ramos-e-Silva M, Bernardini E, Filgueira AL. Capillaroscopy in psoriasis vulgaris. J Eur Acad Dermatol Venereol. 1996;7:192-3. [CrossRef]
22. Ohtsuka T, Yamakage A, Miyachi Y. Statistical definition of nailfold capillary pattern in patients with psoriasis. Int J Dermatol. 1994;33:779-82. [CrossRef] [PubMed]
23. Leroux B, Barraza S, Estrella V, et al. Valor clínico de las imágenes de capilaroscopia periungueal en pacientes con psoriasis. Med Cutan Iber Lat Am. 2004;32:61-4.
24. Bhushan M, Moore T, Herrick AL, Griffiths CEM. Nailfold video capillaroscopy in psoriasis. Br J Dermatol. 2000;142:1171-6.
25. Salli L, Raimondi F, Pappalardo A. Periungual capillaroscopy in psoriatic arthritis. Clin Ter. 1999;150:409-12.
26. Redisch W, Messina EJ, Hughes G, McEwen C. Capillaroscopic observations in rheumatic diseases. Ann Rheum Dis. 1970;29:244-53. [PubMed] [CrossRef]
27. Zaric D, Clemmensen OJ, Worm AM, Stahl D. Capillary microscopy of the nail fold in patients with psoriasis and psoriatic arthritis. Dermatologica. 1982;164:10-4.
28. Cervini C, Grassi W. Periungual capillary microscopy in patients with chronic polyarthritis and psoriasis arthropathica. Z Rheumatol. 1984;43:311-3. [PubMed]
29. Graceffa D, Amorosi B, Maiani E, et al. Capillaroscopy in psoriatic and rheumatoid arthritis: a useful tool for differential diagnosis. Arthritis. 2013;2013:957480. [PubMed]
30. Bartosińska J, Chodorowska G. Autorska propozycja klasyfikacji obrazów kapilaroskopowych w łuszczycy zwyczajnej i stawowej. Post Dermatol Alergol. 2009;26(1):17-24.
31. Yano K, Brown LF, Detmar M. Control of hair growth and follicle size by VEGF-mediated angiogenesis. J Clin Invest. 2001;107(4):409-17. [CrossRef] [PubMed]
32. Simonetti O, Lucarini G, Bernardini ML, et al. Expression of vascular endothelial growth factor, apoptosis inhibitors (survivin and p16) and CCL27 in alopecia areata before and after diphencyprone treatment: an immunohistochemical study. Br J Dermatol. 2004;150:940-8.
33. Mecklenburg L, Tobin DJ, Müller-Röver S, et al. Active hair growth (anagen) is associated with angiogenesis. J Invest Dermatol. 2000;114:909-16. [PubMed] [Web of Science] [CrossRef]
34. Schneider MR, Schmidt-Ullrich R, Paus R. The hair follicle as a dynamic miniorgan. Curr Biol. 2009;19(3):R132-42. [CrossRef] [Web of Science]
35. Miele C, Rochford JJ, Filippa N, et al. Insulin and insulin-like growth factor-I induce vascular endothelial growth factor mRNA expression via different signaling pathways. J Biol Chem. 2000;275:21695-702.
36. Grassi W, Del Medico P. Atlas of capillaroscopy. Milano: Medical Publishing and New Media EDRA; 2004.
37. Ganzetti G, Campanati A, Simonetti O, et al. Videocapillaroscopic pattern of alopecia areata before and after diphenylcyclopropenone treatment. Int J Immunopathol Pharmacol. 2011;24:1087-91. [PubMed]
38. Rubisz-Brzezińska J, Bendkowski W. Capillaroscopic pattern of ungual folds of the fingers in alopecia areata. Przegl Dermatol. 1979;66:471-5.
Downloads
Published
Issue
Section
License
Copyright (c) 2015 Polish Journal of Public Health
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 Unported License.
