rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2009-1147rsp-1061Research ArticleСтатьиArticlesМикроциркуляторные нарушения - взаимосвязь с периферической сосудистой реактивностью и структурно-функциональными свойствами эндотелия при системной склеродермииMicrocirculatory disturbances – relationship with peripheral vascular reactivity and structure-functional properties of endothelium in systemic sclerosisRuzentsovaU YRuzentsovaU Yruljana@mail.ru200915082009474№4 (2009)2631Copyright © Ruzentsova U.Y., 20092009Ruzentsova U.Y.Ruzentsova U.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/1061

Цель. Оценить базальный капиллярный кровоток и изучить выраженность микроциркуляторных нарушений в зависимости от содержания эндотелина-1 в плазме и структурно-функционального состояния эндотелия у больных системной склеродермией (ССД). Материал и методы. В исследование включены 34 больных ССД (31 жен., 3 муж., ср. возраст 48±2,1 лет), длительностью заболевания 9,9±1,3 лет, и 15 практически здоровых лиц, сопоставимых по возрасту и полу. Комплексное обследование включало лазерную допплерографию, оценку эндотелий-зависимой (ЭЗВД) и эндотелий-независимой вазодилатации (ЭНВД), плазменной концентрации эндотелина-1 (ЭТ-1), определение уровня циркулирующих эндотелиальных клеток (ЦЭК) в периферической крови. Результаты. У всех больных ССД выявлено снижение капилллярной перфузии, нарушение периферической сосудистой реактивности в сравнении с практически здоровыми лицами. Выявлена зависимость выраженности микроциркуляторных нарушений у больных ССД от содержания ЭТ-1 в плазме. Базальные значения концентрации ЭТ-1 были достоверно выше в сравнении с группой контроля. Показатели периферической микроциркуляции находились в тесной корреляционной зависимости от плазменной концентрации ЭТ-1 и уровня ЦЭК, что указывает на системный характер нарушений капиллярного кровотока при ССД. Вывод. Выраженность микроциркуляторных нарушений при ССД зависит от степени изменения структурно-функционального состояния эндотелия как на периферическом, так и на системном сосудистых уровнях.

Microcirculatory disturbances – relationship with peripheral vascular reactivity and structure- functional properties of endothelium in systemic sclerosis. Objective. To assess basal capillary blood flow and examine degree of microcirculatory disturbances depending on plasma endothelin 1 content and structure-functional status of endothelium in pts with systemic sclerosis (SS). Material and methods. 31 pts with SS (31 female and 3 male) with mean age 48±2,1 years and disease duration 9,9±1,3 years and 15 healthy persons match on age and sex were included. Laser Doppler flowmetry, assessment of plasma endothelin-1 (ET1), peripheral blood circulating endothelial cells (CEC), endothelium-dependent (EDVD) and endothelium-independent vasodilatation (EIVD) was performed. Results. All pts with SS had decrease of capillary perfusion and disturbance of peripheral vessel reactivity in comparison with healthy persons. Microcirculatory disorders intensity in SS was shown to depend on plasma ET1 level. Basal values of ET1 concentration were significantly higher in comparison with control group. Peripheral microcirculation measures tightly correlated with plasma ET1 and CEC what point to systemic character of capillary blood flow disturbances in SS. Conclusion. Microcirculatory disorders intensity in SS depends on degree of structure-functional endothelium changes on peripheral and systemic vessel levels.

системная склеродермиянарушения микроциркуляцииперифе- рическая сосудистая реактивностьsystemic sclerosismicrocirculation disorderperipheral vessel reactivityReferences<div><p>Krieg T, Hunzelmann N, Gabrielli A, Jablonska S. Scleroderma. Eur. J. Dermatol., 2008, 18, 213-4.</p><p>Dorffler-Melly J, Luscher TF, Wenk M., et al. Endothelin-1 and cold provocation in health, primary Raynaud’s phenomenon, and progressive systemic sclerosis. Microvasc. Res., 1996, 52, 193-7.</p><p>Rubens C, Ewert R, Halank M., et al. Big endothelin-1 and endothelin-1 plasma levels are correlated with the severity of primary pulmonary hypertension. Chest, 2001, 120, 1562-9.</p><p>Abraham DJ, Vancheeswaran R, Dashwood MR., et al. Increased levels of endothelin-1 and differential endothelin type A and B receptor expression in scleroderma-associated fibrotic lung disease. Am. J. Pathol., 1997, 151, 831-41.</p><p>Dooley A, Gao B, Bradley N., et al. Abnormal nitric oxide metabolism in systemic sclerosis: increased levels of nitrated proteins and asymmetric dimethylarginine. Rheumatology (Oxford), 2006, 45, 676-84.</p><p>Dooley A, Gao B, Shi-Wen X., et al. Effect of nitric oxide and peroxynitrite on type I collagen synthesis in normal and scleroderma dermal fibroblasts. Free Radic. Biol. Med., 2007, 43, 253-64.</p><p>Mukerjee D, Yap LB, Ong V., et al. The myth of pulmonary Raynaud‘s phenomenon: the contribution of pulmonary arterial vasospasm in patients with systemic sclerosis related pulmonary arterial hypertension. Ann. Rheum. Dis., 2004, 63, 1627-31.</p><p>Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Arthritis Rheum., 1980, 23, 581-90.</p><p>Rushentsova U, Opazo Saez AM, Mosel F., et al. Laser Doppler imager (LDI) scanner and intradermal injection for in vivo pharmacology in human skin microcirculation: responses to acetylcholine, endothelin-1 and their repeatability. Br. J. Clin. Pharmacol., 2005, 59, 511-9.</p><p>Anderson ME, Hollis S, Moore T., et al. Non-invasive assessment of vascular reactivity in forearm skin of patients with primary Raynaud’s phenomenon and systemic sclerosis. Br. J. Rheumatol., 1996, 35, 1281-8.</p><p>Kubli S, Waeber B, Dalle-Ave A, Feihl F: Reproducibility of laser Doppler imaging of skin blood flow as a tool to assess endothelial function. J. Cardiovasc. Pharmacol., 2000, 36, 640-8.</p><p>Herrick AL. Pathogenesis of Raynaud’s phenomenon. Rheumatology (Oxford), 2005, 44, 587-96.</p><p>Suschek CV, Schnorr O, Kolb-Bachofen V. The role of iNOS in chronic inflammatory processes in vivo: is it damage-promoting, protective, or active at all? Curr. Mol. Med., 2004, 4, 763-75.</p><p>Mitchell A, Rushentsova U, Siffert W., et al. The angiotensin II receptor antagonist valsartan inhibits endothelin 1-induced vasoconstriction in the skin microcirculation in humans in vivo: influence of the G-protein beta3 subunit (GNB3) C825T polymorphism. Clin. Pharmacol. Ther., 2006, 79, 274-81.</p><p>Rushentsova U, Detmer N, Mitchell A, Philipp T. Effects of ET-1 antagonism on ET-1-mediated vasoconstriction in the skin microcirculation in man in vivo. J. Hypertension, 2006, 24(4), 207-10.</p><p>Sunderkotter C, Riemekasten G: Pathophysiology and clinical consequences of Raynaud’s phenomenon related to systemic sclerosis. Rheumatology (Oxford), 2006, 45, suppl 3:iii33-iii35.</p></div><br /><div><p>Krieg T, Hunzelmann N, Gabrielli A, Jablonska S. Scleroderma. Eur. J. Dermatol., 2008, 18, 213-4.</p><p>Dorffler-Melly J, Luscher TF, Wenk M., et al. Endothelin-1 and cold provocation in health, primary Raynaud’s phenomenon, and progressive systemic sclerosis. Microvasc. Res., 1996, 52, 193-7.</p><p>Rubens C, Ewert R, Halank M., et al. Big endothelin-1 and endothelin-1 plasma levels are correlated with the severity of primary pulmonary hypertension. Chest, 2001, 120, 1562-9.</p><p>Abraham DJ, Vancheeswaran R, Dashwood MR., et al. Increased levels of endothelin-1 and differential endothelin type A and B receptor expression in scleroderma-associated fibrotic lung disease. Am. J. Pathol., 1997, 151, 831-41.</p><p>Dooley A, Gao B, Bradley N., et al. Abnormal nitric oxide metabolism in systemic sclerosis: increased levels of nitrated proteins and asymmetric dimethylarginine. Rheumatology (Oxford), 2006, 45, 676-84.</p><p>Dooley A, Gao B, Shi-Wen X., et al. Effect of nitric oxide and peroxynitrite on type I collagen synthesis in normal and scleroderma dermal fibroblasts. Free Radic. Biol. Med., 2007, 43, 253-64.</p><p>Mukerjee D, Yap LB, Ong V., et al. The myth of pulmonary Raynaud‘s phenomenon: the contribution of pulmonary arterial vasospasm in patients with systemic sclerosis related pulmonary arterial hypertension. Ann. Rheum. Dis., 2004, 63, 1627-31.</p><p>Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee. Arthritis Rheum., 1980, 23, 581-90.</p><p>Rushentsova U, Opazo Saez AM, Mosel F., et al. Laser Doppler imager (LDI) scanner and intradermal injection for in vivo pharmacology in human skin microcirculation: responses to acetylcholine, endothelin-1 and their repeatability. Br. J. Clin. Pharmacol., 2005, 59, 511-9.</p><p>Anderson ME, Hollis S, Moore T., et al. Non-invasive assessment of vascular reactivity in forearm skin of patients with primary Raynaud’s phenomenon and systemic sclerosis. Br. J. Rheumatol., 1996, 35, 1281-8.</p><p>Kubli S, Waeber B, Dalle-Ave A, Feihl F: Reproducibility of laser Doppler imaging of skin blood flow as a tool to assess endothelial function. J. Cardiovasc. Pharmacol., 2000, 36, 640-8.</p><p>Herrick AL. Pathogenesis of Raynaud’s phenomenon. Rheumatology (Oxford), 2005, 44, 587-96.</p><p>Suschek CV, Schnorr O, Kolb-Bachofen V. The role of iNOS in chronic inflammatory processes in vivo: is it damage-promoting, protective, or active at all? Curr. Mol. Med., 2004, 4, 763-75.</p><p>Mitchell A, Rushentsova U, Siffert W., et al. The angiotensin II receptor antagonist valsartan inhibits endothelin 1-induced vasoconstriction in the skin microcirculation in humans in vivo: influence of the G-protein beta3 subunit (GNB3) C825T polymorphism. Clin. Pharmacol. Ther., 2006, 79, 274-81.</p><p>Rushentsova U, Detmer N, Mitchell A, Philipp T. Effects of ET-1 antagonism on ET-1-mediated vasoconstriction in the skin microcirculation in man in vivo. J. Hypertension, 2006, 24(4), 207-10.</p><p>Sunderkotter C, Riemekasten G: Pathophysiology and clinical consequences of Raynaud’s phenomenon related to systemic sclerosis. Rheumatology (Oxford), 2006, 45, suppl 3:iii33-iii35.</p></div><br />

The authors declare that there are no conflicts of interest present.