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Microangiopathy in primary and secondary Raynaud's phenomenon: endothelial lesion serum markers, anatomic alterations and functional abnormalities

Grant number: 10/51667-7
Support Opportunities:Regular Research Grants
Duration: November 01, 2010 - October 31, 2012
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Cristiane Kayser
Grantee:Cristiane Kayser
Host Institution: Escola Paulista de Medicina (EPM). Universidade Federal de São Paulo (UNIFESP). Campus São Paulo. São Paulo , SP, Brazil


Raynaud's phenomenon (RP) is a relatively common disease in the general population. It is benign in most of the cases and has no associated disease (primary RP). It can be also secondary to local or systemic conditions, like the rheumatic autoimmune diseases (RAID). It's known that 10% of patients with primary RP develop RAID. However, the pathogenesis and mechanisms involved in the expression of systemic sclerosis (SS) spectrum diseases with RP are not totally comprehended. Anatomic (nailfold capillaroscopy and videocapillaroscopy) and functional (laser Doppler imaging) methods of microcirculation evaluation can be used to the evaluation of RP patients' microcirculation. Likewise, the study of serum biomarkers of vascular injury evaluation is getting importance in the literature. In the present study, we intend to evaluate in a large population of patients with RP, with defined or pre-clinic disease, different serum markers of endothelial activation, platelet activation, oxidative stress, inflammation, angiogenesis and fibrosis, evolved in RP and SS spectrum diseases pathogenesis, and correlate them with clinical data and anatomic / functional microcirculation changes using nailfold capillaroscopy, videocapillaroscopy and laser Doppler imaging. 50 patients with primary RP, 50 patients with suspected secondary RP (undifferentiated connective tissue disease), 50 patients with systemic sclerosis and 50 healthy controls will be studied. Endothelin-1 (ET-1), vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-13) and von Willebrand factor (vWF) plasma levels will be measured by ELISA, C reactive protein (CRP) by turbidimetry, and thiobarbituric acid reactive substances (TBARS) by acid reaction. ELISA and TBARS reactions will be read by spectrophotometry. The panoramic nailfold capillaroscopy view will be held using a stereomicroscope with magnification of 10 to 25 times. The videocapillaroscopy will be performed under magnification of 200 times, with computerized equipment and the video system Videocap 8.14 (DS-Medica, Italy). Hands blood flow will be measured through laser Doppler imaging, before and after cold stimulus. We will correlationate serum markers with clinical and morphologic variables, with comparison of different parameters between the studied groups. The present study will allow a large approach of mechanisms evolved in primary and secondary RP. It will also allow the development of a master's degree dissertation and the continuation of microcirculation research in our department. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
CAMARGO, C. Z.; SEKIYAMA, J. Y.; ARISMENDI, M. I.; KAYSER, C.. Microvascular abnormalities in patients with early systemic sclerosis: less severe morphological changes than in patients with definite disease. SCANDINAVIAN JOURNAL OF RHEUMATOLOGY, v. 44, n. 1, p. 48-55, . (10/51667-7, 10/12613-9)

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