Miniati, I. and Guiducci, S. and Conforti, M. L. and Rogai, V. and Fiori, G. and Cinelli, M. and Saccardi, R. and Guidi, S. and Bosi, A. and Tyndall, A. and Matucci-Cerinic, M.. (2009) Autologous stem cell transplantation improves microcirculation in systemic sclerosis. Annals of the rheumatic diseases : ARD, Vol. 68. pp. 94-98.
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Official URL: http://edoc.unibas.ch/dok/A6003179
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Abstract
BACKGROUND: In systemic sclerosis (SSc) reduced capillary density decreases blood flow and leads to tissue ischaemia and fingertip ulcers. Nail fold videocapillaroscopy (NVC) is a diagnostic and follow-up parameter useful to evaluate the severity, activity and the stage of SSc microvascular damage. Autologous haemopoietic stem cell transplantation (HSCT) is a new treatment for patients with severe diffuse cutaneous systemic sclerosis (dcSSc) refractory to conventional therapies. We aimed to evaluate the improvement of microvasculature after HSCT using NVC. METHODS: A total of 16 patients with severe dcSSc with a "late" videocapillaroscopy pattern underwent an immunesuppressive treatment: 6 were treated with HSCT and 10 with monthly pulse cyclophosphamide (CYC) 1 g for 6 months and then orally with 50 mg/day for further 6 months. NVC was performed before and after 3 months from the beginning of each treatment and then repeated every 3 months. RESULTS: In all patients, before HSCT NVC showed large avascular areas and ramified capillaries and vascular architectural disorganisation ("late" pattern). At 3 months after HSCT, the NVC pattern changed from "late" into "active", showing frequent giant capillaries (<6/mm) and haemorrhages, absence of avascular areas and angiogenesis phenomena; 1 year after HSCT, microvascular abnormalities were still in the "active" pattern. In patients treated with CYC, no NVC modifications were observed during 24 months of follow-up and the pattern always remained "late". CONCLUSIONS: These results indicate that HSCT with a high dose CYC regimen may foster vascular remodelling, while CYC at lower doses and with a chronic regimen does not influence the microvasculature.
Faculties and Departments: | 03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Rheumatologie FPS (Tyndall) 03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Rheumatologie FPS (Tyndall) 03 Faculty of Medicine > Departement Biomedizin > Former Units at DBM > Rheumatologie FPS (Tyndall) |
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UniBasel Contributors: | De Vere-Tyndall, Alan |
Item Type: | Article, refereed |
Article Subtype: | Research Article |
Publisher: | British Medical Association |
ISSN: | 0003-4967 |
Note: | Publication type according to Uni Basel Research Database: Journal article |
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Identification Number: |
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Last Modified: | 01 Mar 2013 11:14 |
Deposited On: | 01 Mar 2013 11:13 |
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