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D’Oria M, Gandin I, Riccardo P, Hughes M, Lepidi S, Salton F, Confalonieri P, Confalonieri M, Tavano S, Ruaro B. Correlation between Microvascular Damage and Internal Organ Involvement in Scleroderma: Focus on Lung Damage and Endothelial Dysfunction. Diagnostics (Basel) 2022; 13:diagnostics13010055. [PMID: 36611347 PMCID: PMC9818898 DOI: 10.3390/diagnostics13010055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/11/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Systemic sclerosis (SSc) is an incurable connective tissue disease characterized by decreased peripheral blood perfusion due to microvascular damage and skin thickening/hardening. The microcirculation deficit is typically secondary to structural vessel damage, which can be assessed morphologically and functionally in a variety of ways, exploiting different technologies. OBJECTIVE This paper focuses on reviewing new studies regarding the correlation between microvascular damage, endothelial dysfunction, and internal organ involvement, particularly pulmonary changes in SSc. METHODS We critically reviewed the most recent literature on the correlation between blood perfusion and organ involvement. RESULTS Many papers have demonstrated the link between structural microcirculatory damage and pulmonary involvement; however, studies that have investigated correlations between microvascular functional impairment and internal organ damage are scarce. Overall, the literature supports the correlation between organ involvement and functional microcirculatory impairment in SSc patients. CONCLUSIONS Morphological and functional techniques appear to be emerging biomarkers in SSc, but obviously need further investigation.
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Affiliation(s)
- Mario D’Oria
- Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Ilaria Gandin
- Biostatistics Unit, Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy
| | - Pozzan Riccardo
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Michael Hughes
- Northern Care Alliance NHS Foundation Trust, Salford Care Organisation and Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M6 8HD, UK
| | - Sandro Lepidi
- Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Francesco Salton
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Paola Confalonieri
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Marco Confalonieri
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Stefano Tavano
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
| | - Barbara Ruaro
- Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
- Correspondence: ; Tel.: +39-040-399-4871
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Deep learning and computer vision techniques for microcirculation analysis: A review. PATTERNS (NEW YORK, N.Y.) 2022; 4:100641. [PMID: 36699745 PMCID: PMC9868679 DOI: 10.1016/j.patter.2022.100641] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
The analysis of microcirculation images has the potential to reveal early signs of life-threatening diseases such as sepsis. Quantifying the capillary density and the capillary distribution in microcirculation images can be used as a biological marker to assist critically ill patients. The quantification of these biological markers is labor intensive, time consuming, and subject to interobserver variability. Several computer vision techniques with varying performance can be used to automate the analysis of these microcirculation images in light of the stated challenges. In this paper, we present a survey of over 50 research papers and present the most relevant and promising computer vision algorithms to automate the analysis of microcirculation images. Furthermore, we present a survey of the methods currently used by other researchers to automate the analysis of microcirculation images. This survey is of high clinical relevance because it acts as a guidebook of techniques for other researchers to develop their microcirculation analysis systems and algorithms.
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Abstract
PURPOSE OF REVIEW Vascular assessment in systemic sclerosis (SSc) is included in classification criteria for this disease, thus routinely used in the evaluation of patients in which this diagnosis is being considered. In this review, imaging techniques for assessment of vascular involvement in SSc hands and skin are discussed. RECENT FINDINGS Longitudinal use of imaging techniques has important implications for understanding the progressive vasculopathy and fibrotic transition in SSc. Nailfold and oral capillaroscopy as well as laser speckle contrast analysis are established techniques for vascular functional assessment, but longitudinal use is challenged by equipment costs and clinical time constraints. Ultrasound techniques are well described but require technical training. Advances in mobile infrared thermography and optical coherence tomography could potentially provide a point-of-care, quantitative outcome measure in clinical trials and practice. SUMMARY The equipment cost, technical training, data standardization, and invasiveness of vascular assessment techniques that quantify morphological (microangiopathy) and functional (blood flow reduction) are critical for implementation into SSc clinical trials and practice to understand progressive vasculopathy, such as wound development.
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Affiliation(s)
- Tracy M. Frech
- Vanderbilt University Medical Center, Department of Medicine, Division of Rheumatology and Immunology, Nashville, Tennessee, USA
- Veterans Affair Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee, USA
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Pavlov-Dolijanovic S, Petrovic N, Vujasinovic Stupar N, Damjanov N, Radunovic G, Babic D, Sobic-Saranovic D, Artiko V. The Relationship Between 99mTc-Pertechnetate Hand Perfusion Scintigraphy and Nailfold Capillaroscopy in Systemic Sclerosis Patients: A Pilot Study. Arch Rheumatol 2021; 35:321-327. [PMID: 33458654 PMCID: PMC7788645 DOI: 10.46497/archrheumatol.2020.7730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 11/02/2019] [Indexed: 11/26/2022] Open
Abstract
Objectives
This study aims to assess the possible relationship between 99mTc-pertechnetate hand perfusion scintigraphy (HPS) and nailfold capillaroscopy (NC) in systemic sclerosis (SSc) patients. Patients and methods
The study group consisted of 25 SSc patients (6 males; 19 females; mean age 54.2±9.7 years; range, 32 to 67 years), 18 female patients with primary Raynaud's phenomenon (PRP) (mean age 47.1±9.5 years; range, 34 to 65 years) and 10 healthy individuals (3 males, 7 females; mean age 52.7±12.6 years; range, 37 to 73 years). NC and 99mTc-pertechnetate HPS were performed in all examinees. The capillaroscopic findings were classified as normal or scleroderma pattern ("early", "active", or "late"). The fingers-to-palm ratios were calculated for both blood flow (BF) and blood pool (BP) phases of the 99mTc-pertechnetate HPS. Results
Systemic sclerosis patients showed a significantly lower BP ratio than PRP patients and healthy subjects (p=0.004). No statistically significant difference was observed between the SSc and PRP patients in respect to BF ratio. A gradual decrease of BF and BP with the severity of NC microangiopathy pattern ("early", "active" or "late") was found in SSc patients, while the differences were not statistically significant. Patients with diffuse SSc showed lower BF and higher BP than those with limited SSc, while these differences were without statistical significance. There was no significant correlation between BF or BP values and type of SSc (limited or diffuse) (p=0.77 versus p=0.54, respectively) as well as three microangiopathy patterns (p=0.22 versus p=0.54, respectively). Conclusion 99mTc-pertechnetate HPS improves the evaluation of vascular damage in SSc patients. There is no direct relationship between NC and 99mTc-pertechnetate HPS; however, the two methods complement each other in the assessment of microcirculation in SSc.
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Affiliation(s)
| | - Nebojsa Petrovic
- Center for Nuclear Medicine, Clinical Center of Serbia, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | | | - Nemanja Damjanov
- Institute of Rheumatology, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Goran Radunovic
- Institute of Rheumatology, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Dragan Babic
- Institute for Medical Statistics and Informatics, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Dragana Sobic-Saranovic
- Center for Nuclear Medicine, Clinical Center of Serbia, Faculty of Medicine University of Belgrade, Belgrade, Serbia
| | - Vera Artiko
- Center for Nuclear Medicine, Clinical Center of Serbia, Faculty of Medicine University of Belgrade, Belgrade, Serbia
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Ruaro B, Sulli A, Casabella A, Pizzorni C, Paolino S, Smith V, Cutolo M. Peripheral blood perfusion in patients with systemic lupus erythematosus and in primary Raynaud's phenomenon. Eur J Rheumatol 2020; 8:7-11. [PMID: 33196419 DOI: 10.5152/eurjrheum.2020.20027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE This study aims to evaluate blood perfusion (BP) in various cutaneous regions of the hands and face in patients with systemic lupus erythematosus (SLE) and primary Raynaud's phenomenon (PRP) and healthy subjects (HS). METHODS A total of 20 patients with SLE, 20 patients with PRP, and 20 HS were enrolled. BP was detected by laser speckle contrast analysis in different regions of the hand and at the facial level. The absolute nailfold capillary number (CN) was assessed by nailfold videocapillaroscopy. RESULTS Patients with SLE and PRP had significantly lower BP levels than those of HS in 3 hand areas (fingertip, palm, and periungual; p<0.01). However, the SLE, PRP, and HS groups had comparable BP values at the hand dorsum and face. The BP and CN values revealed a positive correlation in the periungual, fingertip, and palm of hands (p<0.01), only in patients with SLE. CONCLUSION Our data demonstrated a correlation between functional and morphological microvascular impairment in patients with SLE.
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Affiliation(s)
- Barbara Ruaro
- Unit of Pulmonology, University Hospital of Trieste,Trieste, Italy
| | - Alberto Sulli
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, San Martino Polyclinic Hospital, University of Genova, Genoa, Italy
| | - Andrea Casabella
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, San Martino Polyclinic Hospital, University of Genova, Genoa, Italy
| | - Carmen Pizzorni
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, San Martino Polyclinic Hospital, University of Genova, Genoa, Italy
| | - Sabrina Paolino
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, San Martino Polyclinic Hospital, University of Genova, Genoa, Italy
| | - Vanessa Smith
- Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.,Department of Internal Medicine, Ghent University, Ghent, Belgium.,Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium
| | - Maurizio Cutolo
- Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, San Martino Polyclinic Hospital, University of Genova, Genoa, Italy
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Ranaldi GT, Villani ER, Franza L. Rationale for ozone-therapy as an adjuvant therapy in COVID-19: a narrative review. Med Gas Res 2020; 10:134-138. [PMID: 33004712 PMCID: PMC8086623 DOI: 10.4103/2045-9912.289462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is the respiratory disease caused by the novel severe acute respiratory syndrome-coronavirus-2 and is characterized by clinical manifestations ranging from mild, flu-like symptoms to severe respiratory insufficiency and multi-organ failure. Patients with more severe symptoms may require intensive care treatments and face a high mortality risk. Also, thrombotic complications such as pulmonary embolisms and disseminated intravascular coagulation are frequent in these patients. Indeed, COVID-19 is characterized by an abnormal inflammatory response resembling a cytokine storm, which is associated to endothelial dysfunction and microvascular complications. To date, no specific treatments are available for COVID-19 and its life-threatening complication. Immunomodulatory drugs, such as hydroxychloroquine and interleukin-6 inhibitors, as well as antithrombotic drugs such as heparin and low molecular weight heparin, are currently being administered with some benefit. Ozone therapy consists in the administration of a mixture of ozone and oxygen, called medical ozone, which has been used for over a century as an unconventional medicine practice for several diseases. Medical ozone rationale in COVID-19 is the possibility of contrasting endothelial dysfunction, modulating the immune response and acting as a virustatic agent. Thus, medical ozone could help to decrease lung inflammation, slow down viral growth, regulate lung circulation and oxygenation and prevent microvascular thrombosis. Ozone-therapy could be considered a feasible, cost-effective and easy to administer adjuvant therapy while waiting for the synthesis of a therapy or the development of the vaccine.
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Affiliation(s)
- Giovanni Tommaso Ranaldi
- Unità Operativa Semplice Dipartimentale Farmacologia Clinica e Sperimentazione Clinica, Azienda Sanitaria, Potenza, Italy
| | | | - Laura Franza
- Department of Emergency Medicine, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
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Yu S, Hu SCS, Yu HS, Chin YY, Cheng YC, Lee CH. Early sign of microangiopathy in systemic sclerosis: The significance of cold stress test in dynamic laser Doppler flowmetry. Clin Hemorheol Microcirc 2019; 71:373-378. [DOI: 10.3233/ch-180419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sebastian Yu
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dermatology, University of California Davis School of Medicine, Sacramento, USA
| | - Stephen Chu-Sung Hu
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsin-Su Yu
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Yi-Ying Chin
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Dermatology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yang-Chun Cheng
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Hung Lee
- Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Gargani L, Bruni C, Barskova T, Hartwig V, Marinelli M, Trivella MG, Matucci-Cerinic M, L'Abbate A. Near-infrared spectroscopic imaging of the whole hand: A new tool to assess tissue perfusion and peripheral microcirculation in scleroderma. Semin Arthritis Rheum 2019; 48:867-873. [DOI: 10.1016/j.semarthrit.2018.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/16/2018] [Accepted: 08/07/2018] [Indexed: 12/13/2022]
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9
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Ivanov AN, Saveleva MS, Kozadaev MN, Matveeva OV, Sal’kovskiy YE, Lyubun GP, Gorin DA, Norkin IA. New Approaches to Scaffold Biocompatibility Assessment. BIONANOSCIENCE 2019. [DOI: 10.1007/s12668-019-00613-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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10
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Bastos P, Patel V, Festy F, Hosny N, Cook RJ. In-vivo imaging of the microvasculature of the soft tissue margins of osteonecrotic jaw lesions. Br Dent J 2018; 223:699-705. [PMID: 29123273 DOI: 10.1038/sj.bdj.2017.888] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2017] [Indexed: 01/20/2023]
Abstract
Introduction Given the increasing incidence of medication-related jaw osteonecrosis, and recognition of the mucosal blood supply's importance, we have developed a non-invasive Real Time Optical Vascular Imaging (RTOVI) instrument. Imaging the red blood cells within the sub-mucosal capillary networks demonstrates the microcirculatory anatomy. We report a small trial, demonstrating the technique's viability, examining mucosal microcirculatory changes adjacent to osteonecrotic lesions.Aims Imaging the microvasculature of soft tissue margins of patients' exposed necrotic bone lesions in situ was intended to provide unique observational as well as quantitative data, using an image analysis routine, based on ImageJ software. Our interest was to evaluate whether this could offer valuable information for complex wound margin management.Methods Four osteoradionecrosis and four medication-related osteonecrosis patients (M:F 1:1 mean 68.25 years) were enrolled under the NRES Ethics 11/LON/0354 and KCL Research Ethics Committee (REC) BDM/14/15-14 approvals. Microvascular images from mucosal margins of exposed mandibular osteonecrosis lesions were compared with equivalent images from both uninvolved contralateral mucosa and similar mucosal sites in four healthy subjects.Results We demonstrated narrow hypo-vascularised oedematous lesion margins surrounded by a concentric inflammatory band and normal mucosa beyond. Parameters reporting individual capillary shape, via mean percentage of occupancy per capillary per field of view and capillary loop aspect ratio, differed significantly between groups (ANOVA, p = 0.0002 and p = 0.04 respectively). Values reporting capillary number and area showed expected changes but did not reach statistical significance.Conclusion This pilot study demonstrated the feasibility of mucosal microvascular imaging in assessing the microvascular changes found in the soft tissues at the margins of osteonecrotic lesions, with potential to inform therapeutic interventions and clinical decisions to continue or modify regime strategies at the earliest opportunity. Given the increasing incidence of medication-related jaw osteonecrosis, and the recognition of the importance of mucosal blood supply, we developed a non-invasive instrument demonstrating microcirculation anatomy by imaging transiting red blood cells.
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Affiliation(s)
- P Bastos
- Dept. Tissue Engineering & Biophotonics KCL Dental Institute, Guy's Campus, London, SE1 9RT
| | - V Patel
- Dept. Tissue Engineering & Biophotonics KCL Dental Institute, Guy's Campus, London, SE1 9RT.,Dept. Oral Surgery GSTFT & KCL Dental Institute, Guy's Campus, London, SE1 9RT
| | - F Festy
- Dept. Tissue Engineering & Biophotonics KCL Dental Institute, Guy's Campus, London, SE1 9RT
| | - N Hosny
- Dept. Tissue Engineering & Biophotonics KCL Dental Institute, Guy's Campus, London, SE1 9RT
| | - R J Cook
- Dept. Tissue Engineering & Biophotonics KCL Dental Institute, Guy's Campus, London, SE1 9RT.,Dept. of Oral Medicine, GSTFT & KCL Dental Institute, Guy's Campus, London, SE1 9RT
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Clinical Characteristics of Systemic Sclerosis With Interstitial Lung Disease. Arch Rheumatol 2018; 33:322-327. [PMID: 30632529 DOI: 10.5606/archrheumatol.2018.6630] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/20/2017] [Indexed: 12/18/2022] Open
Abstract
Objectives This study aims to compare the clinical characteristics of systemic sclerosis (SSc) patients with or without interstitial lung disease (ILD), and figure out whether the differences can be useful to suspect ILD in SSc. Patients and methods We retrospectively collected the clinical data of 108 patients with SSc (13 males, 95 females; mean age 50.1±13.5 years; range 14 to 78 years) and compared them according to the presence of ILD. ILD was confirmed by chest computed tomography, and pulmonary arterial hypertension was suspected when right ventricular systolic pressure was ≥40 mmHg based on echocardiography. Results Of the 108 patients, 49 (45.4) had diffuse type and 59 (54.6) had limited type SSc. Disease duration, percentages of positive anti-scleroderma 70 (anti-Scl70) antibody and anti-centromere antibody, white blood cell, platelet, erythrocyte sedimentation rate (ESR), and presence of pulmonary hypertension differed significantly. On multivariate logistic analysis, positive titer of anti-Scl70 antibody (odds ratio [OR]=15.65, p<0.001), platelet (OR=1.01, p=0.026), ESR (OR=1.02, p=0.037) and pulmonary hypertension (OR=21.97, p=0.003) were associated with ILD in patients with SSc. Conclusion In SSc patients with ILD, disease duration was longer and positive titer of anti-Scl70 antibody was more frequent, positive titer of anti- centromere antibody was less frequent, and white blood cell and platelet counts, ESR levels, and incidence of possible pulmonary hypertension were significantly higher than in those without ILD. Positive titer of anti-Scl70 antibody, platelet, ESR, and combination of pulmonary hypertension were independently associated with the presence of ILD in SSc patients.
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Virzì F, Bianca P, Giammona A, Apuzzo T, Di Franco S, Mangiapane LR, Colorito ML, Catalano D, Scavo E, Nicotra A, Benfante A, Pistone G, Caputo V, Dieli F, Pirrello R, Stassi G. Combined platelet-rich plasma and lipofilling treatment provides great improvement in facial skin-induced lesion regeneration for scleroderma patients. Stem Cell Res Ther 2017; 8:236. [PMID: 29058626 PMCID: PMC5651639 DOI: 10.1186/s13287-017-0690-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 08/05/2017] [Accepted: 10/09/2017] [Indexed: 12/26/2022] Open
Abstract
Background The use of stem cells, including mesenchymal stem cells (MSCs), for regenerative medicine is gaining interest for the clinical benefits so far obtained in patients. This study investigates the use of adipose autologous tissue in combination with platelet-rich plasma (PRP) to improve the clinical outcome of patients affected by systemic sclerosis (SSc). Methods Adipose-derived mesenchymal stem cells (AD-MSCs) and PRPs were purified from healthy donors and SSc patients. The multilineage differentiation potential of AD-MSCs and their genotypic–phenotypic features were investigated. A cytokine production profile was evaluated on AD-MSCs and PRPs from both healthy subjects and SSc patients. The adipose tissue-derived cell fraction, the so-called stromal vascular fraction (SVF), was coinjected with PRP in the perioral area of SSc patients. Results Histopathological and phenotypical analysis of adipose tissue from SSc patients revealed a disorganization of its distinct architecture coupled with an altered cell composition. Although AD-MSCs derived from SSc patients showed high multipotency, they failed to sustain a terminally differentiated progeny. Furthermore, SVFs derived from SSc patients differed from healthy donors in their MSC-like traits coupled with an aberrant cytokine production profile. Finally, the administration of PRP in combination with autologous SVF improved buccal’s rhyme, skin elasticity and vascularization for all of the SSc patients enrolled in this study. Conclusions This innovative regenerative therapy could be exploited for the treatment of chronic connective tissue diseases, including SSc. Electronic supplementary material The online version of this article (doi:10.1186/s13287-017-0690-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Francesco Virzì
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy.,Division of Plastic and Reconstructive Surgery Department of Surgical and Oncological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Paola Bianca
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Alessandro Giammona
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Tiziana Apuzzo
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Simone Di Franco
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Laura Rosa Mangiapane
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Maria Luisa Colorito
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Dario Catalano
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Emanuela Scavo
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Annalisa Nicotra
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Antonina Benfante
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Giuseppe Pistone
- DiBiMIS, Piazza delle Cliniche, 2, University of Palermo, Palermo, 90127, Italy
| | - Valentina Caputo
- DiBiMIS, Piazza delle Cliniche, 2, University of Palermo, Palermo, 90127, Italy
| | - Francesco Dieli
- Central Laboratory of Advanced Diagnosis & Biomedical Research (CLADIBIOR), University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Roberto Pirrello
- Division of Plastic and Reconstructive Surgery Department of Surgical and Oncological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy
| | - Giorgio Stassi
- Cellular and Molecular Pathophysiology Laboratory, Department of Surgical Oncological and Stomatological Sciences, University of Palermo, Via del Vespro 131, Palermo, 90127, Italy.
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Hsu PC, Liao PY, Chang HH, Chiang JY, Huang YC, Lo LC. Nailfold capillary abnormalities are associated with type 2 diabetes progression and correlated with peripheral neuropathy. Medicine (Baltimore) 2016; 95:e5714. [PMID: 28033273 PMCID: PMC5207569 DOI: 10.1097/md.0000000000005714] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Diabetes mellitus (DM) is associated with a state of chronic hyperglycemia with a highly increased risk of vascular complications. The current study aimed to investigate microcirculation abnormalities in patients with type 2 DM and those with pre-DM using nailfold videocapillaroscopy (NVC) and evaluate the possible correlation with microvascular complications.A total of 115 patients with type 2 DM, 41 patients with pre-DM, and 37 healthy subjects without diabetes were enrolled. All subjects underwent NVC to evaluate capillary density, length, morphology, distribution, presence of enlarged loops or hemorrhages, and blood flow. NVC score was used to quantitate the aforementioned characteristics.Patients with type 2 DM showed significantly increased alterations including reduced capillary length (29.6%), irregular distribution (35.7%), and abnormal morphology (59.1%), while the corresponding NVC scores were comparable to those of control subjects. In addition, subjects with pre-DM had a significantly higher NVC score and greater alterations in distribution (26.8%) and morphology (48.8%) than control subjects. NVC score was positively correlated with diabetic peripheral neuropathy (DPN) and the number of microvascular complications.NVC identified a high frequency of microcirculation abnormalities in subjects with pre-DM or type 2 DM compared to those in the control group. NVC score was also capable of detecting microvascular complications in patients with type 2 DM and was correlated with DPN and the number of microvascular complications.
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Affiliation(s)
- Po-Chi Hsu
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung
- Department of Chinese Medicine, Changhua Christian Hospital
| | - Pei-Yung Liao
- Department of Endocrinology, Changhua Christian Hospital
| | - Hen-Hong Chang
- School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, and Research Center for Chinese Medicine and Acupuncture, China Medical University
- Department of Chinese Medicine, China Medical University Hospital, Taichung
| | - John Y. Chiang
- Department of Computer Science and Engineering, National Sun Yat-sen University
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung
| | - Yu-Chuen Huang
- School of Chinese Medicine, College of Chinese Medicine, China Medical University
- Department of Medical Research, China Medical University Hospital, Taichung
| | - Lun-Chien Lo
- Department of Chinese Medicine, Changhua Christian Hospital
- Graduate Institute of Statistical and informational Science, National Changhua University of Education, Changhua, Taiwan
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14
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Affiliation(s)
- W Hermann
- Abteilung Rheumatologie und Klinische Immunologie, Kerckhoff-Klinik, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland.
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