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Abnormal digital neurovascular response to local heating in systemic sclerosis
M Roustit1, G H Simmons, P Carpentier
1Inserm CIC03 - Centre d'Investigation Clinique, CHU de Grenoble, 38043 Grenoble Cedex 09, France.
Rheumatology (Oxford, England)
|April 9, 2008
Summary
Patients with systemic sclerosis (SSc) show abnormal digital neurovascular responses to local heating, unlike those with primary Raynaud
Area of Science:
- Neurovascular function
- Dermatology
- Rheumatology
Background:
- Neurovascular dysfunction is a key feature in systemic sclerosis (SSc) and primary Raynaud's phenomenon (RP).
- The axon reflex-dependent hyperaemia, an initial peak in the skin's local heating response, is a measure of neurovascular function.
Purpose of the Study:
- To investigate neurovascular dysfunction in patients with SSc and primary RP.
- To assess the axon reflex-dependent hyperaemia in the fingers of these patients.
Main Methods:
- Compared finger and forearm thermal hyperaemia in healthy subjects.
- Applied topical anaesthesia (lidocaine/prilocaine) to block cutaneous sensory nerves.
- Measured skin blood flow changes using laser Doppler probes after controlled heating protocols in 10 primary RP and 16 SSc patients.
Main Results:
- Healthy subjects exhibited a higher finger response than the forearm, both blunted by anaesthesia.
- Primary RP patients showed a decreased initial peak response after anaesthesia (P=0.02).
- SSc patients did not show alterations in the initial peak response after anaesthesia, indicating an abnormal neurovascular response.
Conclusions:
- Systemic sclerosis is associated with an abnormal digital neurovascular response to local heating.
- Thermal hyperaemia monitoring may serve as a clinical test for neurovascular function in SSc.
- Further research is needed to correlate this abnormal response with the extent of peripheral vascular disease in SSc.
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