Obliterative vasculopathy in systemic sclerosis: endothelial precursor cells as novel targets for therapy

Evaluation of: Kuwana M, Kaburaki J, Okazaki Y et al. Increase in circulating endothelial precursors by atorvastatin in patients with systemic sclerosis. Arthritis Rheum. 54(6), 1946-1951 (2006). Systemic sclerosis (SSc) is associated with a progressive obliterative vasculopathy that accounts for serious clinical manifestations of the disease, and has, to date, no effective treatment. Vascular obliteration is accompanied by defective vasculogenesis due to impaired production, mobilization or function of bone marrow-derived vascular precursor cells. Statins enhance vascular precursor cell production in chronic cardiovascular diseases and may also have a therapeutic role in SSc. This paper evaluates the results from a recent open-label clinical trial of atorvastatin that support this notion. Larger controlled trials are now needed to critically evaluate the efficacy of statins for repairing vascular damage, enhancing vasculogenesis, and attenuating the burden of chronic vasculopathy in SSc.