Capillary Microvascular Dysfunction in Rheumatoid Arthritis: The Promising Role of Nailfold Videocapillaroscopy-A...

Area of Science:

• Rheumatology
• Cardiovascular Medicine
• Microcirculation Research

Background:

• Rheumatoid arthritis (RA) is an immune-mediated inflammatory disease linked to endothelial dysfunction and cardiovascular complications.
• RA serves as a key model for studying microvascular dysfunction due to its impact on the peripheral microcirculation.
• The dermal capillary network is accessible for assessing microvascular function via Nailfold videocapillaroscopy (NVC) and laser techniques.

Purpose of the Study:

• To review and integrate studies on functional microvascular abnormalities in RA.
• To emphasize the potential of NVC as a tool for dynamic vascular assessment in RA.
• To highlight gaps in current research regarding functional NVC applications in RA.

Main Methods:

• Narrative review of existing literature on dermal microcirculation in RA.
• Analysis of studies employing NVC for structural and functional assessment.
• Evaluation of laser techniques for assessing microvascular reactivity in RA.

Main Results:

• Laser techniques consistently show altered microvascular reactivity in RA.
• Fewer studies have investigated functional alterations using NVC compared to structural assessments.
• NVC demonstrates potential for simultaneously assessing structural and dynamic capillary abnormalities in vivo.

Conclusions:

• NVC is emerging as a promising functional vascular biomarker for RA.
• Current evidence is limited by small sample sizes, cross-sectional designs, and methodological heterogeneity.
• Standardized prospective studies are necessary to validate NVC's role in RA management.