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[Systemic sclerosis after a long-term follow-up]
C Danese1, E Zavattaro, F Marcianò
1Istituto di Clinica Medica Generale e Terapia Medica II, Università degli Studi di Roma La Sapienza, Roma.
Insights
Systemic sclerosis may be triggered by stress, initiating psycho-neuro-immunoendocrinological reactions. This study reviews immunological, hemocoagulative, and haemorheological factors, exploring thymopentin treatment and stress hormones in scleroderma pathogenesis.
Area of Science:
- Immunology
- Pathogenesis
- Rheumatology
Context:
- Systemic sclerosis (SSc) is a chronic autoimmune disease characterized by fibrosis.
- Understanding SSc aetiopathogenesis is crucial for effective treatment strategies.
- Previous research has explored immunological and hemocoagulative aspects of SSc.
Purpose:
- To critically review the aetiopathogenesis of systemic sclerosis in a cohort of 51 patients.
- To correlate immunological responses, hemocoagulative aspects, and haemorheological changes with SSc.
- To investigate the role of stress, endothelin-1, and stress hormones in SSc and Raynaud's phenomenon.
Summary:
- The study reviews immunological (cell-mediated and humoral), hemocoagulative, and haemorheological factors in 51 long-standing systemic sclerosis patients.
- Long-term treatment with thymopentin, an immunomodulating drug, is discussed.
- A pathogenetic scheme is proposed, highlighting stress as a potential trigger for psycho-neuro-immunoendocrinological reactions leading to fibrosis.
Impact:
- Provides insights into the complex aetiopathogenesis of systemic sclerosis.
- Suggests stress as a significant factor in SSc development, potentially influencing psycho-neuro-immunoendocrinological pathways.
- Highlights the potential role of thymopentin in managing SSc through immunomodulation.
Abstract:
The authors suggest some remarks on the aetiopathogenesis of systemic sclerosis through a critical review of a group of 51 patients affected by this disease for many years. In this paper the authors report their previous studies regarding the correlation of immunological response, both cell-mediated and humoral, hemocoagulative aspects and haemorheological changes. From the results of immunological studies, the authors report a long-term treatment with an immunomodulating drug: thymopentin. Moreover they report a recent work about the connection among stressor event, production of endothelin-1 (ET-1) and serum levels of some stress hormones such as possible pathogenetic factors of Raynaud's phenomenon and of scleroderma. This work ends with a proposal of a pathogenetic scheme that, even if it doesn't exclude an infective pathogenesis, considers stress as a factor able to switch on a series of psycho-neuro-immunoendocrinological reactions that can support, through the activation of lymphocytes, fibroblastic proliferation and finally fibrosis.