Nailfold capillaroscopy in SSc: innocent bystander or promising biomarker for novel severe organ involvement/progression?

Autor:	Vanhaecke A; Department of Internal Medicine, Ghent University.; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium., Cutolo M; Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, IRCCS San Martino Polyclinic Hospital, Genoa, Italy., Distler O; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Riccieri V; Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy., Allanore Y; Service de Rheumatology, Université de Paris, Hôpital Cochin, AP-HP CUP, Paris, France., Denton CP; Department of Rheumatology, University College London, Royal Free Hospital, London, UK., Hachulla E; Institute for Translational Research in Inflammation (INFINITE), Université de Lille.; INSERM.; Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), CHU Lille, Lille, France., Ingegnoli F; Division of Clinical Rheumatology, ASST Pini-CTO.; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milano, Italy., Deschepper E; Biostatistics Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium., Avouac J; Service de Rheumatology, Université de Paris, Hôpital Cochin, AP-HP CUP, Paris, France., Jordan S; Department of Rheumatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland., Launay D; Institute for Translational Research in Inflammation (INFINITE), Université de Lille.; INSERM.; Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Autoimmunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), CHU Lille, Lille, France., Melsens K; Department of Internal Medicine, Ghent University.; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium., Pizzorni C; Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, IRCCS San Martino Polyclinic Hospital, Genoa, Italy., Sulli A; Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, IRCCS San Martino Polyclinic Hospital, Genoa, Italy., Vasile M; Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy., Herrick AL; Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Salford Royal NHS Foundation Trust.; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK., Smith V; Department of Internal Medicine, Ghent University.; Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.; Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Centre (IRC), Ghent, Belgium.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2022 Nov 02; Vol. 61 (11), pp. 4384-4396.
DOI:	10.1093/rheumatology/keac079
Abstrakt:	Objectives: Nailfold videocapillaroscopy (NVC) plays a well-established role in differentiating primary from secondary RP due to SSc. However, the association of NVC with novel severe organ involvement/progression in SSc has never been evaluated in a multicentre, multinational study, which we now perform for the first time. Methods: Follow-up data from 334 SSc patients [265 women; 18 limited SSc (lSSc)/203 lcSSc/113 dcSSc] registered between November 2008 and January 2016 by seven tertiary centres in the EUSTAR-database, were analysed. Novel severe organ involvement/progression was defined as new/progressive involvement of the peripheral vasculature, lungs, heart, skin, gastrointestinal tract, kidneys, musculoskeletal system, or death, at the 12- or 24-month follow-up. NVC images at enrolment were quantitatively and qualitatively evaluated according to the standardized definitions of the EULAR Study Group on Microcirculation in Rheumatic Diseases. Uni- and multivariable logistic regression modelling (ULR, MLR) was performed. Results: Of the 334 included SSc patients, 257 (76.9%) developed novel overall severe organ involvement/progression. Following MLR, normal capillary density was associated with less-frequent novel overall severe organ involvement/progression [odds ratio (OR) = 0.77, P < 0.001] and novel peripheral vascular involvement (OR = 0.79, P = 0.043); microhaemorrhages were associated with less novel pulmonary hypertension (OR = 0.47, P = 0.029); and a 'severe' (active/late) NVC pattern was associated with novel overall severe organ involvement/progression (OR = 2.14, P = 0.002) and skin progression (OR = 1.70, P = 0.049). Conclusions: Our results suggest that NVC may be a promising biomarker in SSc, certainly warranting further investigation. Despite the participation of tertiary centres, which follow their patients in a standardized way, we were underpowered to detect associations with infrequent severe organ involvement/progression. (© The Author(s) 2022. Published by Oxford University Press on behalf of the British Society for Rheumatology.)
Databáze:	MEDLINE
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