Decreased lymphatic vessel counts in patients with systemic sclerosis: Association with fingertip ulcers
| Autor: | Jörg H W Distler, Alfiya Akhmetshina, Georg Schett, Tatiana Nevskaya, Gabriella Szücs, Jürgen Beer, Johannes Gusinde, Nicole Reich, Dontscho Kerjaschki, Clara Dees, Katrin Palumbo, Oliver Distler, Matthias Englbrecht, Karin Zwerina, Jochen Zwerina |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male CD31 Pathology medicine.medical_specialty Adolescent Biopsy government.form_of_government Immunology Klinikai orvostudományok Fingers Young Adult Rheumatology Skin Ulcer Prevalence medicine Lymphatic vessel Humans Immunology and Allergy Pharmacology (medical) skin and connective tissue diseases Lymphatic Diseases Aged Lymphatic Vessels Homeodomain Proteins Membrane Glycoproteins Scleroderma Systemic integumentary system medicine.diagnostic_test business.industry Tumor Suppressor Proteins Endothelial Cells Orvostudományok Middle Aged medicine.disease Connective tissue disease Platelet Endothelial Cell Adhesion Molecule-1 Lymphatic Endothelium medicine.anatomical_structure Lymphatic system Skin biopsy government Female business Blood vessel |
| Zdroj: | Arthritis & Rheumatism. 62:1513-1522 |
| ISSN: | 0004-3591 |
| Popis: | Objective Systemic sclerosis (SSc) is a connective tissue disease that is characterized by microvascular disease and tissue fibrosis. Progressive loss and irregular architecture of the small blood vessels are well characterized, but the potential involvement of the lymphatic vessel system has not been analyzed directly in SSc. This study was undertaken to assess whether the lymphatic vascular system is affected in SSc, and whether changes to the lymphatic vessels are associated with dystrophic changes and tissue damage in patients with SSc. Methods Lymphatic endothelial cells in skin biopsy samples from patients with SSc and age- and sex-matched healthy volunteers were identified by staining for podoplanin and prox-1, both of which are specifically expressed in lymphatic endothelial cells but not in blood vascular endothelial cells. CD31 was used as a pan–endothelial cell marker. Statistical analyses were performed using Kruskal-Wallis, Mann-Whitney U, and Spearman's rank correlation tests. Results The numbers of podoplanin- and prox-1–positive lymphatic vessels were significantly reduced in patients with SSc as compared with healthy individuals. The number of podoplanin-positive lymphatic precollector vessels was significantly lower in SSc patients with fingertip ulcers than in SSc patients without ulcers. Moreover, the number of lymphatic vessels correlated inversely with the number of fingertip ulcers at the time of biopsy and with the number of fingertip ulcers per year. The inverse correlation between lymphatic precollector vessel counts and fingertip ulcers remained significant after statistical adjustment for the blood vessel count, age, and modified Rodnan skin thickness score. Conclusion These results demonstrate a severe reduction in the number of lymphatic capillaries and lymphatic precollector vessels in patients with SSc. Patients with decreased lymphatic vessel counts may be at particularly high risk of developing fingertip ulcers. |
| Databáze: | OpenAIRE |
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