Background Raynaud’s phenomenon (RP) is an exaggerated vasospastic response to cold and emotion, which can be primary (idiopathic) or secondary to a number of different conditions, including rheumatological diseases. Functional and/or structural vascular involvement is a key feature of RP. Nailfold capillary microscopy (NC) is the best technique to investigate microvascular abnormalities and to differentiate between primary and secondary RP.
Objectives Based on the findings, suggesting an important role of microvascular involvement in the pathogenesis of RP, we evaluated whether the vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang2) serum levels are associated with clinical manifestations and microvascular changes in NC in patients with RP.
Methods Serum levels of VEGF and Ang2 were determined by an enzyme-linked immunosorbent assay (ELISA) in 78 patients with RP (38 with primary and 40 with secondary RP) and in 30 healthy controls.
Results Morphological changes in nailfold capillaroscopy were seen in 56 out of 76 (73.7%) patients with RP. A normal capillaroscopic pattern or mild changes were found in 36 (47.3%) and moderate/severe abnormalities - in 40 (52.6%) of all RP patients. In all patients with secondary RP, severe or moderate changes in capillaroscopy were found. The severity of microvascular abnormalities were associated with the frequency and severity of vasospastic episodes as well as with the duration of RP. In the control group no pathological changes in nailfold capillaroscopy were observed.
Patients with severe changes in nailfold capillaroscopy showed significantly higher serum levels of VEGF and Ang2 than those without or with mild changes and in the control group. Moreover, there was a significant positive correlation between Ang2 serum levels and the duration of RP as well as the pain severity rating on the VAS scale.
Conclusions Our findings confirm the usefulness of NC as a non-invasive technique in the evaluation of microvascular involvement in RP patients. Moreover, a relationships between the changes in nailfold capillaroscopy and serum levels of VEGF and Ang2 point to a pathogenic role of these molecules in the clinical manifestation of RP.
Disclosure of Interest None Declared