Background Raynaud's phenomenon (RP) is a vascular disorder characterised by reversible vasospastic response of the fingers and toes to cold or emotional stimuli. It can be primary (idiopathic) or secondary (Raynaud's syndrome), related to a number of different pathological conditions, including rheumatic diseases.
Objectives The aim of this study was to investigate the influence of the Multiwave Locked System (MLS) laser therapy on clinical features, microvascular changes in nailfold videocapillaroscopy (NVC) and circulating modulators releasing as a consequence of vascular endothelium injury such as vascular endothelial growth factor (VEGF), angiopoietin 2 (Ang-2) and nitrogen oxide (NO) in patients with primary and secondary RP.
Methods Seventy-eight RP patients and 30 healthy subjects were recruited into the study. All patients with RP received MLS laser irradiation for 3 weeks. Clinical, NVC and laboratory investigations were performed before and after MLS laser therapy. The serum concentration of VEGF and Ang-2 were determined by an enzyme-linked immunosorbent assay (ELISA). Total NO concentration was determined using an indirect method based on assessment of nitrite concentration according to Griess's reaction.
Results After three weeks of MLS laser therapy the clinical improvement manifested by decreasing of the number of RP attacks, duration of single attack and pain intensity in RP patients was observed. After MLS laser therapy, in 65% of patients with primary and in 35% with secondary RP an increase in the loop number and/or a reduction of avascular areas in NVC were observed. In comparison with a control group, higher serum concentration of VEGF, Ang-2 and NO in RP patients was demonstrated (in all cases p<0.001). After MLS laser therapy a reduction of Ang-2 and NO levels in secondary RP patients (in both cases p<0.001) and of Ang-2 in primary RP patients (p<0.01) was found.
Conclusions Our results suggest that NVC may reflect microvascular changes associated with clinical improvement after MLS laser therapy in patients with primary and secondary RP. Ang-2 and NO serum levels may be a useful marker of microvascular abnormalities in RP patients treated with MLS laser therapy.
Disclosure of Interest : None declared
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