Background Raynaud's phenomenon (RP) is a vascular disorder characterised by reversible vasospastic response of the fingers and toes to cold or emotional stimuli. Microvascular abnormalities, manifested as RP, may be due to a severe underlying disease with reduced life expectancy. The unsuccessful effects and limitations of the pharmacological treatment are the reason of searching for new therapeutical methods, such as non-pharmacologic therapy.
Objectives The aim of this study was to investigate the correlation between the Multiwave Locked System (MLS) laser therapy, 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 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 the 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. In RP patients before MLS laser therapy the strong positive correlations between the severity of microvascular abnormalities and Ang-2 (r =0.535, p<0.001), NO (r =0.443, p<0.001) and VEGF (r =0.0382, p<0.05) were observed. After MLS laser therapy such correlations were still observed, however there were not so strong as before therapy and in case of NO the correlation was not significant.
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, VEGF and NO serum levels may be the useful markers of microvascular changes in patients with RP before and after MLS laser therapy.
Disclosure of Interest None declared