Ab1105 association Between Capillaroscopic Alterations and Angiogenic and Tissue Remodeling Factors in Patients With Dermatomyositis.

Abstract

Background:During last years we are seeking for new biomarkers of early or even preclinical diseases stages, precise definition of disease activity and accurate prediction of the disease course as well as biomarkers of treatment efficiency. Nailfold capillaroscopy (NFC) considering as a method for early or even preclinical diagnostic tool for systemic scleroderma, at the same time there is enough data that dermatomyositis (DM) characterized with similar NFC changes along with other idiopathic inflammatory myopathies (IIM) due to the peripheral vascular involvement.Objectives:The goal of our research was aimed to analyze possible association between capillaroscopic alterations and angiogenic, tissue remodeling factors in patients with DM.Methods:44 patients with DM were examined and included in the study. NFC we performed usingDino-Lite CapillaryScope with 200 magnification.We assessed nailfold capillary density (NCD), presence of microhemorrhages, giant, dilated and ramified capillaries, scleroderma patterns (defined as an early, active or late pattern) and neovascular pattern (defined as an active and late scleroderma patterns). We use Manual Muscle Testing 8 (MMT8), Health Assessment Questionnaire (HAQ), Myositis Disease Activity Assessment Tool (MDAAT), Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI), physician’s VAS, patient’s VAS, serum muscle enzymes levels to asses disease activity. The level of transforming growth factor alpha (TGF-α) and vascular endothelial growth factor (VEGF) were assayed by the enzyme immunoassay system in the blood serum. We divided patients into 4 groups: 1stgroup – 17 DM patients with early NFC scleroderma pattern, 2ndgroup included 11 DM patients with active NFC scleroderma pattern, 3rdgroup – 6 DM patients with late NFC scleroderma pattern and 4thgroup included 10 DM patients with no any significant NFC alterations.Results:We didn’t find any significant difference of the VEGF level between examined groups, though the level of VEGF in the 1stgroup was – 473,65±48,24 pg/ml, 2nd– 412,89±106,24 pg/ml, 3rd– 283,0±71,93 pg/ml, 4th– 305,9±45,89 pg/ml (p=0,12, F=2,06), however at the same time we compare the level of VEGF between patients with long disease duration and newly onset disease and VEGF was higher among newly onset active DM patients – 465,32±54,54pg/ml VS 324,96±41,16 pg/ml (p=0,042, F=4,365). The level of TGF-α in the 1stgroup was 100,82±8,98 ng/ml, 2nd– 65,78±9,21 ng/ml, 3rd– 56,9±5,01 ng/ml, 4th– 65,5±10,2 ng/ml, though it was significantly higher in the 1stgroup patients (p=0,002, F=5,88).Conclusion:According to our results we can assume that VEGF and TGF-α could be applied as biomarkers of disease activity and duration, however more data is required.Disclosure of Interests:None declared