Microvascular dysfunction in rheumatoid arthritis assessed by laser Doppler anemometry: relationship to soluble adhesion molecules and extraarticular manifestations

Abstract

In search of a noninvasive diagnostic test for rheumatoid vasculitis (RV), this study addressed the questions whether changes in capillary blood cell velocity (CBV) detected by laser Doppler anemometry in patients with rheumatoid arthritis (RA) were correlated with the levels of soluble adhesion molecules and whether cutaneous flow abnormalities may reflect extraarticular manifestations in RA. In 31 RA patients and 20 patients with osteoarthritis (OA), CBV was measured in the skin above the left ring finger at rest and after 3-min arterial occlusion. Serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble E-selectin (sE-selectin), and soluble P-selectin (sP-selectin) were assessed by enzyme linked immunosorbent assay. Peak CBV was reduced in RA patients compared to OA patients (0.42 +/- 0.07 mm/s vs. 0.70 +/- 0.13 mm/s; P = 0.013). Both CBV during rest and reactive hyperemia were not correlated with the levels of soluble adhesion molecules. There were no significant differences in resting or peak CBV between RA patients with or without extraarticular manifestations. The lack of an inverse correlation between the levels of soluble adhesion molecules and CBV during rest and reactive hyperemia contradicts the assumption that inflammatory vascular damage indicated by increased levels of soluble adhesion molecules was the main reason for the impairment of microcirculation. The present results do not suggest that cutaneous flow abnormalities may reflect extraarticular manifestations in RA.

Capillaroscopy in Psoriatic and Rheumatoid Arthritis: A Useful Tool for Differential Diagnosis

“…In addition, Meyer et al showed modifications of the normal blood flow velocity and microvascular dysfunction in RA [20]. …”

Endothelial Dysfunction in Chronic Inflammatory Diseases

“…Others have identified unique expression profiles in RA patients [48,49,50], although ICAM-1 and P-selectin were also found to be elevated in RA patients in these studies. Several investigators have failed to demonstrate differences in adhesion molecule expression between patients and healthy controls [51]. There is also discordance with regard to the correlation between adhesion molecule expression and markers of disease activity.…”

Nailfold Videocapillaroscopy for the Evaluation of Peripheral Microangiopathy in Rheumatoid Arthritis

“…In an older study, functional impairment of the capillary wall was detected after the intravenous injection of fluorescein sodium using dynamic fluorescence nailfold NVC in patients with RA [ 40 ]. Other microvascular alterations in normal bloodstream have been described in RA patients, including reduced reactive hyperemia in cutaneous capillaries compared to patients with osteoarthritis [ 41 ]. Reduced capillary blood flow and cold-induced vasospasm have been additionally observed using nailfold NVC combined with a cold provocation test [ 42 ].…”