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To investigate whether in vivo capillary microscopy of the lower lip mucosa can be used to assess microvascular disease in systemic sclerosis.
Thirteen patients with systemic sclerosis and 11 healthy control subjects were studied by conventional nailfold capillary microscopy and labial capillaroscopy. The following parameters were analysed: loop le...
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Introduction. Capillaroscopy is a non-invasive imaging method that allows cutaneous microcirculation to be analyzed. During the last decades, a diagnostic and prognostic potential of nailfold capillaroscopy (NVC) has been gaining increasing appreciation. The main indications include Raynaud phenomenon and scleroderma spectrum diseases, however the...
Background
Undifferentiated connective tissue disease at risk for systemic sclerosis (UCTD-risk-SSc) is a condition characterised by Raynaud’s phenomenon and either SSc marker autoantibodies or typical capillaroscopic findings or both, unsatisfying classification criteria for SSc and evolving into definite SSc in about 30-50% of cases (1,2). Recent...
Background
Systemic sclerosis (SSc) is a chronic disease with microvascular damage. Nailfold capillaroscopy is a non-invasive method used for evaluating capillaries in SSc. Its findings could be related to the internal organ involvement and SSc course. In this study, we aimed to determine the association of the capillaroscopic patterns of nailfold...
Objectives:
This study aims to assess the possible relationship between 99mTc-pertechnetate hand perfusion scintigraphy (HPS) and nailfold capillaroscopy (NC) in systemic sclerosis (SSc) patients.
Patients and methods:
The study group consisted of 25 SSc patients (6 males; 19 females; mean age 54.2±9.7 years; range, 32 to 67 years), 18 female pa...
Summary Nailfold capillaroscopy is a simple, non-invasive, inexpensive and useful method for the analysis of microvascular abnormalities that can be found in rheumatic disorders. The well-known Raynaud's phenomenon represents a clinical condition that should promptly lead to a microvascular analysis, in order to distinguish its primary form from th...
Citations
... Firstly, the interference signals were subjected to the Fourier transform, and then the windowed eigen-decomposition (wED) algorithm [27], which can extract the angiography signals. When selecting layers along the Z axis, the epithelium and lamina propria layers were selected, which contain the vascular information for the tissue, and are widely used in the assessment of oral diseases [16,29]. Lastly, en-face projection results were generated by using a green-red depth-encoded maximum intensity projection (MIP) algorithm. ...
Oral cancer, primarily oral squamous cell carcinomas (OSCC), is a major health concern worldwide. The current gold standard for the diagnosis of OSCC is biopsy and histopathological analysis, which is invasive and can place a huge financial burden on the healthcare system. Optical coherence tomography-based angiography (OCTA) is a non-invasive imaging technique that shows promise as an imaging modality to aid the diagnosis of OSCC. This Letter outlines the development of a handheld intraoral OCT probe applied to a swept-source OCT system with an angiography function for oral applications. The probe has a thin body with a diameter of 17.8 mm and a two-lens system with a working distance that is adjustable from 20.92 mm to 24.08 mm, a field of view 9 mm in diameter, an imaging depth of ∼1.7 mm, and resolutions of 39.38 µm (laterally) and 33.37 µm (axially). This probe was used to scan 14 oral sites to evaluate its ability to scan various sites in the oral cavity. This system has the potential to reduce invasive procedures and aid early OSCC diagnosis.
... By contrast, no striking difference was found between the CI values of these two groups. Defective vasodilatation is characteristic of vasculopathy in SSc, which may involve any organ system, including the pulmonary vascular bed (20)(21)(22). Although a proper statistical comparison could not be performed because of the small number of patients, one can speculate that mild anemia may lead to a mild increase in PVR in patients with defective vasodilatation, such as SSc. ...
Objective:
Pulmonary hypertension (PH) is a one of the major causes of death in patients with systemic sclerosis (SSc). In this study, we investigated the impact of updated hemodynamic definition proposed by the 6th PH World Symposium (6th WSPH) on the frequency of PH and its subtypes in patients with SSc.
Methods:
Patients with SSc admitted between 2015 and 2019 and who underwent right heart catheterization (RHC) were included. The frequency of PH and its subgroups based on the hemodynamic definitions of both 2015 European Society of Cardiology/European respiratory Society (ESC/ERS) PH guidelines and 6th WSPH was compared.
Results:
Of the 65 patients with SSc, 23 (35.4%) had normal mean pulmonary arterial pressure (mPAP), 20 (30.8%) had mildly elevated mPAP (21-24 mm Hg), and 22 (33.8%) had PH [pulmonary arterial hypertension (PAH) (n=16, 24.6%), group 2 PH (n=5, 7.7%), group 3 PH (n=1, 1.5%)] according to the 2015 ESC/ERS PH definition. Based on the updated criteria, 7 (10.8% of total cohort) additional patients were reclassified as having PH [PAH (n=3), group 2 PH (n=3), group 3 PH (n=1)].
Conclusion:
The impact of the updated definition on the frequency of PH and PAH in our cohort was greater than previously reported, which may be caused by the difference in screening strategies for PAH.
... В 1976 г. те же авторы наблюдали непрерывное изменение характера капиллярного кровотока во время холодового воздействия как при первичном, так и при вторичном синдроме Рейно. Детализированные исследования A. Bollinger, W. Grassi, P. Carpentier и A. Herrick, проведенные в 1980-1990 гг., способствовали дальнейшему использованию капилляроскопии ногтевого ложа (КНЛ) в диагностике ревматологических заболеваний [2][3][4]. ...
... Согласно общепризнанным стандартам капилляроскопической техники исследования существуют три основных паттерна -«ранний», «активный» и «поздний» (рис. [1][2][3][4]. ...
This article considers capillaroscopic changes in the patients with systemic sclerosis compared to the patients with a group of rheumatological diseases (rheumatoid arthritis, polymyositis, osteoarthritis) and the patients with idiopathic pulmonary hypertension. All the patients diagnosed with systemic sclerosis according to nailfold capillaroscopy had a characteristic combination of capillary disorders (Raynauds syndrome): the expansion of all three segments of the capillary loop, the loss of capillaries, and the destruction of the nail fold. In the comparison groups, the capillaroscopic picture was represented by single pathological changes that did not add up to the pathognomonic scleroderma patterns, with the exception of the groups with dermato/polymyositis, where 2 patients had significant Raynauds syndrome. There were also significant differences in the density of the capillaries in the patients with systemic sclerosis in comparison with the other groups.
... Широко обсуждается первичная роль эндотелиальной дисфункции (ЭД) при ССД, которая реализуется за счет повышенной экспрессии молекул адгезии, приводя к дальнейшему воспалению и фиброзу в стенках сосудов и ишемии органов [11]. Также при ЭД нарушается высвобождение оксида азота, что может иметь значительные последствия для структуры и функционирования сосудов [12]. ...
Relevance . In this article, the authors draw the attention of readers to the modern possibilities of using the biomicroscopy of the bulbar conjunctiva (BMBC) method in the diagnosis of microcirculatory (MC) disorders in systemic sclerosis (SS). Comparison of BMBC results of patients with SS with a control group allowed us to identify microcirculatory signs of this disease, and comparison the changes detected during nail capillaroscopy (NC) showed additional diagnostic capabilities of the BMBC method. The aim of the study was to identify new MC signs in SS using the BMBC-method, which can be further used to assess the dynamics and search for patterns with the clinical picture. Materials and methods . 48 patients with SS, the average age was 51±1.7 years were examined by BMBC, the ratio of women to men was 46:2, respectively. The control group consisted of healthy individuals without any diseases that could affect to the microcirculatory bed (MCB); the average age was 47.4±2.3 years, and the ratio of women to men was 20:10. The results showed statistically significant changes in angioarchitectonics among patients with SS compared with the control. A significant decrease in the average diameter of arterioles (14.1±0.7 μm) and capillaries (6.6±0.2 μm) was observed in the group of patients with SS compared with the control (16.6±0.6 μm, p=0.0165 and 7.3±0.2 μm, p=0.0356, respectively, for arterioles and capillaries). The decrease in capillaries during SS in four regions of the temporal section of the bulbar conjunctiva was incremental and amounted to: 15.3% in the area of the angle of the eye, 23.3% in the transitional region, 28.1% in the central and 37.9% in the perilimbal in comparison with the control. Conclusions . The BMBC-method is highly informative in the diagnosis of MC-disorders in SS. The main BMBC changes in the MC disorders caused by SS are the disturbance of MCB by the increasing tortuosity of microvessels, the contour discontinuity and the presence of local wall extensions. A peculiarity is the reduction of the capillary bed in all four regions of the temporal section of the bulbar conjunctiva with a maximum in the perilymb area.
... Studies of the parameters of capillary blood flow are important for the diagnosis of many socially significant diseases such as diabetes, Raynaud's disease, psoriasis, cardiovascular diseases. A number of diseases (for example, psoriasis, scleroderma) are characterized by local disorders of the morphology of the capillary network in an arbitrary area of arms [1][2][3]. Capillary network visualization and automation of capillary counting in the affected skin areas are the tasks to be solved in order to conduct diagnostics. This requires observing capillaries over an area of a few square millimeters. ...
The paper discusses the features of applying the method of local compensation of video frame displacements in the study of microcirculation parameters by the methods of video capillaroscopy (VCS) and microphotoplethysmography (micro-PPG). The results of the assessment and compensation of local displacements of images of the capillary network in the region of the hand of a conditionally healthy volunteer are presented. The result of the computation of the synthesized image of capillaries with equalized contrast based on the processing of a locally-combined sequence of video frames is shown. An example of capillary visualization using the frequency analysis of locally aligned video frames is given. The effectiveness of the method of local image stabilization within the study of the capillary network of mucous membranes using a laparoscope is demonstrated.
... 12 The only tool that is used to objectivize disease activity and microvasculature abnormalities in SSc is NVC; however, NVC has some limitations, including the difficulty visualizing capillaries in some patients because of low skin transparency or darki pigmentation, as well as the possibility of coexisting mechanical or chemical causes of microangiopathy in the nail fold. Grassi et al. 13 performed capillary microscopy on the lip of patients with SSc, and found significant microvascular changes relative to the controls; therefore, capillary microscopy is an alternative technique for patients in whom NVC is difficult to perform. The use of sublingual microcirculation has been of great help in the diagnosis and monitoring of critical patients with different types of shock, 10 and therefore, sublingual microcirculation data may correlate with chronic microcirculation abnormalities, such as in patients with SSc. ...
Introduction:
Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by fibrosis, inflammation, and microcirculatory alterations.
Objective:
To evaluate abnormalities in the sublingual microcirculation of SSc patients and to establish any differences compared to healthy controls.
Methods:
The sublingual microcirculation was determined using a Sidestream dark-field (SDF) imaging device (MicroScan; MicroVision Medical, Amsterdam, the Netherlands) in patients with SSc and controls.
Results:
Twelve patients with SSc (75% with diffuse cutaneous SSc) were evaluated (mean age: 52.08 ± 2.08 years). A group of 20 volunteers was used as the control. Significantly lower total capillary density (TCD) (9.2 [8.5-9.7] vs. 10.9 [9.8-12.5]) and functional capillary density (FCD) (7.0 [6.8-7.5] vs. 8.6 [7.5-9.8]) were observed in SSc patients than in healthy controls.
Conclusions:
SSc is related to significantly lower capillary density in the sublingual microcirculation, and the SDF imaging technique could be an alternative to nailfold video-capillaroscopy for diagnosing and following-up patients with SSc.
... All rights reserved. At this step, 24 articles were excluded: -18 studies described oropharyngeal manifestations of SSc without assessing patients' quality of life [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] -5 studies evaluated the use of scales 28-32 -1 study compared two different subpopulations of SSc patients 33 . ...
Background
Oropharyngeal features are frequent and often understated in the treatment clinical guidelines of systemic sclerosis in spite of important consequences on comfort, esthetics, nutrition and daily life. The aim of this systematic review was to assess a correlation between the oropharyngeal manifestations of systemic sclerosis and patients’ health‐related quality of life.
Methods
A systematic search was conducted using four databases [PubMed®, Cochrane Database®, Dentistry & Oral Sciences Source®, and SCOPUS®] up to January 2018, according to the Preferred reporting items for systematic reviews and meta analyses. Grey literature and hand search were also included. Study selection, risk bias assessment (Newcastle‐Ottawa scale) and data extraction were performed by two independent reviewers. The review protocol was registered on PROSPERO database with the code CRD42018085994.
Results
From 375 screened studies, 6 cross‐sectional studies were included in the systematic review. The total number of patients included per study ranged from 84 to 178. These studies reported a statistically significant association between oropharyngeal manifestations of systemic sclerosis (mainly assessed by maximal mouth opening and the mouth handicap in systemic sclerosis scale) and an impaired quality of life (measured by different scales). Studies were unequal concerning risk of bias mostly because of low level of evidence, different recruiting sources of samples, and different scales to assess the quality of life.
Conclusion
This systematic review demonstrates a correlation between oropharyngeal manifestations of systemic sclerosis and impaired quality of life, despite the low level of evidence of included studies. Large‐scaled studies are needed to provide stronger evidence of this association.
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... From a clinical point of view, the importance of microcirculation is due to the fact that the capillary beds represent a vascular area where trophic-metabolic exchanges between blood and tissue take place, thus leading to an irreplaceable role in organ function [22]. In oral diagnosis, the capillary loops have long been used as clinical indicators for diseases, such as highgrade dysplasia, carcinoma in situ, systemic sclerosis, and invasive carcinoma in oral erythroplakia as compared to healthy cases [23][24][25]. Particularly for oral cancers and therapy-induced mucositis, the tissue vascularity is crucial in the detection of early changes for assessing the cancer margins and potentially the presence of subclinical abnormalities beyond the clinical margins [16]. Therefore, an ability to properly visualize and analyze microvascular features can be critical for improved disease staging and therapeutic management. ...
We report the development of optical coherence tomography- (OCT) based angiography (OCTA) to image blood flow within microcirculatory tissue beds in human oral cavity in vivo with a field of view at 10 mm × 10 mm. Three-dimensional (3D) structural and vascular images of labial mucosa tissue are obtained at a single 3D acquisition. Pathologic mucosal sites with mouth ulcers are examined using the OCT tomograms and angiograms, upon which to monitor the lesion healing process over a period of 2 weeks. Quantitative metrics of the capillary loop density within the lamina propria layer are evaluated, providing statistically significant difference between healthy and diseased conditions over time. Furthermore, tissue anatomy and vessel morphology of other susceptible sites to ulcer, such as tongue, alveolar mucosa, and labial frenulum, are also imaged to demonstrate the promise of the proposed method as a clinically useful tool for the diagnosis and monitoring of therapeutic treatment of oral tissue abnormalities.
... Microvascular changes such as those assessed by nailfold capillaroscopy are seen in all involved organs (lung, heart, kidneys and gastrointestinal tract) (24). ...
Vascular injury is the main change the pathogenesis of SSc and occurs earlier, before the appearance of fibrosis. The new scleroderma 2013 criteria increased diagnostic sensitivity and specificity, by including capillaroscopic changes, besides the clinical picture and serological disease. Peripheral microvascular changes in capillaroscopy correlate with the severity of the skin damage but also with systemic involvement. The objective of this paper is to review and describe the current knowledge on nailfold capillaroscopy, as an easy, non-invasive and low cost technique for evaluating the vascular microangiopathy.
... Sclerodermic vessels pathology shows concentric intimal proliferation, marked luminal obstruction, and lymphocyte infi ltration (12). Microvasculature changes, such as those assessed by nailfold capillaroscopy, are seen in all involved organs (lungs, heart, kidneys, and gastrointestinal tract), demonstrating the widespread nature of capillary changes in this disease (13). ...
Systemic sclerosis is an autoimmune disease, characterized by fibrosis and vascular abnormalities, which determine the clinical manifestations and prognosis. The aim of this study was the assessment of intrarenal vascularization in diffuse systemic sclerosis patients and its correlations with nailfold capillaroscopy abnormalities. Material and methods. The study was performed on 11 patients with diffuse systemic sclerosis without any renal abnormalities and 11 sex- and age-matched controls. In all patients were determined: glomerular filtration rate (GFR), proteinuria, urinary sediment, resistive (RI) and pulsatility (PI) index of interlobar renal arteries and the number of nailfold capillaries/mm. All the data were presented as mean ± standard deviation. The statistically analysis was done using Pearson’s test and Student’s t-test, p < 0.05 was considered statistically significant. Results. The mean age of diffuse systemic sclerosis patients was 46.90 ± 4.98 years, and the mean length of disease was 4.63 ± 2.96 years. GFR, RI, and PI were significantly lower in diffuse systemic sclerosis patients than in controls (p < 0.001). It was identified a strong correlation between nailfold capillaries density/mm and GFR (r = 0.719, p < 0.05), RI (r = - 0.784, p < 0.01), PI (r = - 0.748, p < 0.01), and the mean length of the disease (r = - 0.85, p < 0.001). Conclusion. In patients with systemic sclerosis, intrarenal vascularization and glomerular filtration rate correlate with the capillaroscopic findings.
