系统性硬化症

系统性硬化症 (SSc) 或硬皮病是一种进行性自身免疫疾病,其特征是由结缔组织堆积增加引起的皮肤结构和外观的变化。该疾病会影响身体的许多其他部位,但通常仅在疾病的早期阶段或以有限形式影响皮肤。2013年,美国风湿病学会 (ACR) 和欧洲抗风湿病联盟 (EULAR) 发布并强化了 SSc 的分类指引1 van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis. 2013;72:1747-55.

,这使得此疾病的早期和有限的皮肤形式更加敏感。除了手指上的皮肤增厚外,新分类还涉及与(微)循环相关的几个因素。一种是毛细血管的损伤,可以通过甲褶视频毛细管镜检查 (NVC) 检测到,而且其提高了 2013 EULAR/ACR SSc 分类标准的特异性和敏感性。

近年来,有几项研究表明,激光散斑对比分析 (LASCA) 可以作为一种有价值的技术用于进一步的SSc 研究,并作为疾病分类的一种诊断工具。2 Ruaro B, Sulli A, Smith V, Pizzorni C, Gallo M, Cutolo M. speckle contrast analysis: a new method to evaluate peripheral blood perfusion in systemic sclerosis patients. Ann Rheum Dis. 2014; 73: 1181-5.,3Ruaro B, Sulli A, Smith V, Paolino S, Pizzorni C, Cutolo M. Short-term follow-up of digital ulcers by laser speckle contrast analysis in systemic sclerosis patients. Microvasc Res. 2015;101:82-5.    

也有几项研究表明该技术可用于评估和监测治疗效果。4 Ruaro B, Paolino S, Pizzorni C, Cutolo M, Sulli A. Assessment of treatment effects on digital ulcer and blood perfusion by laser speckle contrast analysis in a patient affected by systemic sclerosis. Reumatismo. 2017;69:134-136.,5 Bo Chen; Xiaojun Wang; Xiao Long; Mingzi Zhang; Jiuzuo Huang; Nanze Yu; Jing Xu, Supportive Use of Adipose-Derived Stem Cells in Cell-Assisted Lipotransfer for Localized Scleroderma, Plastic and Reconstructive Surgery. 141(6):1395–1407 研究局部给药药物效果的一种方法是将离子导入结合 LASCA。6 M Roustit, F Gaillard-Bigot, S Blaise, F Stanke-Labesque, C Cracowski, C Seinturier, J-F Jourdil, B Imbert, PH Carpentier and J-L Cracowski, Cutaneous Iontophoresis of Treprostinil in Systemic Sclerosis: A Proof-of-Concept Study, Clin Pharmacol Ther. 2014 Apr;95(4):439-45.

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PeriCam PSI NR 用于手部检查

Perilont micropharmacology system

离子导入 是一种运送带电分子或药物穿过组织屏障的技术。离子导入结合 LASCA 是研究局部给药药物对系统性硬化症患者影响的一种有价值的工具。

离子导入

参考文献:

  1. van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, et al. 2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative. Ann Rheum Dis. 2013;72:1747-55.
  2. Ruaro B, Sulli A, Smith V, Pizzorni C, Gallo M, Cutolo M. speckle contrast analysis: a new method to evaluate peripheral blood perfusion in systemic sclerosis patients. Ann Rheum Dis. 2014; 73: 1181-5.
  3. Ruaro B, Sulli A, Smith V, Paolino S, Pizzorni C, Cutolo M. Short-term follow-up of digital ulcers by laser speckle contrast analysis in systemic sclerosis patients. Microvasc Res. 2015;101:82-5.
  4. Ruaro B, Paolino S, Pizzorni C, Cutolo M, Sulli A. Assessment of treatment effects on digital ulcer and blood perfusion by laser speckle contrast analysis in a patient affected by systemic sclerosis. Reumatismo. 2017;69:134-136.
  5. Bo Chen; Xiaojun Wang; Xiao Long; Mingzi Zhang; Jiuzuo Huang; Nanze Yu; Jing Xu, Supportive Use of Adipose-Derived Stem Cells in Cell-Assisted Lipotransfer for Localized Scleroderma, Plastic and Reconstructive Surgery. 141(6):1395–1407
  6. M Roustit, F Gaillard-Bigot, S Blaise, F Stanke-Labesque, C Cracowski, C Seinturier, J-F Jourdil, B Imbert, PH Carpentier and J-L Cracowski, Cutaneous Iontophoresis of Treprostinil in Systemic Sclerosis: A Proof-of-Concept Study, Clin Pharmacol Ther. 2014 Apr;95(4):439-45.
  7. Ruaro B, Sulli A, Smith V, Pizzorni C, Gallo M, Cutolo M. speckle contrast analysis: a new method to evaluate peripheral blood perfusion in systemic sclerosis patients. Ann Rheum Dis. 2014; 73: 1181-5.
  8. Ruaro B, Sulli A, Pizzorni C, Paolino S, Smith V, Cutolo M. Correlations between skin blood perfusion values and nailfold capillaroscopy scores in systemic sclerosis patients. Microvasc Res. 2016;105:119-24.

案例:

意大利热那亚大学、比利时根特大学

Maurizio Cutolo(意大利热那亚大学)、Barbara Ruaro(意大利热那亚大学)、Vanessa Smith(比利时根特大学)

InLASCA 可以分析外周血流灌注并给出其强度值。我们最近使用 LASCA 进行的研究表明,在指尖、胸膜周围区域和手掌水平,SSc 患者的血流灌注明显低于健康受试者,但面部水平除外7Ruaro B, Sulli A, Smith V, Pizzorni C, Gallo M, Cutolo M. speckle contrast analysis: a new method to evaluate peripheral blood perfusion in systemic sclerosis patients. Ann Rheum Dis. 2014; 73: 1181-5. ,8Ruaro B, Sulli A, Pizzorni C, Paolino S, Smith V, Cutolo M. Correlations between skin blood perfusion values and nailfold capillaroscopy scores in systemic sclerosis patients. Microvasc Res. 2016;105:119-24.

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