1
|
Ruaro B, Confalonieri M, Salton F, Wade B, Baratella E, Geri P, Confalonieri P, Kodric M, Biolo M, Bruni C. The Relationship between Pulmonary Damage and Peripheral Vascular Manifestations in Systemic Sclerosis Patients. Pharmaceuticals (Basel) 2021; 14:403. [PMID: 33922710 PMCID: PMC8145021 DOI: 10.3390/ph14050403] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/13/2021] [Accepted: 04/19/2021] [Indexed: 12/18/2022] Open
Abstract
Systemic sclerosis (SSc) is an autoimmune disease, characterized by the presence of generalized vasculopathy and tissue fibrosis. Collagen vascular disorder in SSc is due to fibroblast and endothelial cell dysfunctions. This leads to collagen overproduction, vascular impairment and immune system abnormalities and, in the last stage, multi-organ damage. Thus, to avoid organ damage, which has a poor prognosis, all patients should be carefully evaluated and followed. This is particularly important in the initial disease phase, so as to facilitate early identification of any organ involvement and to allow for appropriate therapy. Pulmonary disease in SSc mainly involves interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH). High-resolution computed tomography (HRCT) and pulmonary function tests (PFT) have been proposed to monitor parenchymal damage. Although transthoracic echocardiography is the most commonly used screening tool for PAH in SSc patients, definitive diagnosis necessitates confirmation by right heart catheterization (RHC). Moreover, some studies have demonstrated that nailfold videocapillaroscopy (NVC) provides an accurate evaluation of the microvascular damage in SSc and is able to predict internal organ involvement, such as lung impairment. This review provides an overview of the correlation between lung damage and microvascular involvement in SSc patients.
Collapse
Affiliation(s)
- Barbara Ruaro
- Department of Pulmonology, University Hospital of Cattinara, 34149 Trieste, Italy; (M.C.); (F.S.); (P.G.); (P.C.); (M.K.); (M.B.)
| | - Marco Confalonieri
- Department of Pulmonology, University Hospital of Cattinara, 34149 Trieste, Italy; (M.C.); (F.S.); (P.G.); (P.C.); (M.K.); (M.B.)
| | - Francesco Salton
- Department of Pulmonology, University Hospital of Cattinara, 34149 Trieste, Italy; (M.C.); (F.S.); (P.G.); (P.C.); (M.K.); (M.B.)
| | - Barbara Wade
- AOU City of Health and Science of Turin, Department of Science of Public Health and Pediatrics, University of Torino, 10126 Torino, Italy;
| | - Elisa Baratella
- Department of Radiology, Cattinara Hospital, University of Trieste, 34149 Trieste, Italy;
| | - Pietro Geri
- Department of Pulmonology, University Hospital of Cattinara, 34149 Trieste, Italy; (M.C.); (F.S.); (P.G.); (P.C.); (M.K.); (M.B.)
| | - Paola Confalonieri
- Department of Pulmonology, University Hospital of Cattinara, 34149 Trieste, Italy; (M.C.); (F.S.); (P.G.); (P.C.); (M.K.); (M.B.)
| | - Metka Kodric
- Department of Pulmonology, University Hospital of Cattinara, 34149 Trieste, Italy; (M.C.); (F.S.); (P.G.); (P.C.); (M.K.); (M.B.)
| | - Marco Biolo
- Department of Pulmonology, University Hospital of Cattinara, 34149 Trieste, Italy; (M.C.); (F.S.); (P.G.); (P.C.); (M.K.); (M.B.)
| | - Cosimo Bruni
- Department of Experimental and Clinical Medicine, Division of Rheumatology, University of Firenze, 50121 Florence, Italy;
| |
Collapse
|