Evaluation of the capillaroscopy using endothelin-1 as a marker of endothelial activation in microvascular injury and cutaneous ulcerations.

OBJECTIVES: To evaluate the presence of ET-1 in patients with scleroderma and its correlation with the level of disease activity; to verify if the levels of endothelin are associated with the clinical profile and autoantibodies of scleroderma, and even if there is an association with microvascular injury detected by nailfold capillaroscopy. METHODS: A total of 74 patients, 37 patients with scleroderma, the remaining being controls, were subjected to measurement of ET-1 by ELISA. Patients with scleroderma were evaluated through a questionnaire about characteristics of the disease and determination of autoantibodies. Disease severity was defined by the criteria of Medsger and microvascular disease was accessed through nailfold capillaroscopy. RESULTS: Of the 37 patients with scleroderma, three (8.1%) were men and 34 (91.89%) women, with a mean age of 48.97 ± 13.36 years and mean disease duration of 42.54 ± 13, 35. The amounts of ET-1 in the controls was 0.41 to 5.65 pg / ml (median of 2.26 pg / ml) and, in the scleroderma group, from 0.41 to 8.82 pg / ml (median, 0.41 pg / ml), with p = 0.0007. There was no correlation with disease duration, patient age and the degree of skin involvement. No correlation was found between serum levels of ET-1 and disease severity (p = 0.13). Higher levels of ET-1 were observed in the form of overlap (1.49 to 6.82 pg / ml). CONCLUSION: The levels of ET-1 in scleroderma were inferior to controls. There was no association of ET-1 levels with the variables studied.

Avaliação da capilaroscopia usando Endotelina-1 como um marcador de ativação endotelial na lesão microvascular e úlceras cutâneas / Evaluation of the capillaroscopy using endothelin-1 as a marker of endothelial activation in microvascular injury and cutaneous ulcerations

OBJETIVO: Avaliar a presença da ET-1 em pacientes portadores de esclerodermia e a sua correlação com o nível de atividade da doença; verificar se os níveis de endotelina estão associados com o perfil clínico e de autoanticorpos da esclerodermia e, ainda, se há associação com lesão microvascular detectada pela capilaroscopia periungueal. MÉTODOS: Um total de 74 pacientes, sendo 37 portadores de esclerodermia e o restante controle, foram submetidos à dosagem de ET-1 por meio de teste de ELISA. Pacientes com esclerodermia foram analisados através de um questionário sobre características da doença e pesquisa de autoanticorpos. A gravidade da doença foi definida pelos critérios de Medsger e a doença microvascular foi acessada através de capilaroscopia periungueal. RESULTADOS: Dos 37 pacientes com esclerodermia três (8,1%) eram homens e 34 (91,89%) mulheres, com idade média de 48,97 ? 13,36 anos e tempo médio de doença de 42,54 ? 13,35 anos. Os valores da ET-1 nos controles foram de 0,41 a 5,65 pg/ml (mediana de 2,26 pg/ml) e nos com esclerodermia de 0,41 a 8.82 pg/ml (mediana de 0,41 pg/ml) com p de 0,0007. Não houve correlação com o tempo de doença, idade do paciente e com o nível de acometimento cutâneo. Não encontrou-se correlação entre nível de ET-1 sérica e gravidade da doença (p=0,13). Níveis maiores de ET-1 foram observados na forma de superposição (1,49 a 6,82 pg/ml). CONCLUSÃO: Os níveis de ET-1 em esclerodérmicos mostraram-se inferiores aos controles. Não houve associação dos níveis de ET-1 com as variáveis estudadas.

Objectives: To evaluate the presence of ET-1 in patients with scleroderma and its correlation with the level of disease activity; to verify if the levels of endothelin are associated with the clinical profile and autoantibodies of scleroderma, and even if there is an association with microvascular injury detected by nailfold capillaroscopy. METHODS: A total of 74 patients, 37 patients with scleroderma, the remaining being controls, were subjected to measurement of ET-1 by ELISA. Patients with scleroderma were evaluated through a questionnaire about characteristics of the disease and determination of autoantibodies. Disease severity was defined by the criteria of Medsger and microvascular disease was accessed through nailfold capillaroscopy. RESULTS: Of the 37 patients with scleroderma, three (8.1%) were men and 34 (91.89%) women, with a mean age of 48.97 ± 13.36 years and mean disease duration of 42.54 ± 13, 35. The amounts of ET-1 in the controls was 0.41 to 5.65 pg / ml (median of 2.26 pg / ml) and, in the scleroderma group, from 0.41 to 8.82 pg / ml (median, 0.41 pg / ml), with p = 0.0007. There was no correlation with disease duration, patient age and the degree of skin involvement. No correlation was found between serum levels of ET-1 and disease severity (p = 0.13). Higher levels of ET-1 were observed in the form of overlap (1.49 to 6.82 pg / ml). CONCLUSION: The levels of ET-1 in scleroderma were inferior to controls. There was no association of ET-1 levels with the variables studied.

Cutaneous manifestations associated with antiphospholipid antibodies.

BACKGROUND: Primary Antiphospholipid Antibody Syndrome (PAAS) is characterized by detection of antiphospholipid antibodies associated with venous or arterial thrombosis and/or miscarriages by patients with no other associated disease such as systemic lupus erythematosus (SLE). Primary Antiphospholipid Antibody Syndrome has many clinical manifestations of which dermatological ones are probably the most common. The purpose of this study was to determine the frequency of each cutaneous lesion, describing clinical features essential for diagnosis, in patients with Antiphospholipid Antibody Syndrome (AAS) attending Walter Cantídio University Hospital. METHODS: Sixty patients with clinical findings suggestive of AAS were screened, and submitted for clinical and laboratory evaluations including lupus anticoagulant (KCT), anticardiolipin antibodies (IgG and IgM: ELISA), routine laboratory tests and screening tests for possible associated conditions. RESULTS: Twenty-five cases of primary and 14 cases of secondary AAS were diagnosed by clinical and laboratory evidences. Persistent elevated antiphospholipid antibodies without history of thromboembolic events or miscarriages were demonstrated in 21 patients. Forty percent of the patients with AAS had a cutaneous feature as the major complaint. These were dermographism (15), acrocyanosis (13), urticaria (9), diffuse alopecia (9), livedo reticularis (seven), Raynaud's phenomenon (three), purpura (two), ulcers and necrosis (four), nodules (four), pterygium ungueum (one) and subungual hemorrhage (one). CONCLUSIONS: Dermatological complaints are very frequent in patients with AAS and may be the first clue to the syndrome. Therefore a careful history and detailed physical examination are essential to diagnose AAS. All dermatologists should investigate the possibility of AAS when facing cutaneous findings related to venous or arterial thrombosis or microthrombosis.

Efficacy of 8-bromoguanosine against murine cutaneous leishmaniasis induced with Leishmania amazonensis.

BACKGROUND AND METHODS: In this study, we investigated the effect of 8-bromoguanosine (8Brguo), an immunostimulatory compound, in a murine model of experimental cutaneous leishmaniasis. RESULTS: The results indicated that treatment by intraperitoneal administration of 8Brguo (150 mg/kg once daily for 1 week and thereafter once weekly for 1 month) diluted in Tween-80 produces an effect similar to that of treatment with the classical antimonial drug, Glucantime, in Leishmania amazonensis-infected CBA/J mice. While complete cure did not occur, animals treated with the nucleoside had small lesions in the infected footpad and delayed surface ulceration. Studies involving examination of serum glutamic pyruvic transaminase activity, concentration of urea, blood pathology and histology of the spleen, kidney and liver showed no apparent toxicity of the nucleoside in treated mice. CONCLUSION: The protective in vivo effect during murine leishmaniasis as well as the lack of apparent toxicity of 8Brguo as attested by blood/serum pathology and histology from treated mice encourage further studies of C8-substituted guanine ribonucleosides, such as 8Brguo, as new leishmanial drugs and as modifiers of the immunological response to combat infections with intracellular pathogens.