Clinical significance of CCN2/connective tissue growth factor in Behçet's disease patients.

AIM: Behçet's disease (BD) is a chronic autoimmune vasculitic disorder of unclear pathogenesis. CCN2/CTGF (connective tissue growth factor) is one of the CCN family members which carry out pro-angiogenic biological functions and play an important role in inflammatory and autoimmune diseases. The aim of the present study was to assess CCN2 plasma concentrations in BD patients and to analyze their association with clinical features of the disease, activity and laboratory parameters. METHODS: We included 87 BD patients and 60 healthy control subjects matched for age and gender. Demographic, clinical, disease activity and severity data were recorded. Plasma CCN2 concentrations were measured using enzyme-linked immunosorbent assay. RESULTS: The plasma concentrations of CCN2 in BD patients were significantly elevated compared to healthy controls. The mean plasma CCN2 levels in patients with major organ involvement were significantly higher than those without. Patients who received steroids or cyclophosphamide showed a significant reduction in CCN2 levels. This was confirmed by the results of multivariate analysis. Patients with active ocular disease had a significant increase in CCN2 compared to the inactive group. On the other hand, CCN2 levels were not significantly correlated with overall disease activity and severity scores. CONCLUSION: Behçet's disease patients showed a significant increase of CCN2 levels, especially in the group of patients with major organ involvement. A significant reduction of these levels was found in patients who received steroids or cyclophosphamide. Larger studies with further investigations of the precise role of CCN2 in BD pathogenesis might lead to novel therapies for the clinical management of this disease.

Relationship between nailfold capillary abnormalities and vestibular dysfunction in systemic sclerosis.

OBJECTIVE: To investigate the vestibular dysfunction in a cohort of patients with systemic sclerosis (SSc) and to correlate the findings with disease parameters and microvascular involvement. METHODS: Vestibular affection was assessed in 30 female SSc patients and 29 age-matched healthy females subjects by using the computerized dynamic platform posturography (CDP). Assessment of microvasculature was done by nailfold videocapillaroscopy (NVC). The main clinical correlates of disease, such as renal function, skin, articular and lung involvement, were evaluated by clinical and instrumental investigations. RESULTS: Subtle vestibular dysfunction was detected in 33% of SSc patients. They exhibited significant decrease in their vestibular ratio values compared to controls (P=0.01). There was a statistical significant association of vestibular affection with both Rodnan's skin score and vascular severity score. Moreover a significant association was found between vestibular dysfunction and NVC patterns. On the other hand, no correlation was observed between vestibular impairment with age, disease duration, disease subsets, autoantibodies and the other clinical disease parameters. CONCLUSION: Our results showed an evidence of vestibular impairment in patients with SSc. Vestibular dysfunction positively correlates with vascular severity score as assessed by NVC.