Riccieri V, Rinaldi T, Spadaro A, Scrivo R, Ceccarelli F, Franco M Di, Taccari E, Valesini G
Dipartimento di Terapia Medica, Cattedra di Reumatologia, Università di Roma 'La Sapienza', 00185, Rome, Italy.
Clin Rheumatol. 2003 May;22(2):102-6. doi: 10.1007/s10067-002-0684-z.
The aim of this study was to investigate whether interleukin-13 (IL-13) serum levels correlate to different nailfold capillaroscopy (NC) findings in patients with systemic sclerosis (SSc). IL-13 serum levels were measured using an ELISA method. The following NC abnormalities were considered: the presence of giant loops, haemorrhages, loss of capillaries, disorganisation of the vascular array, ramified/bushy capillaries and sludging of blood. A semiquantitative rating scale was adopted to score these changes, as well as a rating system for avascular areas and three morphological NC patterns ('early', 'active' and 'late'). Mean capillary density was determined by counting the total number of capillaries in a 1 mm length, and the arterial and venous diameters of the capillary as well as the total loop diameter were measured. In SSc patients IL-13 serum levels were significantly higher than in controls ( P < 00.1), whereas in patients with ( n=8) and without ( n=24) abnormal IL-13 serum levels (>17 pg/ml) the comparison of the NC features showed significantly relevant differences concerning a more frequent 'active' NC pattern ( P < 0.02), the presence of haemorrhages ( P < 0.0037) and sludging of blood ( P < 0.038), as well as larger total loop ( P < 0.036) and arterial ( P < 0.03) diameters, in those patients with elevated IL-13 serum levels. The study confirmed that IL-13 serum levels are higher in the sera of patients with SSc, and shows for the first time the significant correlations between this serological finding and some of the main relevant SSc capillaroscopic features, leading us to believe that this cytokine not only seems to sustain the immunological and fibrotic process of SSc, but might have a role in determining the more severe microvascular lesions in this disease.
本研究的目的是调查系统性硬化症（SSc）患者血清白细胞介素-13（IL-13）水平是否与不同的甲襞毛细血管镜检查（NC）结果相关。采用酶联免疫吸附测定（ELISA）法检测血清IL-13水平。以下NC异常情况被纳入考虑：巨型襻的存在、出血、毛细血管缺失、血管排列紊乱、分支状/丛生状毛细血管以及血液淤滞。采用半定量评分量表对这些变化进行评分，同时采用无血管区评分系统以及三种形态学NC模式（“早期”、“活动期”和“晚期”）。通过计数1毫米长度内的毛细血管总数来确定平均毛细血管密度，并测量毛细血管的动脉和静脉直径以及总襻直径。SSc患者的血清IL-13水平显著高于对照组（P<0.01），而在IL-13血清水平异常（>17 pg/ml）的患者（n = 8）和无异常的患者（n = 24）中，NC特征比较显示，IL-13血清水平升高的患者中，“活动期”NC模式更为常见（P<0.02）、出血的存在（P<0.0037）和血液淤滞（P<0.038），以及总襻直径（P<0.036）和动脉直径（P<0.03）更大，存在显著相关差异。该研究证实SSc患者血清中的IL-13水平更高，并首次表明这一血清学发现与SSc一些主要相关的毛细血管镜特征之间存在显著相关性，使我们相信这种细胞因子不仅似乎维持了SSc的免疫和纤维化过程，而且可能在决定该疾病更严重的微血管病变中起作用。
