Kuryliszyn-Moskal Anna, Kita Jacek, Dakowicz Agnieszka, Chwieśko-Minarowska Sylwia, Moskal Diana, Kosztyła-Hojna Bożena, Jabłońska Ewa, Klimiuk Piotr Adrian
Department of Rehabilitation, Medical University of Bialystok, M. Sklodowskiej-Curie 24A, 15-276, Bialystok, Poland,
Clin Rheumatol. 2015 Mar;34(3):489-96. doi: 10.1007/s10067-014-2637-8. Epub 2014 May 13.
The aim of this study was to investigate the influence of the Multiwave Locked System (MLS) laser therapy on clinical features, microvascular changes in nailfold videocapillaroscopy (NVC) and circulating modulators releasing as a consequence of vascular endothelium injury such as vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang-2) in patients with primary and secondary Raynaud's phenomenon. Seventy-eight RP patients and 30 healthy volunteers were recruited into the study. All patients with RP received MLS laser irradiation for 3 weeks. Clinical, NVC and laboratory investigations were performed before and after the MLS laser therapy. The serum concentration of VEGF and Ang-2 were determined by an enzyme-linked immunosorbent assay (ELISA). After 3 weeks of MLS laser therapy, the clinical improvement manifested by decreasing of the number of RP attacks, mean duration of Raynaud's attack and pain intensity in RP patients was observed. After MLS laser therapy in 65% of patients with primary and in 35% with secondary RP, an increase in the loop number and/or a reduction in avascular areas in NVC were observed. In comparison with a control group, higher serum concentration of VEGF and Ang-2 in RP patients was demonstrated. After MLS laser therapy, a reduction of Ang-2 in both groups of RP patients was found. Our results suggest that NVC may reflect microvascular changes associated with clinical improvement after MLS laser therapy in patients with primary and secondary RP. Ang-2 serum levels may be a useful marker of microvascular abnormalities in RP patients treated with MLS laser therapy.
本研究旨在探讨多波长锁定系统（MLS）激光疗法对原发性和继发性雷诺现象患者的临床特征、甲襞微血管显微镜检查（NVC）中的微血管变化以及血管内皮损伤后释放的循环调节因子（如血管内皮生长因子（VEGF）和血管生成素2（Ang-2））的影响。78例雷诺现象患者和30名健康志愿者被纳入研究。所有雷诺现象患者均接受MLS激光照射3周。在MLS激光治疗前后进行临床、NVC和实验室检查。采用酶联免疫吸附测定（ELISA）法测定血清VEGF和Ang-2浓度。MLS激光治疗3周后，观察到雷诺现象患者的雷诺发作次数减少、雷诺发作平均持续时间和疼痛强度降低，临床症状改善。MLS激光治疗后，65%的原发性雷诺现象患者和35%的继发性雷诺现象患者的NVC中环数量增加和/或无血管区域减少。与对照组相比，雷诺现象患者的血清VEGF和Ang-2浓度更高。MLS激光治疗后，两组雷诺现象患者的Ang-2均降低。我们的结果表明，NVC可能反映原发性和继发性雷诺现象患者在MLS激光治疗后与临床改善相关的微血管变化。Ang-2血清水平可能是接受MLS激光治疗的雷诺现象患者微血管异常的有用标志物。
