Department of Ophthalmology and Vision Rehabilitation, Medical University of Lodz, Zeromskiego 113, 90-549 Lodz, Poland.
Department of Dermatology and Venerology, Medical University of Lodz, Hallera 1, 90-647 Lodz, Poland.
Mediators Inflamm. 2020 Jan 24;2020:7649480. doi: 10.1155/2020/7649480. eCollection 2020.
Systemic sclerosis (SSc) is a connective tissue disorder characterized by tissue hypoxia, excessive fibrosis of skin and internal organs, and angiogenesis imbalance. The aim of the study was to evaluate in SSc patients the association between the retinal microcirculation disturbances and the presence of peripheral trophic changes and to determine the role of angiogenesis factors in the formation of vascular changes in scleroderma. Twenty-five SSc patients and 25 age- and sex-matched healthy controls were included to the study. Assay of vascular endothelial growth factor (VEGF) and soluble VEGF receptor-2 (sVEGFR-2) in blood serum and tears was done for all patients and controls using enzyme-linked immunosorbent assay. Retinal blood circulation was investigated with fluorescein angiography (FA) in the SSc patients only. In our research, proportion of mainly hypertensive patients presenting with a large spectrum of retinal microvascular lesions was 72%, while proportion of patients with skin microvascular lesions within distal phalanxes of fingers and toes was 76%. We noticed that patients with pathological changes in the FA examination had finger ulcerations significantly more often than patients without changes in the eye fundus. There were no statistically significant differences in the serum concentration of VEGF and sVEGFR2 between subjects in both analyzed groups. Analysis of lower levels of VEGF ( = <0.001) and sVEGFR-2 ( = <0.001) in blood serum accompanied by simultaneous higher levels of VEGF/sVEGFR-2 ratio in tears of SSc patients, as compared with the control group, indicates the superiority of proangiogenic factors in patients' tears.
系统性硬化症（SSc）是一种结缔组织疾病，其特征为组织缺氧、皮肤和内脏器官过度纤维化以及血管生成失衡。本研究旨在评估 SSc 患者视网膜微循环障碍与外周营养障碍的相关性，并确定血管生成因子在硬皮病血管变化形成中的作用。本研究纳入了 25 例 SSc 患者和 25 名年龄和性别匹配的健康对照者。采用酶联免疫吸附试验检测所有患者和对照者血清和泪液中的血管内皮生长因子（VEGF）和可溶性 VEGF 受体-2（sVEGFR-2）。仅对 SSc 患者进行荧光素血管造影（FA）检查视网膜血液循环。在我们的研究中，主要表现为高血压且具有广泛视网膜微血管病变的患者比例为 72%，而手指和脚趾远端指节皮肤微血管病变的患者比例为 76%。我们注意到 FA 检查有病变的患者手指溃疡明显多于眼底无变化的患者。在这两个分析组中，血清 VEGF 和 sVEGFR2 浓度在受试者之间没有统计学差异。与对照组相比，SSc 患者血清中 VEGF（ = <0.001）和 sVEGFR-2（ = <0.001）水平较低，同时泪液中 VEGF/sVEGFR-2 比值较高（ = <0.001），表明患者泪液中促血管生成因子具有优势。
