Belch J J, McLaren M, Anderson J, Lowe G D, Sturrock R D, Capell H A, Forbes C D
Prostaglandins Leukot Med. 1985 Jan;17(1):1-9. doi: 10.1016/0262-1746(85)90029-0.
Patients with systemic sclerosis (SS) often suffer from Raynaud's Syndrome (RS). As prostacyclin (PGI2) is of benefit in the treatment of RS in SS, we have measured endogenous stable metabolites of PGI2 (PGI2m) in 42 patients with Raynaud's Phenomenon (RP) of varying aetiology (15 SS patients, 15 patients with Raynaud's Disease (RD) but no other symptoms, and 12 other RS patients with probable connective tissue disorder). Results were compared with 15 matched controls. Since abnormally rigid red blood cells (RBC) may occur in SS, we also measured RBC deformability (filtration technique). Results show that the SS group have significantly elevated PGI2m levels compared to patients with RD alone and normal controls. In addition, SS patients have more rigid RBC. If all 42 patients with RS were analysed, a significant correlation between PGF and RBC filtration was obtained. The cells of SS patients are resistant to the effects of PGI2 and it would appear that as a compensatory mechanism, production of PGI2 is increased. Treatment with exogenous PGI2 may overcome this resistance and improve microcirculatory flow. The more rigid RBC in SS may also be related to the increased endogenous PGI2. These results may have important clinical implications and allow new therapeutic approaches.
系统性硬化症（SS）患者常伴有雷诺氏综合征（RS）。由于前列环素（PGI2）对治疗SS中的RS有益，我们测定了42例不同病因的雷诺现象（RP）患者（15例SS患者、15例仅有雷诺氏病（RD）但无其他症状的患者以及12例可能患有结缔组织病的其他RS患者）体内PGI2的内源性稳定代谢产物（PGI2m）。将结果与15例匹配的对照进行比较。由于SS患者可能出现异常僵硬的红细胞（RBC），我们还测定了RBC的变形性（过滤技术）。结果显示，与单纯RD患者和正常对照相比，SS组的PGI2m水平显著升高。此外，SS患者的RBC更僵硬。如果对所有42例RS患者进行分析，PGF与RBC过滤之间存在显著相关性。SS患者的细胞对PGI2的作用具有抗性，似乎作为一种代偿机制，PGI2的产生增加。外源性PGI2治疗可能克服这种抗性并改善微循环血流。SS中更僵硬的RBC也可能与内源性PGI2增加有关。这些结果可能具有重要的临床意义，并为新的治疗方法提供依据。
