Third Internal Medicine, Diabetes and Rheumatology Department, University of Medicine and Pharmacy "Victor Babeș", 300041 Timișoara, Romania.
Internal Medicine Department, "Victor Popescu" Military Hospital, 300080 Timișoara, Romania.
Int J Mol Sci. 2024 Sep 14;25(18):9925. doi: 10.3390/ijms25189925.
Nailfold capillaroscopy is a non-invasive investigation, which allows for the study of the microvasculature (anatomical and functional). Rheumatoid arthritis (RA) is associated with a high risk of cardiovascular atherosclerotic diseases, with endothelial dysfunction (macrovascular and microvascular) representing the first step in atherosclerosis development. The aim of this study is represented by the assessment of microvascular endothelial dysfunction in RA patients by means of nailfold capillaroscopy and to assess its evolution after a period of 12 months of anti TNF-alpha treatment. The study included 70 consecutive patients with RA and 70 healthy subjects, matched for age and gender, as the control group. Rheumatoid factor, anti-cyclic citrullinated peptide antibodies, serum TNF-α, C reactive protein, and erythrocytes sedimentation rate were evaluated in all patients, but in controls, only rheumatoid factor, serum TNF-α, C reactive protein, and erythrocytes sedimentation rate were measured. The RA activity was measured by DAS28. Nailfold capillaroscopy was carried out in all patients and controls, determining the baseline nailfold capillary density (Db), nailfold capillary density during reactive hyperemia (Dh), and nailfold capillary density after venous congestion (Dc). Data were presented as mean ± standard deviation. Statistical analysis was performed using ANOVA and Pearson's correlation, with < 0.05 being statistically significant. Db, Dh, and Dc were lower in RA patients than in controls ( < 0.0001), correlating with RA activity and TNF-α ( < 0.05). After 12 months of anti TNF-α treatment, microvascular endothelial dysfunction improved ( < 0.0001). Microvascular endothelial dysfunction can be assessed by nailfold capillaroscopy, with anti TNF-α medication contributing to its improvement.
甲襞毛细血管显微镜检查是一种非侵入性的检查方法，可以研究微血管（解剖和功能）。类风湿关节炎（RA）与心血管动脉粥样硬化疾病的高风险相关，内皮功能障碍（大血管和微血管）是动脉粥样硬化发展的第一步。本研究的目的是通过甲襞毛细血管显微镜检查评估 RA 患者的微血管内皮功能障碍，并评估在抗 TNF-α治疗 12 个月后的演变。该研究纳入了 70 例连续的 RA 患者和 70 名年龄和性别匹配的健康对照者。所有患者均评估了类风湿因子、抗环瓜氨酸肽抗体、血清 TNF-α、C 反应蛋白和红细胞沉降率，但在对照组中仅测量了类风湿因子、血清 TNF-α、C 反应蛋白和红细胞沉降率。RA 活动度通过 DAS28 测量。对所有患者和对照者进行了甲襞毛细血管显微镜检查，确定基线甲襞毛细血管密度（Db）、反应性充血时的甲襞毛细血管密度（Dh）和静脉充血后的甲襞毛细血管密度（Dc）。数据以平均值±标准差表示。采用方差分析和 Pearson 相关性进行统计分析， < 0.05 为统计学显著差异。RA 患者的 Db、Dh 和 Dc 均低于对照组（ < 0.0001），与 RA 活动度和 TNF-α相关（ < 0.05）。经过 12 个月的抗 TNF-α治疗，微血管内皮功能障碍得到改善（ < 0.0001）。甲襞毛细血管显微镜检查可评估微血管内皮功能障碍，抗 TNF-α药物有助于改善其功能。
