Screm Gianluca, Gandin Ilaria, Mondini Lucrezia, Cifaldi Rossella, Confalonieri Paola, Bozzi Chiara, Salton Francesco, Bandini Giulia, Monteleone Giorgio, Hughes Michael, Cameli Paolo, Novello Marileda, Della Porta Rossana, Pietro Geri, Confalonieri Marco, Ruaro Barbara
Pulmonology Unit, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy.
Biostatistics Unit, Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy.
J Clin Med. 2025 Jul 28;14(15):5311. doi: 10.3390/jcm14155311.
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), including granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA), represent a spectrum of systemic disorders characterized by necrotizing inflammation of small- to medium-sized vessels. Nailfold videocapillaroscopy (NVC) is a validated, non-invasive technique routinely employed in the assessment of microvascular involvement in systemic sclerosis and in the differential diagnosis of Raynaud's phenomenon; its application in the context of AAV, particularly EGPA, has not been investigated yet. The present study aims to assess the presence and the possible pattern of microcirculatory abnormalities detected by NVC in EGPA patients, and to explore potential correlations between capillaroscopic findings and disease activity status. A total of 29 patients with EGPA (19 women and 10 men), aged between 51 and 73 years, and 29 age- and sex-matched healthy controls were retrospectively enrolled between October 2023 and April 2025, after providing informed consent and meeting the inclusion and exclusion criteria. NVC was conducted in both groups to assess various morphological parameters, and mean capillary density was also calculated. This study observed the presence of capillaroscopic alterations in the EGPA group, including decreased capillary density (38%), neoangiogenesis (72%), rolling (100%), pericapillary stippling (66%), and inverted capillary apex (52%). Overall, when comparing healthy controls with EGPA patients, microcirculatory abnormalities were significantly more prevalent in the latter. Specifically, scores for neoangiogenesis, capillary rolling, pericapillary stippling, and inverted capillary apex showed -values < 0.001. Our study demonstrates a higher prevalence of four nailfold videocapillaroscopic abnormalities in patients with EGPA compared to healthy controls. However, the identification of these capillaroscopic alterations as specific to EGPA requires further confirmation. Ongoing studies aim to explore the potential role of NVC as a diagnostic marker and to investigate its correlation with the clinical manifestations of EGPA.
抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV），包括肉芽肿性多血管炎（GPA）、显微镜下多血管炎（MPA）和嗜酸性肉芽肿性多血管炎（EGPA），是一系列以中小血管坏死性炎症为特征的全身性疾病。甲襞视频毛细血管镜检查（NVC）是一种经过验证的非侵入性技术，常用于评估系统性硬化症中的微血管受累情况以及雷诺现象的鉴别诊断；其在AAV，尤其是EGPA中的应用尚未得到研究。本研究旨在评估EGPA患者中通过NVC检测到的微循环异常的存在情况及其可能的模式，并探讨毛细血管镜检查结果与疾病活动状态之间的潜在相关性。在2023年10月至2025年4月期间，在获得知情同意并符合纳入和排除标准后，共回顾性纳入了29例年龄在51至73岁之间的EGPA患者（19名女性和10名男性）以及29名年龄和性别匹配的健康对照者。两组均进行了NVC以评估各种形态学参数，并计算平均毛细血管密度。本研究观察到EGPA组存在毛细血管镜改变，包括毛细血管密度降低（38%）、新生血管形成（72%）、滚动（100%）、毛细血管周围点状沉着（66%）和毛细血管顶端倒置（52%）。总体而言，将健康对照者与EGPA患者进行比较时，微循环异常在后者中明显更为普遍。具体而言，新生血管形成、毛细血管滚动、毛细血管周围点状沉着和毛细血管顶端倒置的评分显示P值<0.001。我们的研究表明，与健康对照者相比，EGPA患者中甲襞视频毛细血管镜检查的四种异常更为普遍。然而，将这些毛细血管镜改变确定为EGPA特有的改变需要进一步证实。正在进行的研究旨在探索NVC作为诊断标志物的潜在作用，并研究其与EGPA临床表现的相关性。
