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Raynaud's phenomenon and systemic sclerosis.
Ann Ital Med Int. 1996 Apr-Jun; 11(2):125-31.AI

Abstract

In systemic sclerosis, the exaggerated generalized vasospastic tendency is clinically represented by Raynaud's phenomenon as shown by an early digital arterial closure after cold stimulation, and by an inadequate vasodilatory response to heat. The phenomenon is not restricted to the extremities, and can also occur in internal organs. Repeated attacks of Raynaud's phenomenon may contribute to vascular disease in systemic sclerosis by a mechanism of reperfusion injury of the endothelium, and may contribute to tissue fibrosis. Although the aetiology and pathogenesis of Raynaud's phenomenon remain unknown, recent advances in the understanding of mechanisms of vascular tone control provide us with an opportunity to reconsider the pathogenetic process of Raynaud's phenomenon. It is now clear that neuropeptides, the vascular endothelium, and platelets are the three major contributors to the control of vascular tone. Our hypothesis suggests the presence of a sensory nervous system failure, leading to an unopposed endothelial and platelet control of vascular tone. Endothelial injury and platelet activation in systemic sclerosis lead to a shift in vascular function to a pro-vasospastic function not balanced by a vasodilatory sensory input; thus, enhanced vasospasm is generated. The investigation of the role of local vascular mediators in vasospasm may lead to a better understanding of vascular tone control and of Raynaud's phenomenon pathophysiology in systemic sclerosis.

Authors+Show Affiliations

Istituto di Clinica Medica IV, Università degli Studi di Firenze.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

8974438

Citation

Generini, S, et al. "Raynaud's Phenomenon and Systemic Sclerosis." Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna, vol. 11, no. 2, 1996, pp. 125-31.
Generini S, Kahaleh B, Matucci-Cerinic M, et al. Raynaud's phenomenon and systemic sclerosis. Ann Ital Med Int. 1996;11(2):125-31.
Generini, S., Kahaleh, B., Matucci-Cerinic, M., Pignone, A., Lombardi, A., & Ohtsuka, T. (1996). Raynaud's phenomenon and systemic sclerosis. Annali Italiani Di Medicina Interna : Organo Ufficiale Della Societa Italiana Di Medicina Interna, 11(2), 125-31.
Generini S, et al. Raynaud's Phenomenon and Systemic Sclerosis. Ann Ital Med Int. 1996 Apr-Jun;11(2):125-31. PubMed PMID: 8974438.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Raynaud's phenomenon and systemic sclerosis. AU - Generini,S, AU - Kahaleh,B, AU - Matucci-Cerinic,M, AU - Pignone,A, AU - Lombardi,A, AU - Ohtsuka,T, PY - 1996/4/1/pubmed PY - 1996/4/1/medline PY - 1996/4/1/entrez SP - 125 EP - 31 JF - Annali italiani di medicina interna : organo ufficiale della Societa italiana di medicina interna JO - Ann. Ital. Med. Int. VL - 11 IS - 2 N2 - In systemic sclerosis, the exaggerated generalized vasospastic tendency is clinically represented by Raynaud's phenomenon as shown by an early digital arterial closure after cold stimulation, and by an inadequate vasodilatory response to heat. The phenomenon is not restricted to the extremities, and can also occur in internal organs. Repeated attacks of Raynaud's phenomenon may contribute to vascular disease in systemic sclerosis by a mechanism of reperfusion injury of the endothelium, and may contribute to tissue fibrosis. Although the aetiology and pathogenesis of Raynaud's phenomenon remain unknown, recent advances in the understanding of mechanisms of vascular tone control provide us with an opportunity to reconsider the pathogenetic process of Raynaud's phenomenon. It is now clear that neuropeptides, the vascular endothelium, and platelets are the three major contributors to the control of vascular tone. Our hypothesis suggests the presence of a sensory nervous system failure, leading to an unopposed endothelial and platelet control of vascular tone. Endothelial injury and platelet activation in systemic sclerosis lead to a shift in vascular function to a pro-vasospastic function not balanced by a vasodilatory sensory input; thus, enhanced vasospasm is generated. The investigation of the role of local vascular mediators in vasospasm may lead to a better understanding of vascular tone control and of Raynaud's phenomenon pathophysiology in systemic sclerosis. SN - 0393-9340 UR - https://www.unboundmedicine.com/medline/citation/8974438/Raynaud's_phenomenon_and_systemic_sclerosis_ L2 - http://www.diseaseinfosearch.org/result/2275 DB - PRIME DP - Unbound Medicine ER -