Abstract：
Systemic sclerosis (SSc) is a complex autoimmune connective-tissue disease, characterised by vasculopathy and fibrosis of the skin and internal organs. Activation of microvascular endothelial cells (ECs) causes the intimal hyperplasia that characterises the vascular remodelling in SSc. The most frequent complication of SSc is the development of digital ulcers (DUs). Thymic stromal lymphopoietin (TSLP) may trigger fibrosis and sustain vascular damage. Aim of this study was to evaluate the correlation between serum level of TSLP and DUs.
75 consecutive SSc patients were enrolled and serum TSLP levels were measured. The presence of history of DUs (HDU) was evaluated. Recurrent new DUs were defined as the presence of at least 3 episodes of DUs in a 12-months follow up period. The risk of developing new DUs was calculated by applying the capillaroscopic skin ulcer risk index (CSURI).
The median value of TSLP was higher in patients with HDU than patients without HDU [181.67 pg/ml (IQR 144.67; 265.66) vs 154.67 pg/ml (IQR 110.67; 171.33), p < 0.01]. The median value of TSLP was higher in patients with an increased CSURI index than patients without an increased CSURI [188 pg/ml (IQR 171.33; 246.33) vs 159.33 pg/ml (IQR 128.67; 218), p < 0.01]. Kaplan-Meier curves demonstrated that free survival from new DUs was significantly (p < 0.01) lower in SSc patients with increased TSLP serum levels.
TSLP might have a key role in digital microvascular damage of SSc patients.
75 consecutive SSc patients were enrolled and serum TSLP levels were measured. The presence of history of DUs (HDU) was evaluated. Recurrent new DUs were defined as the presence of at least 3 episodes of DUs in a 12-months follow up period. The risk of developing new DUs was calculated by applying the capillaroscopic skin ulcer risk index (CSURI).
The median value of TSLP was higher in patients with HDU than patients without HDU [181.67 pg/ml (IQR 144.67; 265.66) vs 154.67 pg/ml (IQR 110.67; 171.33), p < 0.01]. The median value of TSLP was higher in patients with an increased CSURI index than patients without an increased CSURI [188 pg/ml (IQR 171.33; 246.33) vs 159.33 pg/ml (IQR 128.67; 218), p < 0.01]. Kaplan-Meier curves demonstrated that free survival from new DUs was significantly (p < 0.01) lower in SSc patients with increased TSLP serum levels.
TSLP might have a key role in digital microvascular damage of SSc patients.
摘要：
背景：系统性硬化症（SSc）是一种复杂的自身免疫性结缔组织疾病，以皮肤和内脏器官的血管病变和纤维化为特征。微血管内皮细胞（EC）的激活会导致内膜增生，这是SSc血管重塑的特征。SSc最常见的并发症是数字溃疡（DU）的发展。胸腺基质淋巴细胞生成素（TSLP）可能引发纤维化并维持血管损伤。本研究的目的是评估血清TSLP水平与DU之间的相关性。
方法：纳入75例连续SSc患者，测定血清TSLP水平。评估了DU（HDU）历史的存在。反复出现的新DU被定义为在12个月的随访期内出现至少3次DU。通过应用毛细管镜皮肤溃疡风险指数（CSURI）计算开发新DU的风险。
结果：HDU患者的TSLP中位值高于无HDU患者[181.67pg/ml（IQR144.67;265.66）vs154.67pg/ml（IQR110.67;171.33），p<0.01]。CSURI指数升高的患者的TSLP中位值高于CSURI指数升高的患者[188pg/ml(IQR171.33;246.33)vs159.33pg/ml(IQR128.67;218)，p<0.01]。Kaplan-Meier曲线表明，在TSLP血清水平升高的SSc患者中，新DU的自由生存率显着降低（p<0.01）。
结论：TSLP可能在SSc患者的数字微血管损伤中起关键作用。
方法：纳入75例连续SSc患者，测定血清TSLP水平。评估了DU（HDU）历史的存在。反复出现的新DU被定义为在12个月的随访期内出现至少3次DU。通过应用毛细管镜皮肤溃疡风险指数（CSURI）计算开发新DU的风险。
结果：HDU患者的TSLP中位值高于无HDU患者[181.67pg/ml（IQR144.67;265.66）vs154.67pg/ml（IQR110.67;171.33），p<0.01]。CSURI指数升高的患者的TSLP中位值高于CSURI指数升高的患者[188pg/ml(IQR171.33;246.33)vs159.33pg/ml(IQR128.67;218)，p<0.01]。Kaplan-Meier曲线表明，在TSLP血清水平升高的SSc患者中，新DU的自由生存率显着降低（p<0.01）。
结论：TSLP可能在SSc患者的数字微血管损伤中起关键作用。
