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Capillary loss reflects disease activity and prognosis in patients with systemic sclerosis

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Capillary density on nailfold capillaroscopy (NFC) is considered a promising instrument for assessing disease characteristics in patients with systemic sclerosis (SSc), however, there is no agreement yet over how to analyze and interpret the results. The objective of this study was to investigate the possible associations of the mean number of capillaries with disease characteristics, disease activity [measured by the European Scleroderma Study Group (EScSG) disease activity score] and survival in a singlecenter cohort of patients with SSc. Sixtyeight patients were included; 54 had followup at 6 months. Thirtytwo images per patient were assessed independently by two raters, scoring the mean number of capillaries in all fingers (N), in the 3rd finger of the dominant hand (dN3) and in the 4th finger of the nondominant hand (ndN4) for each patient. NFC ‘early’, ‘active’ and ‘late’ patterns were also assessed. Two thousand and seventysix images were scored at baseline, 1,728 at followup. Baseline N was median (IQR) 5.1 (2.7) for rater 1, and 4.9 (1.7) for rater 2, respectively. N was significantly lower in patients with a history of digital ulcers (DUs), vs. those who never had DUs 4.8 (1.4) vs. 6.4 (3.1), P=0.016. A lower N was associated with higher disease activity at baseline and followup (linear regression adjusted for age, sex and history of DUs). A lower ndN4 was associated with increased mortality (logistic regression adjusted for age and sex). In conclusion, in patients with SSc, a lower mean number of capillaries assessed by NFC was associated with higher disease activity after 6 months of followup and with shorter survival.
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Document Type: Research Article

Affiliations: 1: Department of Internal Medicine and Rheumatology, Cantacuzino Clinical Hospital, ‘Carol Davila’ University of Medicine and Pharmacy, 020475 Bucharest, Romania 2: Optoelectronica SA 2001, 050883 Bucharest, Romania

Publication date: October 1, 2020

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  • Experimental and Therapeutic Medicine aims to ensure the expedient publication, in both print and electronic format, of studies relating to biology, gene therapy, infectious disease, microbiology, molecular cardiology and molecular surgery. The journal welcomes studies pertaining to all aspects of molecular medicine, and studies relating to in vitro or in vivo experimental model systems relevant to the mechanisms of disease are also included.

    All materials submitted to this journal undergo the appropriate review via referees who are experts in this field. All materials submitted follow international guidelines with regard to approval of experiments on humans and animals.
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