title: [Systemic sclerosis after a long-term follow-up].
abstract: The authors suggest some remarks on the aetiopathogenesis of systemic sclerosis through a critical review of a group of 51 patients affected by this disease for many years. In this paper the authors report their previous studies regarding the correlation of immunological response, both cell-mediated and humoral, hemocoagulative aspects and haemorheological changes. From the results of immunological studies, the authors report a long-term treatment with an immunomodulating drug: thymopentin. Moreover they report a recent work about the connection among stressor event, production of endothelin-1 (ET-1) and serum levels of some stress hormones such as possible pathogenetic factors of Raynaud's phenomenon and of scleroderma. This work ends with a proposal of a pathogenetic scheme that, even if it doesn't exclude an infective pathogenesis, considers stress as a factor able to switch on a series of psycho-neuro-immunoendocrinological reactions that can support, through the activation of lymphocytes, fibroblastic proliferation and finally fibrosis.
authors.affiliation: Istituto di Clinica Medica Generale e Terapia Medica II, Università degli Studi di Roma La Sapienza, Roma.
authors.forename: C
authors.initials: C
authors.lastname: Danese
authors.forename: E
authors.initials: E
authors.lastname: Zavattaro
authors.forename: F
authors.initials: F
authors.lastname: Marcianò
authors.forename: M L
authors.initials: ML
authors.lastname: Sebastiani
authors.forename: M A
authors.initials: MA
authors.lastname: Perego
mesh_terms: D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011928:Raynaud Disease / Q000150:complications; D012595:Scleroderma, Systemic / Q000097:blood / Q000150:complications / Q000188:drug therapy / Q000209:etiology / Q000276:immunology; D013997:Time Factors
vernacular_title: Riflessioni sulla sclerosi sistemica dopo un follow-up a lungo termine.