The response of skin perfusion and of rheological and immunological variables to intravenous prostanoid administration in Raynaud's phenomenon secondary to collagenosis.
BACKGROUND
Prostanoids are used in the treatment of Raynaud's phenomenon and acral perfusion disorders secondary to collagenosis. In subjective terms, intravenous administration of these agents produces success in more than 50% of patients. The therapeutic outcome of clinical administration of alprostadil or iloprost may vary from individual to individual.


METHODS
The following variables were analysed in a cross-over study in 27 patients with collagenosis and Raynaud's phenomenon: plasma viscosity and erythrocyte aggregation (rheological variables), partial pressure of oxygen and laser Doppler flowmetry in the finger region, and lymphocyte phenotyping and interleukin (IL) determinations (immunological variables).


RESULTS
Laser Doppler flowmetry revealed significant differences between patients with secondary Raynaud's phenomenon and a control group of 25 healthy subjects. Laser Doppler readings did not change significantly as a result of the treatments. Therapy with iloprost produced a reduction in IL-1beta, L-selectin (CD 62 L) and IL-6.


CONCLUSIONS
The change in immunological variables due to iloprost may explain the long-term effects of prostaglandins in the treatment of Raynaud's phenomenon. From our results it is not possible to infer any preference for iloprost or alprostadil.
Drinda
S
S
Division of Rheumatology and Osteology, Department of Clinical Medicine III, Friedrich Schiller University Jena, Germany. stefan.drinda@med.uni-jena.de
Neumann
T
T
Pöhlmann
G
G
Vogelsang
H
H
Stein
G
G
Wolf
G
G
Hein
G
G
D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity / Q000187:drug effects; D003095:Collagen Diseases / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D018592:Cross-Over Studies; D016207:Cytokines / Q000276:immunology; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011453:Prostaglandins / Q000008:administration & dosage*; D011928:Raynaud Disease / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology*; D012867:Skin / Q000098:blood supply* / Q000187:drug effects* / Q000276:immunology; D016896:Treatment Outcome
D016207:Cytokines; D011453:Prostaglandins