title: Lymphatic and blood vessels in scleroderma skin, a morphometric analysis.
abstract: Vascular involvement is frequent in systemic sclerosis, but the role of the lymphatic vasculature is poorly known. Our aim was to evaluate lymphatic vessels in systemic sclerosis skin lesions. We studied skin forearm biopsies of 9 patients with systemic sclerosis and 7 age-matched controls. Lymphatic vessels were labeled with the monoclonal antibody D2-40 and blood vessels with a polyclonal antibody to von Willebrand Factor. All blood and lymphatic vessels present in each section were counted and total area, inner luminal area, and shape factors were measured. The number of blood and lymphatic vessels in papillary dermis was greater and their diameter lower than in reticular dermis both in systemic sclerosis and controls. In the reticular dermis, the number of lymphatic vessels was markedly reduced in systemic sclerosis (4.9 +/- 1.1 microm(-2) versus 8.9 +/- 1.2 microm(-2)P = .03), and a similar trend was observed in papillary dermis (8.4 +/- 3.7 microm(-2) versus 8.1 +/- 5.3 microm(-2)). Interestingly, the number of periglandular lymphatics in systemic sclerosis was not different from controls. The inner luminal area (possibly indicating compensatory dilation) of lymphatic vessels, particularly the periglandular ones, was greater in systemic sclerosis than in controls. No differences were observed in the number of blood vessels, but the percentage of blood vessel profiles (without lumen) was significantly less in systemic sclerosis both in papillary and in reticular dermis. In conclusion, our data show that skin lesions in systemic sclerosis are characterized by a selective rarefaction of lymphatic vasculature that spares periglandular vessels and that might have a pathogenic role in the evolution and in the clinical manifestations of the disease.
authors.affiliation: Department of Neuroscience, Section of Molecular Medicine, University of Siena, Via Aldo Moro, 53100 Siena, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Rossi
authors.forename: Francesca
authors.initials: F
authors.lastname: Sozio
authors.forename: Piersante
authors.initials: P
authors.lastname: Sestini
authors.forename: Elisabetta A
authors.initials: EA
authors.lastname: Renzoni
authors.forename: Korsa
authors.initials: K
authors.lastname: Khan
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Denton
authors.forename: David J
authors.initials: DJ
authors.lastname: Abraham
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Weber
mesh_terms: D000328:Adult; D001808:Blood Vessels / Q000378:metabolism / Q000473:pathology*; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005542:Forearm / Q000098:blood supply / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D042601:Lymphatic Vessels / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012595:Scleroderma, Systemic / Q000378:metabolism / Q000473:pathology*; D012867:Skin / Q000098:blood supply / Q000378:metabolism / Q000473:pathology*; D042582:Vascular Endothelial Growth Factor C / Q000378:metabolism; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D042582:Vascular Endothelial Growth Factor C; D014841:von Willebrand Factor