Reviews
Implications of endothelial shear stress on systemic sclerosis vasculopathy and treatment
T.M. Frech1, D.R. Machin2, M.A. Murtaugh3, G.J. Stoddard4, S.I. Bloom5, J.V. Phibbs6, A.J. Donato7
- University of Utah, Department of Internal Medicine; University of Utah Hospitals and Clinics; and VAMC Salt Lake City, GRECC, Salt Lake City, UT, USA. tracy.frech@hsc.utah.edu
- University of Utah, Department of Internal Medicine, Salt Lake City, UT, USA.
- University of Utah, Department of Internal Medicine, Salt Lake City, UT, USA.
- University of Utah, Department of Internal Medicine, Salt Lake City, UT, USA.
- University of Utah, Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA.
- University of Utah Hospitals and Clinics, Salt Lake City, UT, USA.
- University of Utah, Department of Internal Medicine; University of Utah, Department of Exercise and Sport Science; University of Utah, Dept. of Nutrition and Integrative Physiology, University of Utah; and VAMC Salt Lake City, GRECC, Salt Lake City, USA.
CER11407
2018 Vol.36, N°4 ,Suppl.113
PI 0175, PF 0182
Reviews
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PMID: 30277867 [PubMed]
Received: 17/05/2018
Accepted : 30/07/2018
In Press: 20/09/2018
Published: 30/09/2018
Abstract
There are no Federal Drug Administration approved drugs for the treatment of systemic sclerosis vascular digital ulcers (DU) in the United States, which are thought to be an end-stage result of prolonged ischaemia due to severe, prolonged Raynaud’s phenomenon. Most therapeutics for vasodilation used in SSc work different pathways to target the smooth muscle to induce vessel relaxation. Longitudinal studies of vascular function allow insight into the effects of medications used for Raynaud’s phenomenon in the SSc patient population. In this review, we discuss vascular tone, the function of the endothelium in SSc, and provide the rationale for longitudinal studies of vascular function and therapeutics that target the endothelial shear stress in addition to vasodilation for treatment and prevention of DU. This review provides the rationale for vasodilatory medication use for treatment of SSc-related DU and justifies access to non-FDA approved medications for this indication.
