Autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis-related microvasculopathy

Objective: Autologous hematopoietic stem cell transplantation (AHSCT) is a therapeutic option for patients with severe and progressive systemic sclerosis (SSc). Here, we aimed to investigate how AHSCT affects the vasculopathy of SSc patients. Methods: Twenty-seven SSc patients were retrospectively a...

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Main Authors: Maynara Santana-Gonçalves, Djúlio Zanin-Silva, Álvaro Henrique-Neto, Daniela A. Moraes, Marianna Y. Kawashima- Vasconcelos, João R. Lima-Júnior, Juliana B. E. Dias, Vinícius Bragagnollo, Júlia T. C. de Azevedo, Dimas T. Covas, Kelen C. R. Malmegrim, Leandra Ramalho, Maria Carolina Oliveira
Format: Article
Language:English
Published: SAGE Publishing 2022-03-01
Series:Therapeutic Advances in Musculoskeletal Disease
Online Access:https://doi.org/10.1177/1759720X221084845
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author Maynara Santana-Gonçalves
Djúlio Zanin-Silva
Álvaro Henrique-Neto
Daniela A. Moraes
Marianna Y. Kawashima- Vasconcelos
João R. Lima-Júnior
Juliana B. E. Dias
Vinícius Bragagnollo
Júlia T. C. de Azevedo
Dimas T. Covas
Kelen C. R. Malmegrim
Leandra Ramalho
Maria Carolina Oliveira
author_facet Maynara Santana-Gonçalves
Djúlio Zanin-Silva
Álvaro Henrique-Neto
Daniela A. Moraes
Marianna Y. Kawashima- Vasconcelos
João R. Lima-Júnior
Juliana B. E. Dias
Vinícius Bragagnollo
Júlia T. C. de Azevedo
Dimas T. Covas
Kelen C. R. Malmegrim
Leandra Ramalho
Maria Carolina Oliveira
author_sort Maynara Santana-Gonçalves
collection DOAJ
description Objective: Autologous hematopoietic stem cell transplantation (AHSCT) is a therapeutic option for patients with severe and progressive systemic sclerosis (SSc). Here, we aimed to investigate how AHSCT affects the vasculopathy of SSc patients. Methods: Twenty-seven SSc patients were retrospectively assessed, before and after AHSCT, for vessel morphology (nailfold capillaroscopy), skin expression of endothelial markers and serum levels of markers of inflammation, angiogenesis and endothelial activation. Skin biopsies were analyzed by immunohistochemistry (IHC) for expression of CD31, VE-cadherin, E-selectin, angiopoietin-1 (Ang1), angiopoietin-2 (Ang2), Tie-2, vascular endothelial growth factor A (VEGFA), vascular endothelial growth factor receptor 2 (VEGFR2), and endothelin-1 before and 12 months post-AHSCT. Serum samples from SSc patients were assessed before and up to 36 months after AHSCT for IL-6, von Willebrand factor (vWF), CXC Motif Chemokine Ligand 8 (CXCL8), Endothelin-1, epidermal growth factor (EGF), VEGFA, Pentraxin-3, Intercellular Adhesion Molecule 1 (ICAM-1), E-selectin, P-selectin, Thrombomodulin and IL-18 levels, and compared to healthy control samples. Results: On nailfold capillaroscopy, the number of capillaries increased at 1 year, while giant capillaries decreased at 6 months and 1 year after AHSCT. In the skin biopsies, expression of E-selectin notably decreased and Ang1 increased after AHSCT. At baseline, all vascular markers evaluated in the serum were significantly higher in SSc patients when compared to healthy controls, except for ICAM-1. When compared at different time points after AHSCT, Thrombomodulin, Pentraxin-3, vWF, and IL-18 levels remained generally stable at high levels until 36 months after AHSCT. Conclusion: Our results suggest that AHSCT contributes to improvements of the vessel morphology and dermal microvasculopathy, but does not normalize elevated levels of serum vascular markers in SSc patients. Additional vascular therapeutic approaches might contribute to more effectively treat the endothelial injury.
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spelling doaj.art-fe689f9799d147c78acb120702099a532022-12-22T02:50:21ZengSAGE PublishingTherapeutic Advances in Musculoskeletal Disease1759-72182022-03-011410.1177/1759720X221084845Autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis-related microvasculopathyMaynara Santana-GonçalvesDjúlio Zanin-SilvaÁlvaro Henrique-NetoDaniela A. MoraesMarianna Y. Kawashima- VasconcelosJoão R. Lima-JúniorJuliana B. E. DiasVinícius BragagnolloJúlia T. C. de AzevedoDimas T. CovasKelen C. R. MalmegrimLeandra RamalhoMaria Carolina OliveiraObjective: Autologous hematopoietic stem cell transplantation (AHSCT) is a therapeutic option for patients with severe and progressive systemic sclerosis (SSc). Here, we aimed to investigate how AHSCT affects the vasculopathy of SSc patients. Methods: Twenty-seven SSc patients were retrospectively assessed, before and after AHSCT, for vessel morphology (nailfold capillaroscopy), skin expression of endothelial markers and serum levels of markers of inflammation, angiogenesis and endothelial activation. Skin biopsies were analyzed by immunohistochemistry (IHC) for expression of CD31, VE-cadherin, E-selectin, angiopoietin-1 (Ang1), angiopoietin-2 (Ang2), Tie-2, vascular endothelial growth factor A (VEGFA), vascular endothelial growth factor receptor 2 (VEGFR2), and endothelin-1 before and 12 months post-AHSCT. Serum samples from SSc patients were assessed before and up to 36 months after AHSCT for IL-6, von Willebrand factor (vWF), CXC Motif Chemokine Ligand 8 (CXCL8), Endothelin-1, epidermal growth factor (EGF), VEGFA, Pentraxin-3, Intercellular Adhesion Molecule 1 (ICAM-1), E-selectin, P-selectin, Thrombomodulin and IL-18 levels, and compared to healthy control samples. Results: On nailfold capillaroscopy, the number of capillaries increased at 1 year, while giant capillaries decreased at 6 months and 1 year after AHSCT. In the skin biopsies, expression of E-selectin notably decreased and Ang1 increased after AHSCT. At baseline, all vascular markers evaluated in the serum were significantly higher in SSc patients when compared to healthy controls, except for ICAM-1. When compared at different time points after AHSCT, Thrombomodulin, Pentraxin-3, vWF, and IL-18 levels remained generally stable at high levels until 36 months after AHSCT. Conclusion: Our results suggest that AHSCT contributes to improvements of the vessel morphology and dermal microvasculopathy, but does not normalize elevated levels of serum vascular markers in SSc patients. Additional vascular therapeutic approaches might contribute to more effectively treat the endothelial injury.https://doi.org/10.1177/1759720X221084845
spellingShingle Maynara Santana-Gonçalves
Djúlio Zanin-Silva
Álvaro Henrique-Neto
Daniela A. Moraes
Marianna Y. Kawashima- Vasconcelos
João R. Lima-Júnior
Juliana B. E. Dias
Vinícius Bragagnollo
Júlia T. C. de Azevedo
Dimas T. Covas
Kelen C. R. Malmegrim
Leandra Ramalho
Maria Carolina Oliveira
Autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis-related microvasculopathy
Therapeutic Advances in Musculoskeletal Disease
title Autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis-related microvasculopathy
title_full Autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis-related microvasculopathy
title_fullStr Autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis-related microvasculopathy
title_full_unstemmed Autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis-related microvasculopathy
title_short Autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis-related microvasculopathy
title_sort autologous hematopoietic stem cell transplantation modifies specific aspects of systemic sclerosis related microvasculopathy
url https://doi.org/10.1177/1759720X221084845
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