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Acromegaly is a rare chronic disease, caused by the over-secretion of growth hormone (GH), that creates a pro-inflammatory state, but the exact mechanisms by which GH or insulin-like growth factor 1 (IGF-I) act on inflammatory cells are not fully understood. Aim of the study was to evaluate Interleukin-33 (IL33) and D-series resolvins 1 (RvD1) and the skin perfusion of hands in patients with acromegaly (AP) and healthy controls (HC). IL33 and RvD1 have been assessed in 20 AP and 20 HC. Nailfold videocapillaroscopy (NVC) was performed and skin perfusion of hands was assessed by laser speckle contrast analysis (LASCA) in both populations. IL33 was significantly higher in AP compared to HC [73.08 pg/ml (IQR 47.11–100.80 pg/ml) vs 41.5 4 pg/ml (IQR 20.16–55.49 pg/ml), p < 0.05] and RvD1 was significantly lower in AP than HC [36.1 pg/ml (IQR 27.88–66.21 pg/ml) vs 60.01 pg/ml (IQR 46.88–74.69 pg/ml), p < 0.05]. At LASCA, peripheral blood perfusion (PBP) was significantly lower in AP compared to HC [56.66 pU (IQR 46.29–65.44 pU) vs 87 pU (IQR 80–98 pU), p < 0.001]. The median values of ROI1 and ROI3 were significantly lower in AP compared to HC [112.81 pU (IQR 83.36–121.69 pU) vs 131 pU (IQR 108–135 pU), p < 0.05] and [59.78 pU (IQR 46.84–79.75 pU) vs 85 pU (IQR 78–98 pU), p < 0.05], respectively. The proximal-distal gradient (PDG) was observed in 8 of 20 (40 %) AP. Serum IL33 is higher in AP compared to HC; conversely, RvD1 is lower in AP compared to HC. Reduction of PBP of hands was present in AP compared to HC, probably due to endothelial dysfunction. • Acromegalic patients had higher serum level of IL33 than HC. • Acromegalic patients had lower serum level of RvD1 than HC. • Reduction of PBP of hands was present in AP compared to HC, probably due to endothelial dysfunction. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the role of Color Doppler Ultrasonography (CDUS) of proper palmar digital arteries (PPDA) as predictive marker of new digital ulcers (DUs) in systemic sclerosis (SSc) patients during 5 years follow-up. 36 SSc patients were examined using nailfold videocapillaroscopy (NVC) and CDUS of PPDA. Fourteen (38.9%) patients had chronic or acute occlusions (C and D pattern) on CDUS evaluation. Using a cut-off of 0.70, 21 (58.3%) patients had a Resistive Index (RI) ≥0.70. Nineteen (52.8%) patients developed new DUs during the follow-up. The median value of RI was higher in SSc patients with DUs than in SSc patients without DUs [0.73 (IQR 0.70–0.81) vs 0.67 (IQR 0.57–0.70), p < 0.0001]. The Kaplan-Meier analysis showed a free survival from new DUs higher (p < 0.01) in SSc patients with Pattern A and B than SSc patients with Pattern C and D. The Kaplan-Meier curves showed that free survival from new DUs is lower (p < 0.001) in SSc patients with increased RI (≥0.70) than in SSc patients with normal RI. In multivariate analysis with two co-variates, RI ≥ 0.70 [HR 5.197 (1.471–18.359), p < 0.01] and NVC late scleroderma pattern [HR 7.087 (1.989–25.246), p < 0.01] were predictive markers of new DUs. RI of PPDA in association with NVC could be used to evaluate SSc patients with increased risk of new DUs development. • In systemic sclerosis, microvascular and macrovascular damage is present • Digital ulcers are main vascular complication of systemic sclerosis • Color Doppler Ultrasonography was used to evaluate macrovascular damage of proper palmar digital arteries • In SSc patients with new digital ulcers, morphological and functional damage of proper palmar digital arteries is present • Increased Resistive Index of proper palmar digital arteries is a predictive marker of new digital ulcers [ABSTRACT FROM AUTHOR]

To evaluate expansion of CD21low B cells and their role in B cell homeostasis, apoptosis, clinical manifestations and serum vascular endothelial growth factor (VEGF) in systemic sclerosis (SSc). B-cells subpopulations and apoptosis have been assessed in 74 SSc patients and 20 healthy donors. Renal Doppler ultrasound, echocardiography, pulmonary function test and VEGF were performed. SSc patients with expanded CD21low B cells (SSc-CD21low) show a distinct B cell profile with increased memory B cells compared to patients without CD21low B cells (SSc-CD21+). Renal resistive index, systolic pulmonary arterial pressure and FVC/DLCO ratio were significantly higher in SSc-CD21low group than SSc-CD21+, DLCO was lower in SSc-CD21low group than SSc-CD21+. We found a positive linear correlation between CD21low and sPAP, RI and FVC/DLCO ratio whereas a negative correlation was observed between CD21low and DLCO and VEGF levels. CD21low B cells are increased in SSc patients with visceral vascular manifestations. • CD21low percentage of B cells are higher in SSc patients than healthy donor. • CD21low percentage is higher in SSc patients with visceral vascular damage. • VEGF increases in SSc patients with low CD21low percentage. • CD21low percentage is a marker of impaired angiogenesis and vascular damage. [ABSTRACT FROM AUTHOR]