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Published in: Autoimmunity Highlights 1/2016

Open Access 01-12-2016 | Original Article

Nailfold videocapillaroscopy and serum VEGF levels in scleroderma are associated with internal organ involvement

Authors: Maria De Santis, Angela Ceribelli, Francesca Cavaciocchi, Chiara Crotti, Marco Massarotti, Laura Belloli, Bianca Marasini, Natasa Isailovic, Elena Generali, Carlo Selmi

Published in: Autoimmunity Highlights | Issue 1/2016

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Abstract

Purpose

Nailfold videocapillaroscopy (NVC) identifies the microvascular hallmarks of systemic sclerosis (SSc) and vascular endothelial growth factor (VEGF) and may play a pivotal role in the associated vasculopathy. The aim of the present study was to compare NVC alterations with clinical subsets, internal organ involvement, and serum VEGF levels in a cohort of selected SSc cases.

Methods

We studied 44 patients with SSc who were evaluated within 3 months from enrollment by NVC, skin score, severity index, pulmonary function tests, carbon monoxide diffusing capacity (DLCO), echocardiography, pulmonary high-resolution computed tomography (HRCT), gastroesophageal (GE) endoscopy or manometry or X-ray, and serum autoantibodies. Serum VEGF-A levels were determined by ELISA in 72 SSc patients and 31 healthy controls.

Results

Giant capillaries were inversely correlated with age (p = 0.034, r = −0.34) and to the extent of reticular pattern at HRCT (p = 0.04, r = −0.5). Avascular areas were directly correlated with capillaroscopy skin ulcer risk index (CSURI) (p = 0.006, r = +0.4) and severity index (p = 0.004, r = +0.5). The mean capillary density was directly correlated to the ulcer number (p = 0.02, r = +0.4) and to DLCO/alveolar volume (p = 0.02, r = +0.4) and inversely correlated with severity index (p = 0.01, r = −0.4) and skin score (p = 0.02, r = −0.4). Serum VEGF levels were higher in the SSc population vs controls (p = 0.03) and inversely correlated with DLCO (p = 0.01, r =−0.4) and directly with ground-glass and reticular pattern at HRCT (p = 0.04, r = +0.4 for both).

Conclusions

Our data suggest the importance of NVC not only for the diagnosis, but also for the global evaluation of SSc patients. Of note, serum VEGF levels may act as a biomarker of interstitial lung involvement.
Literature
1.
go back to reference De Santis M, Selmi C (2015) The autoinflammatory side of systemic sclerosis. Isr Med Assoc J 17(1):47–49PubMed De Santis M, Selmi C (2015) The autoinflammatory side of systemic sclerosis. Isr Med Assoc J 17(1):47–49PubMed
6.
go back to reference Selmi C, Ceribelli A, Generali E, Scire CA, Alborghetti F, Colloredo G, Porrati L, Achenza MI, De Santis M, Cavaciocchi F, Massarotti M, Isailovic N, Paleari V, Invernizzi P, Matthias T, Zucchi A, Meroni PL (2016) Serum antinuclear and extractable nuclear antigen antibody prevalence and associated morbidity and mortality in the general population over 15 years. Autoimmun Rev 15(2):162–166. doi:10.1016/j.autrev.2015.10.007 CrossRefPubMed Selmi C, Ceribelli A, Generali E, Scire CA, Alborghetti F, Colloredo G, Porrati L, Achenza MI, De Santis M, Cavaciocchi F, Massarotti M, Isailovic N, Paleari V, Invernizzi P, Matthias T, Zucchi A, Meroni PL (2016) Serum antinuclear and extractable nuclear antigen antibody prevalence and associated morbidity and mortality in the general population over 15 years. Autoimmun Rev 15(2):162–166. doi:10.​1016/​j.​autrev.​2015.​10.​007 CrossRefPubMed
7.
go back to reference van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, Matucci-Cerinic M, Naden RP, Medsger TA Jr, Carreira PE, Riemekasten G, Clements PJ, Denton CP, Distler O, Allanore Y, Furst DE, Gabrielli A, Mayes MD, van Laar JM, Seibold JR, Czirjak L, Steen VD, Inanc M, Kowal-Bielecka O, Muller-Ladner U, Valentini G, Veale DJ, Vonk MC, Walker UA, Chung L, Collier DH, Csuka ME, Fessler BJ, Guiducci S, Herrick A, Hsu VM, Jimenez S, Kahaleh B, Merkel PA, Sierakowski S, Silver RM, Simms RW, Varga J, Pope JE (2013) 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 65(11):2737–2747. doi:10.1002/art.38098 CrossRefPubMedPubMedCentral van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, Matucci-Cerinic M, Naden RP, Medsger TA Jr, Carreira PE, Riemekasten G, Clements PJ, Denton CP, Distler O, Allanore Y, Furst DE, Gabrielli A, Mayes MD, van Laar JM, Seibold JR, Czirjak L, Steen VD, Inanc M, Kowal-Bielecka O, Muller-Ladner U, Valentini G, Veale DJ, Vonk MC, Walker UA, Chung L, Collier DH, Csuka ME, Fessler BJ, Guiducci S, Herrick A, Hsu VM, Jimenez S, Kahaleh B, Merkel PA, Sierakowski S, Silver RM, Simms RW, Varga J, Pope JE (2013) 2013 classification criteria for systemic sclerosis: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum 65(11):2737–2747. doi:10.​1002/​art.​38098 CrossRefPubMedPubMedCentral
8.
go back to reference Cutolo M, Pizzorni C, Tuccio M, Burroni A, Craviotto C, Basso M, Seriolo B, Sulli A (2004) Nailfold videocapillaroscopic patterns and serum autoantibodies in systemic sclerosis. Rheumatology (Oxford) 43(6):719–726. doi:10.1093/rheumatology/keh156 CrossRef Cutolo M, Pizzorni C, Tuccio M, Burroni A, Craviotto C, Basso M, Seriolo B, Sulli A (2004) Nailfold videocapillaroscopic patterns and serum autoantibodies in systemic sclerosis. Rheumatology (Oxford) 43(6):719–726. doi:10.​1093/​rheumatology/​keh156 CrossRef
9.
go back to reference Sebastiani M, Manfredi A, Colaci M, D’Amico R, Malagoli V, Giuggioli D, Ferri C (2009) Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. Arthritis Rheum 61(5):688–694. doi:10.1002/art.24394 CrossRefPubMed Sebastiani M, Manfredi A, Colaci M, D’Amico R, Malagoli V, Giuggioli D, Ferri C (2009) Capillaroscopic skin ulcer risk index: a new prognostic tool for digital skin ulcer development in systemic sclerosis patients. Arthritis Rheum 61(5):688–694. doi:10.​1002/​art.​24394 CrossRefPubMed
10.
go back to reference Maurer B, Distler A, Suliman YA, Gay RE, Michel BA, Gay S, Distler JH, Distler O (2014) Vascular endothelial growth factor aggravates fibrosis and vasculopathy in experimental models of systemic sclerosis. Ann Rheum Dis 73(10):1880–1887. doi:10.1136/annrheumdis-2013-203535 CrossRefPubMed Maurer B, Distler A, Suliman YA, Gay RE, Michel BA, Gay S, Distler JH, Distler O (2014) Vascular endothelial growth factor aggravates fibrosis and vasculopathy in experimental models of systemic sclerosis. Ann Rheum Dis 73(10):1880–1887. doi:10.​1136/​annrheumdis-2013-203535 CrossRefPubMed
11.
go back to reference Manetti M, Guiducci S, Romano E, Ceccarelli C, Bellando-Randone S, Conforti ML, Ibba-Manneschi L, Matucci-Cerinic M (2011) Overexpression of VEGF165b, an inhibitory splice variant of vascular endothelial growth factor, leads to insufficient angiogenesis in patients with systemic sclerosis. Circ Res 109(3):e14–e26. doi:10.1161/CIRCRESAHA.111.242057 CrossRefPubMed Manetti M, Guiducci S, Romano E, Ceccarelli C, Bellando-Randone S, Conforti ML, Ibba-Manneschi L, Matucci-Cerinic M (2011) Overexpression of VEGF165b, an inhibitory splice variant of vascular endothelial growth factor, leads to insufficient angiogenesis in patients with systemic sclerosis. Circ Res 109(3):e14–e26. doi:10.​1161/​CIRCRESAHA.​111.​242057 CrossRefPubMed
12.
go back to reference Bielecki M, Kowal K, Lapinska A, Chwiesko-Minarowska S, Chyczewski L, Kowal-Bielecka O (2011) Peripheral blood mononuclear cells from patients with systemic sclerosis spontaneously secrete increased amounts of vascular endothelial growth factor (VEGF) already in the early stage of the disease. Adv Med Sci 56(2):255–263. doi:10.2478/v10039-011-0025-z CrossRefPubMed Bielecki M, Kowal K, Lapinska A, Chwiesko-Minarowska S, Chyczewski L, Kowal-Bielecka O (2011) Peripheral blood mononuclear cells from patients with systemic sclerosis spontaneously secrete increased amounts of vascular endothelial growth factor (VEGF) already in the early stage of the disease. Adv Med Sci 56(2):255–263. doi:10.​2478/​v10039-011-0025-z CrossRefPubMed
13.
go back to reference Kajihara I, Jinnin M, Honda N, Makino K, Makino T, Masuguchi S, Sakai K, Fukushima S, Inoue Y, Ihn H (2013) Scleroderma dermal fibroblasts overexpress vascular endothelial growth factor due to autocrine transforming growth factor beta signaling. Mod Rheumatol 23(3):516–524. doi:10.1007/s10165-012-0698-6 CrossRefPubMed Kajihara I, Jinnin M, Honda N, Makino K, Makino T, Masuguchi S, Sakai K, Fukushima S, Inoue Y, Ihn H (2013) Scleroderma dermal fibroblasts overexpress vascular endothelial growth factor due to autocrine transforming growth factor beta signaling. Mod Rheumatol 23(3):516–524. doi:10.​1007/​s10165-012-0698-6 CrossRefPubMed
14.
go back to reference Solanilla A, Villeneuve J, Auguste P, Hugues M, Alioum A, Lepreux S, Ducroix JP, Duhaut P, Conri C, Viallard JF, Nurden AT, Constans J, Ripoche J (2009) The transport of high amounts of vascular endothelial growth factor by blood platelets underlines their potential contribution in systemic sclerosis angiogenesis. Rheumatology (Oxford) 48(9):1036–1044. doi:10.1093/rheumatology/kep154 CrossRef Solanilla A, Villeneuve J, Auguste P, Hugues M, Alioum A, Lepreux S, Ducroix JP, Duhaut P, Conri C, Viallard JF, Nurden AT, Constans J, Ripoche J (2009) The transport of high amounts of vascular endothelial growth factor by blood platelets underlines their potential contribution in systemic sclerosis angiogenesis. Rheumatology (Oxford) 48(9):1036–1044. doi:10.​1093/​rheumatology/​kep154 CrossRef
15.
go back to reference Alivernini S, De Santis M, Tolusso B, Mannocci A, Bosello SL, Peluso G, Pinnelli M, D’Antona G, La Torre G, Ferraccioli G (2009) Skin ulcers in systemic sclerosis: determinants of presence and predictive factors of healing. J Am Acad Dermatol 60(3):426–435. doi:10.1016/j.jaad.2008.11.025 CrossRefPubMed Alivernini S, De Santis M, Tolusso B, Mannocci A, Bosello SL, Peluso G, Pinnelli M, D’Antona G, La Torre G, Ferraccioli G (2009) Skin ulcers in systemic sclerosis: determinants of presence and predictive factors of healing. J Am Acad Dermatol 60(3):426–435. doi:10.​1016/​j.​jaad.​2008.​11.​025 CrossRefPubMed
16.
go back to reference Valentini G, Medsger TA Jr, Silman AJ, Bombardieri S (2003) Conclusion and identification of the core set of variables to be used in clinical investigations. Clin Exp Rheumatol 21(3 Suppl 29):S47–S48PubMed Valentini G, Medsger TA Jr, Silman AJ, Bombardieri S (2003) Conclusion and identification of the core set of variables to be used in clinical investigations. Clin Exp Rheumatol 21(3 Suppl 29):S47–S48PubMed
17.
go back to reference De Santis M, Bosello S, La Torre G, Capuano A, Tolusso B, Pagliari G, Pistelli R, Danza FM, Zoli A, Ferraccioli G (2005) Functional, radiological and biological markers of alveolitis and infections of the lower respiratory tract in patients with systemic sclerosis. Respir Res 6:96. doi:10.1186/1465-9921-6-96 CrossRefPubMedPubMedCentral De Santis M, Bosello S, La Torre G, Capuano A, Tolusso B, Pagliari G, Pistelli R, Danza FM, Zoli A, Ferraccioli G (2005) Functional, radiological and biological markers of alveolitis and infections of the lower respiratory tract in patients with systemic sclerosis. Respir Res 6:96. doi:10.​1186/​1465-9921-6-96 CrossRefPubMedPubMedCentral
18.
go back to reference De Santis M, Inzitari R, Bosello SL, Peluso G, Fanali C, Iavarone F, Zizzo G, Bocci M, Cabras T, Messana I, Fuso L, Varone F, Pagliari G, Castagnola M, Ferraccioli G (2011) Beta-thymosins and interstitial lung disease: study of a scleroderma cohort with a 1-year follow-up. Respir Res 12:22. doi:10.1186/1465-9921-12-22 CrossRefPubMedPubMedCentral De Santis M, Inzitari R, Bosello SL, Peluso G, Fanali C, Iavarone F, Zizzo G, Bocci M, Cabras T, Messana I, Fuso L, Varone F, Pagliari G, Castagnola M, Ferraccioli G (2011) Beta-thymosins and interstitial lung disease: study of a scleroderma cohort with a 1-year follow-up. Respir Res 12:22. doi:10.​1186/​1465-9921-12-22 CrossRefPubMedPubMedCentral
19.
go back to reference De Santis M, Bosello SL, Peluso G, Pinnelli M, Alivernini S, Zizzo G, Bocci M, Capacci A, La Torre G, Mannocci A, Pagliari G, Varone F, Pistelli R, Danza FM, Ferraccioli G (2012) Bronchoalveolar lavage fluid and progression of scleroderma interstitial lung disease. Clin Respir J 6(1):9–17. doi:10.1111/j.1752-699X.2010.00228.x CrossRefPubMed De Santis M, Bosello SL, Peluso G, Pinnelli M, Alivernini S, Zizzo G, Bocci M, Capacci A, La Torre G, Mannocci A, Pagliari G, Varone F, Pistelli R, Danza FM, Ferraccioli G (2012) Bronchoalveolar lavage fluid and progression of scleroderma interstitial lung disease. Clin Respir J 6(1):9–17. doi:10.​1111/​j.​1752-699X.​2010.​00228.​x CrossRefPubMed
20.
go back to reference Yamasaki Y, Narain S, Hernandez L, Barker T, Ikeda K, Segal MS, Richards HB, Chan EK, Reeves WH, Satoh M (2006) Autoantibodies against the replication protein A complex in systemic lupus erythematosus and other autoimmune diseases. Arthritis Res Ther 8(4):R111. doi:10.1186/ar2000 CrossRefPubMedPubMedCentral Yamasaki Y, Narain S, Hernandez L, Barker T, Ikeda K, Segal MS, Richards HB, Chan EK, Reeves WH, Satoh M (2006) Autoantibodies against the replication protein A complex in systemic lupus erythematosus and other autoimmune diseases. Arthritis Res Ther 8(4):R111. doi:10.​1186/​ar2000 CrossRefPubMedPubMedCentral
21.
go back to reference Ceribelli A, Cavazzana I, Franceschini F, Airo P, Tincani A, Cattaneo R, Pauley BA, Chan EK, Satoh M (2010) Anti-Th/To are common antinucleolar autoantibodies in Italian patients with scleroderma. J Rheumatol 37(10):2071–2075. doi:10.3899/jrheum.100316 CrossRefPubMed Ceribelli A, Cavazzana I, Franceschini F, Airo P, Tincani A, Cattaneo R, Pauley BA, Chan EK, Satoh M (2010) Anti-Th/To are common antinucleolar autoantibodies in Italian patients with scleroderma. J Rheumatol 37(10):2071–2075. doi:10.​3899/​jrheum.​100316 CrossRefPubMed
22.
23.
go back to reference Cavagna L, Nuno L, Scire CA, Govoni M, Longo FJ, Franceschini F, Neri R, Castaneda S, Sifuentes Giraldo WA, Caporali R, Iannone F, Fusaro E, Paolazzi G, Pellerito R, Schwarting A, Saketkoo LA, Ortego-Centeno N, Quartuccio L, Bartoloni E, Specker C, Pina Murcia T, La Corte R, Furini F, Foschi V, Bachiller Corral J, Airo P, Cavazzana I, Martinez-Barrio J, Hinojosa M, Giannini M, Barsotti S, Menke J, Triantafyllias K, Vitetta R, Russo A, Bogliolo L, Bajocchi G, Bravi E, Barausse G, Bortolotti R, Selmi C, Parisi S, Salaffi F, Montecucco C, Gonzalez-Gay MA, Group AC (2016) Serum Jo-1 autoantibody and isolated arthritis in the antisynthetase syndrome: review of the literature and report of the experience of AENEAS Collaborative Group. Clin Rev Allergy Immunol. doi:10.1007/s12016-016-8528-9 PubMed Cavagna L, Nuno L, Scire CA, Govoni M, Longo FJ, Franceschini F, Neri R, Castaneda S, Sifuentes Giraldo WA, Caporali R, Iannone F, Fusaro E, Paolazzi G, Pellerito R, Schwarting A, Saketkoo LA, Ortego-Centeno N, Quartuccio L, Bartoloni E, Specker C, Pina Murcia T, La Corte R, Furini F, Foschi V, Bachiller Corral J, Airo P, Cavazzana I, Martinez-Barrio J, Hinojosa M, Giannini M, Barsotti S, Menke J, Triantafyllias K, Vitetta R, Russo A, Bogliolo L, Bajocchi G, Bravi E, Barausse G, Bortolotti R, Selmi C, Parisi S, Salaffi F, Montecucco C, Gonzalez-Gay MA, Group AC (2016) Serum Jo-1 autoantibody and isolated arthritis in the antisynthetase syndrome: review of the literature and report of the experience of AENEAS Collaborative Group. Clin Rev Allergy Immunol. doi:10.​1007/​s12016-016-8528-9 PubMed
24.
go back to reference Cavagna L, Nuno L, Scire CA, Govoni M, Longo FJ, Franceschini F, Neri R, Castaneda S, Giraldo WA, Caporali R, Iannone F, Fusaro E, Paolazzi G, Pellerito R, Schwarting A, Saketkoo LA, Ortego-Centeno N, Quartuccio L, Bartoloni E, Specker C, Murcia TP, La Corte R, Furini F, Foschi V, Corral JB, Airo P, Cavazzana I, Martinez-Barrio J, Hinojosa M, Giannini M, Barsotti S, Menke J, Triantafyllias K, Vitetta R, Russo A, Bajocchi G, Bravi E, Barausse G, Bortolotti R, Selmi C, Parisi S, Montecucco C, Gonzalez-Gay MA, group Ac (2015) Clinical spectrum time course in anti Jo-1 positive antisynthetase syndrome: results from an International Retrospective Multicenter Study. Medicine (Baltimore) 94(32):e1144. doi:10.1097/MD.0000000000001144 CrossRef Cavagna L, Nuno L, Scire CA, Govoni M, Longo FJ, Franceschini F, Neri R, Castaneda S, Giraldo WA, Caporali R, Iannone F, Fusaro E, Paolazzi G, Pellerito R, Schwarting A, Saketkoo LA, Ortego-Centeno N, Quartuccio L, Bartoloni E, Specker C, Murcia TP, La Corte R, Furini F, Foschi V, Corral JB, Airo P, Cavazzana I, Martinez-Barrio J, Hinojosa M, Giannini M, Barsotti S, Menke J, Triantafyllias K, Vitetta R, Russo A, Bajocchi G, Bravi E, Barausse G, Bortolotti R, Selmi C, Parisi S, Montecucco C, Gonzalez-Gay MA, group Ac (2015) Clinical spectrum time course in anti Jo-1 positive antisynthetase syndrome: results from an International Retrospective Multicenter Study. Medicine (Baltimore) 94(32):e1144. doi:10.​1097/​MD.​0000000000001144​ CrossRef
25.
go back to reference Karvinen H, Pasanen E, Rissanen TT, Korpisalo P, Vahakangas E, Jazwa A, Giacca M, Yla-Herttuala S (2011) Long-term VEGF-A expression promotes aberrant angiogenesis and fibrosis in skeletal muscle. Gene Ther 18(12):1166–1172. doi:10.1038/gt.2011.66 CrossRefPubMed Karvinen H, Pasanen E, Rissanen TT, Korpisalo P, Vahakangas E, Jazwa A, Giacca M, Yla-Herttuala S (2011) Long-term VEGF-A expression promotes aberrant angiogenesis and fibrosis in skeletal muscle. Gene Ther 18(12):1166–1172. doi:10.​1038/​gt.​2011.​66 CrossRefPubMed
26.
go back to reference Distler O, Del Rosso A, Giacomelli R, Cipriani P, Conforti ML, Guiducci S, Gay RE, Michel BA, Bruhlmann P, Muller-Ladner U, Gay S, Matucci-Cerinic M (2002) Angiogenic and angiostatic factors in systemic sclerosis: increased levels of vascular endothelial growth factor are a feature of the earliest disease stages and are associated with the absence of fingertip ulcers. Arthritis Res 4(6):R11CrossRefPubMedPubMedCentral Distler O, Del Rosso A, Giacomelli R, Cipriani P, Conforti ML, Guiducci S, Gay RE, Michel BA, Bruhlmann P, Muller-Ladner U, Gay S, Matucci-Cerinic M (2002) Angiogenic and angiostatic factors in systemic sclerosis: increased levels of vascular endothelial growth factor are a feature of the earliest disease stages and are associated with the absence of fingertip ulcers. Arthritis Res 4(6):R11CrossRefPubMedPubMedCentral
28.
go back to reference Bosello S, De Santis M, Lama G, Spano C, Angelucci C, Tolusso B, Sica G, Ferraccioli G (2010) B cell depletion in diffuse progressive systemic sclerosis: safety, skin score modification and IL-6 modulation in an up to thirty-6 months follow-up open-label trial. Arthritis Res Ther 12(2):R54. doi:10.1186/ar2965 CrossRefPubMedPubMedCentral Bosello S, De Santis M, Lama G, Spano C, Angelucci C, Tolusso B, Sica G, Ferraccioli G (2010) B cell depletion in diffuse progressive systemic sclerosis: safety, skin score modification and IL-6 modulation in an up to thirty-6 months follow-up open-label trial. Arthritis Res Ther 12(2):R54. doi:10.​1186/​ar2965 CrossRefPubMedPubMedCentral
29.
go back to reference De Santis M, Bosello SL, Capoluongo E, Inzitari R, Peluso G, Lulli P, Zizzo G, Bocci M, Tolusso B, Zuppi C, Castagnola M, Ferraccioli G (2012) A vascular endothelial growth factor deficiency characterises scleroderma lung disease. Ann Rheum Dis 71(9):1461–1465. doi:10.1136/annrheumdis-2011-200657 CrossRefPubMed De Santis M, Bosello SL, Capoluongo E, Inzitari R, Peluso G, Lulli P, Zizzo G, Bocci M, Tolusso B, Zuppi C, Castagnola M, Ferraccioli G (2012) A vascular endothelial growth factor deficiency characterises scleroderma lung disease. Ann Rheum Dis 71(9):1461–1465. doi:10.​1136/​annrheumdis-2011-200657 CrossRefPubMed
30.
go back to reference Kaner RJ, Crystal RG (2001) Compartmentalization of vascular endothelial growth factor to the epithelial surface of the human lung. Mol Med 7(4):240–246PubMedPubMedCentral Kaner RJ, Crystal RG (2001) Compartmentalization of vascular endothelial growth factor to the epithelial surface of the human lung. Mol Med 7(4):240–246PubMedPubMedCentral
31.
32.
go back to reference De Franceschi L, Bosello S, Scambi C, Biasi D, De Santis M, Caramaschi P, Peluso G, La Verde V, Bambara LM, Ferraccioli G (2011) Proteome analysis of biological fluids from autoimmune-rheumatological disorders. Proteom Clin Appl 5(1–2):78–89. doi:10.1002/prca.201000069 CrossRef De Franceschi L, Bosello S, Scambi C, Biasi D, De Santis M, Caramaschi P, Peluso G, La Verde V, Bambara LM, Ferraccioli G (2011) Proteome analysis of biological fluids from autoimmune-rheumatological disorders. Proteom Clin Appl 5(1–2):78–89. doi:10.​1002/​prca.​201000069 CrossRef
Metadata
Title
Nailfold videocapillaroscopy and serum VEGF levels in scleroderma are associated with internal organ involvement
Authors
Maria De Santis
Angela Ceribelli
Francesca Cavaciocchi
Chiara Crotti
Marco Massarotti
Laura Belloli
Bianca Marasini
Natasa Isailovic
Elena Generali
Carlo Selmi
Publication date
01-12-2016
Publisher
Springer International Publishing
Published in
Autoimmunity Highlights / Issue 1/2016
Print ISSN: 2038-0305
Electronic ISSN: 2038-3274
DOI
https://doi.org/10.1007/s13317-016-0077-y

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