Abstract

GARCES-ALANIS, Marco A.  and  RODRIGUEZ-OROZCO, Alain R.. Pathophysiology of digital vasculopathy in patients with systemic sclerosis. Narrative review. Rev. mex. angiol. [online]. 2024, vol.52, n.2, pp.65-72.  Epub Oct 25, 2024. ISSN 2696-130X.  https://doi.org/10.24875/rma.24000018.

This review focuses on the pathophysiology of digital vasculopathy in patients with systemic sclerosis and discusses studies published between 2017 and 2023. Several mechanisms of vascular damage that explain the pathophysiology of digital vasculopathy in patients with systemic sclerosis are discussed, such as uncontrolled activation of the immune system that does not allow control of profibrotic changes, predominance of vasoconstriction phenomena over vasodilatation phenomena, modification of vascular cytoarchitecture, ineffective angiogenesis, decrease in the number of endothelial cell progenitors, release of inhibitory molecules of the neurovascular relationship, increase of adhesion molecules that promote fibrosis and the appearance of digital ulcers, and stimulation of a complex process of mesenchymal endothelial transition. These mechanisms could amplify the damage established by increased oxidative stress and autoantibodies. They also point to the complexity of digital vasculopathy in systemic sclerosis and open new possibilities to improve the diagnosis and treatment of these patients.

Keywords : Digital vasculopathy; Raynaud’s phenomenon; Pathophysiology; Systemic sclerosis.

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