Capillaroscopic findings and vascular biomarkers in systemic sclerosis: Association of low CD40L levels with late scleroderma pattern

•We investigated the association of NVC findings and vascular biomarkers in a relatively early group of SSc patients.•NVC was found to be a useful tool reflecting the characteristics and severity of the disease.•sCD40L was the only biomarker differently regulated between NVC patterns and significantly lower in patients with late pattern.•CD40L may be one of the the key molecules in early/active phase, probably declines in later stage of vascular injury in SSc.•Biomarker studies in SSc may give us an opportunity to identify specific stages of the disease with therapeutic implications in the future.

ObjectiveTo determine the relationship between vascular biomarkers reflecting the vascular injury and neoangiogenesis with capillaroscopic changes in systemic sclerosis (SSc).MethodsNailfold video-capillaroscopy (NVC) was performed qualitatively (early, active and late scleroderma patterns) in 72 SSc patients (66 female) fulfilling ACR/EULAR (2013) criteria. Serum samples of patients were collected and analysed by flow cytometer with multiplex kits of sCD40L, tPA, MCP-1, sE-selectin, IL-8, IL-6, VEGF, sP-selectin, TGF-β1 and VCAM at the same time with NVC.ResultsCompared to healthy subjects; tPA (p = 0.02), MCP-1 (p = 0.001), sE-selectin (p = 0.008) and TGF-β1 (p = 0.001) levels were significantly higher, however sP-selectin (p = 0.011) and IL-8 (p = 0.001) levels were lower in SSc patients. SSc patients were defined according to NVC patterns as ‘early’ (n = 10), ‘active’ (n = 37) and ‘late’ (n = 25). According to NVC patterns of SSc patients, only sCD40L levels were significantly lower in the ‘late’ group (p = 0.039). The other markers were similar among NVC groups.ConclusionsNVC is a useful method for investigating the vascular pathogenesis and severity of SSc. Although the levels were similar to healthy controls in patients with early/active NVC patterns, there were lower sCD40L serum levels in patients with late NVC pattern. CD40L may have a role in the early/active phase of vascular involvement.