Exploring sarcoidosis via nailfold capillaroscopy: A window into the disease’s microvascular landscape

Lucrezia Mondini; Mariangela Barbieri; Liliana Trotta; Giorgio Monteleone; Luca Ruggero; Anna De Nes; Chiara Torregiani; Rossella Cifaldi; Caterina Antonaglia; Michael Hughes; Francesco Salton; Marco Confalonieri; Paola Confalonieri; Ilaria Gandin; Barbara Ruaro

doi:10.36141/svdld.v42i4.17137

Exploring sarcoidosis via nailfold capillaroscopy: A window into the disease’s microvascular landscape

Authors

Lucrezia Mondini Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Mariangela Barbieri Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Liliana Trotta Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Giorgio Monteleone Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy
Luca Ruggero Pulmonology Unit, General Hospital “Santa Maria degli Angeli”, 33170 Pordenone, Italy
Anna De Nes Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Chiara Torregiani Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Rossella Cifaldi Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Caterina Antonaglia Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Michael Hughes Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester & Salford Royal NHS Foundation Trust, Manchester M6 8HD, UK
Francesco Salton Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Marco Confalonieri Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Paola Confalonieri Pulmonology Unit, University of Trieste, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, Trieste, Italy
Ilaria Gandin Biostatistics Unit, Department of Medical Sciences, University of Trieste, 34149 Trieste, Italy
Barbara Ruaro Pulmonology Unit, Department of Medical Surgical and Health Sciences, Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy

Keywords:

sarcoidosis; endothelial damage; interstitial lung disease

Abstract

Background and aim: Sarcoidosis is a systemic granulomatous inflammatory disease that can affect virtually any organ, with a predilection for the lungs. It may present vasculitic features involving small, medium, or large vessels. Microvascular alterations in sarcoidosis can be assessed using nailfold videocapillaroscopy (NVC), a tool widely applied in the diagnosis and monitoring of systemic sclerosis, among other conditions. The aim of our study was to detect microcirculatory changes in patients with sarcoidosis and investigate their potential correlation with organ involvement.

Methods: We conducted a single-center, retrospective case-control study involving three groups: 51 patients diagnosed with sarcoidosis, 51 healthy volunteers serving as controls, and 51 patients with systemic sclerosis. The groups were similar in sex and age. All participants underwent nailfold videocapillaroscopy (NVC) to assess microvascular changes.

Results: This study confirmed the presence of non-specific microcirculatory abnormalities in patients with sarcoidosis, particularly in terms of reduced capillary density, the presence of angiogenesis, and slowed capillary flow. Although these alterations do not currently appear to correlate with specific clinical aspects of the disease, (e.g. the presence of autoantibodies, laboratory parameters and variables of lung function).

Conclusions: Our findings confirm the presence of non-specific microvascular abnormalities in sarcoidosis. However, the identification of these capillaroscopic alterations as specific to sarcoidosis requires further confirmation. Ongoing studies aim to explore the potential role of NVC as a diagnostic marker and to investigate its correlation with the clinical manifestations of sarcoidosis.

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