Impaired microvascular response to cholinergic stimuli in primary Sjogren's syndrome

László Kovács, Tamás Török, F. Bari, Zsuzsanna Kéri, Attila Kovács, Éva Makula, G. Pokorny

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Objective - Signs of a parasympathetic dysfunction have been revealed in primary Sjogren's syndrome (SS). Its role in the pathogenesis and the clinical picture of the disease is not clear. To investigate the responsiveness of SS patients to a cholinergic agonist, a model was used involving examination of the cutaneous microcirculation. The microvascular response to the administration of carbachol was measured, a muscarinic cholinergic agonist. Methods - Twenty two SS patients and 12 controls were examined. Carbachol and 0.9% saline solution were administered intracutaneously into the forearm skin at two distinct places. Skin blood flow (SBF) in the injected areas was measured continuously before and for 10 minutes after the injections by means of a laser Doppler perfusion monitor. The increase in SBF in response to carbachol (dSBF), reflecting vasodilatation, was calculated by a formula including the baseline and the maximum SBF values after the injections of carbachol and saline solution. Results - The vasodilatation was significantly lower in SS patients than in the controls (mean dSBF: 2.1 (range: 1.0-4.5) versus 3.3 (range: 1.7-7.6), p=0.02). With non-responder patients defined as those in whom a smaller response was observed than in any of the controls, 11 of the 22 SS patients proved to be non-responders to carbachol. Comparisons of demographic, clinical and laboratory characteristics and HLA class II genotypes between responder and non-responder SS patients did not show any significant differences. Conclusions - A diminished or absent response to carbachol indicates a cholinergic dysfunction in SS patients. A disturbance in the neurotransmission at a receptorial or postreceptorial level is hypothesised. Unresponsiveness to cholinergic stimuli may contribute to exocrine insufficiency.

Original languageEnglish
Pages (from-to)48-53
Number of pages6
JournalAnnals of the Rheumatic Diseases
Volume59
Issue number1
DOIs
Publication statusPublished - 2000

Fingerprint

Sjogren's Syndrome
Carbachol
Cholinergic Agents
Skin
Blood
Sodium Chloride
Vasodilation
Microcirculation
Cholinergic Agonists
Muscarinic Agonists
Injections
Forearm
Synaptic Transmission
Lasers
Perfusion
Genotype
Demography

ASJC Scopus subject areas

  • Rheumatology
  • Immunology

Cite this

Impaired microvascular response to cholinergic stimuli in primary Sjogren's syndrome. / Kovács, László; Török, Tamás; Bari, F.; Kéri, Zsuzsanna; Kovács, Attila; Makula, Éva; Pokorny, G.

In: Annals of the Rheumatic Diseases, Vol. 59, No. 1, 2000, p. 48-53.

Research output: Contribution to journalArticle

Kovács, László ; Török, Tamás ; Bari, F. ; Kéri, Zsuzsanna ; Kovács, Attila ; Makula, Éva ; Pokorny, G. / Impaired microvascular response to cholinergic stimuli in primary Sjogren's syndrome. In: Annals of the Rheumatic Diseases. 2000 ; Vol. 59, No. 1. pp. 48-53.
@article{569b9e034e1148b4a7cc4ac67233cfe9,
title = "Impaired microvascular response to cholinergic stimuli in primary Sjogren's syndrome",
abstract = "Objective - Signs of a parasympathetic dysfunction have been revealed in primary Sjogren's syndrome (SS). Its role in the pathogenesis and the clinical picture of the disease is not clear. To investigate the responsiveness of SS patients to a cholinergic agonist, a model was used involving examination of the cutaneous microcirculation. The microvascular response to the administration of carbachol was measured, a muscarinic cholinergic agonist. Methods - Twenty two SS patients and 12 controls were examined. Carbachol and 0.9{\%} saline solution were administered intracutaneously into the forearm skin at two distinct places. Skin blood flow (SBF) in the injected areas was measured continuously before and for 10 minutes after the injections by means of a laser Doppler perfusion monitor. The increase in SBF in response to carbachol (dSBF), reflecting vasodilatation, was calculated by a formula including the baseline and the maximum SBF values after the injections of carbachol and saline solution. Results - The vasodilatation was significantly lower in SS patients than in the controls (mean dSBF: 2.1 (range: 1.0-4.5) versus 3.3 (range: 1.7-7.6), p=0.02). With non-responder patients defined as those in whom a smaller response was observed than in any of the controls, 11 of the 22 SS patients proved to be non-responders to carbachol. Comparisons of demographic, clinical and laboratory characteristics and HLA class II genotypes between responder and non-responder SS patients did not show any significant differences. Conclusions - A diminished or absent response to carbachol indicates a cholinergic dysfunction in SS patients. A disturbance in the neurotransmission at a receptorial or postreceptorial level is hypothesised. Unresponsiveness to cholinergic stimuli may contribute to exocrine insufficiency.",
author = "L{\'a}szl{\'o} Kov{\'a}cs and Tam{\'a}s T{\"o}r{\"o}k and F. Bari and Zsuzsanna K{\'e}ri and Attila Kov{\'a}cs and {\'E}va Makula and G. Pokorny",
year = "2000",
doi = "10.1136/ard.59.1.48",
language = "English",
volume = "59",
pages = "48--53",
journal = "Annals of the Rheumatic Diseases",
issn = "0003-4967",
publisher = "BMJ Publishing Group",
number = "1",

}

TY - JOUR

T1 - Impaired microvascular response to cholinergic stimuli in primary Sjogren's syndrome

AU - Kovács, László

AU - Török, Tamás

AU - Bari, F.

AU - Kéri, Zsuzsanna

AU - Kovács, Attila

AU - Makula, Éva

AU - Pokorny, G.

PY - 2000

Y1 - 2000

N2 - Objective - Signs of a parasympathetic dysfunction have been revealed in primary Sjogren's syndrome (SS). Its role in the pathogenesis and the clinical picture of the disease is not clear. To investigate the responsiveness of SS patients to a cholinergic agonist, a model was used involving examination of the cutaneous microcirculation. The microvascular response to the administration of carbachol was measured, a muscarinic cholinergic agonist. Methods - Twenty two SS patients and 12 controls were examined. Carbachol and 0.9% saline solution were administered intracutaneously into the forearm skin at two distinct places. Skin blood flow (SBF) in the injected areas was measured continuously before and for 10 minutes after the injections by means of a laser Doppler perfusion monitor. The increase in SBF in response to carbachol (dSBF), reflecting vasodilatation, was calculated by a formula including the baseline and the maximum SBF values after the injections of carbachol and saline solution. Results - The vasodilatation was significantly lower in SS patients than in the controls (mean dSBF: 2.1 (range: 1.0-4.5) versus 3.3 (range: 1.7-7.6), p=0.02). With non-responder patients defined as those in whom a smaller response was observed than in any of the controls, 11 of the 22 SS patients proved to be non-responders to carbachol. Comparisons of demographic, clinical and laboratory characteristics and HLA class II genotypes between responder and non-responder SS patients did not show any significant differences. Conclusions - A diminished or absent response to carbachol indicates a cholinergic dysfunction in SS patients. A disturbance in the neurotransmission at a receptorial or postreceptorial level is hypothesised. Unresponsiveness to cholinergic stimuli may contribute to exocrine insufficiency.

AB - Objective - Signs of a parasympathetic dysfunction have been revealed in primary Sjogren's syndrome (SS). Its role in the pathogenesis and the clinical picture of the disease is not clear. To investigate the responsiveness of SS patients to a cholinergic agonist, a model was used involving examination of the cutaneous microcirculation. The microvascular response to the administration of carbachol was measured, a muscarinic cholinergic agonist. Methods - Twenty two SS patients and 12 controls were examined. Carbachol and 0.9% saline solution were administered intracutaneously into the forearm skin at two distinct places. Skin blood flow (SBF) in the injected areas was measured continuously before and for 10 minutes after the injections by means of a laser Doppler perfusion monitor. The increase in SBF in response to carbachol (dSBF), reflecting vasodilatation, was calculated by a formula including the baseline and the maximum SBF values after the injections of carbachol and saline solution. Results - The vasodilatation was significantly lower in SS patients than in the controls (mean dSBF: 2.1 (range: 1.0-4.5) versus 3.3 (range: 1.7-7.6), p=0.02). With non-responder patients defined as those in whom a smaller response was observed than in any of the controls, 11 of the 22 SS patients proved to be non-responders to carbachol. Comparisons of demographic, clinical and laboratory characteristics and HLA class II genotypes between responder and non-responder SS patients did not show any significant differences. Conclusions - A diminished or absent response to carbachol indicates a cholinergic dysfunction in SS patients. A disturbance in the neurotransmission at a receptorial or postreceptorial level is hypothesised. Unresponsiveness to cholinergic stimuli may contribute to exocrine insufficiency.

UR - http://www.scopus.com/inward/record.url?scp=0034025087&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034025087&partnerID=8YFLogxK

U2 - 10.1136/ard.59.1.48

DO - 10.1136/ard.59.1.48

M3 - Article

VL - 59

SP - 48

EP - 53

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

SN - 0003-4967

IS - 1

ER -