A Mechanistic study of GTN to understand finger blood flow in SSc
Research type
Research Study
Full title
A mechanistic study of topical glyceryl trinitrate to understand the pathophysiology of finger blood flow in systemic sclerosis
IRAS ID
242333
Contact name
Ariane Herrick
Contact email
Sponsor organisation
The University of Manchester
Duration of Study in the UK
0 years, 6 months, 0 days
Research summary
Raynaud's phenomenon is episodic colour change of the extremities, primarily of the fingers and toes. It can be "primary" in which case the problem is completely reversible, or secondary to an underlying disease, for example the connective tissue disease systemic sclerosis. Systemic sclerosis is associated with blood vessel changes resulting in Raynaud's phenomenon which can be very severe, progressing to irreversible tissue damage with ulceration and even gangrene.
We do not understand what causes Raynaud's phenomenon, nor why the characteristic blood vessel abnormalities of systemic sclerosis occur. These can be directly visualised at the nailbed using the non-invasive technique of nailfold capillaroscopy, which is generally used to examine the structure of very small blood vessels called capillaries. Glyceryl trinitrate (GTN) increases blood flow in patients with systemic sclerosis as well as in healthy control subjects and patients with primary Raynaud's phenomenon. Now that we can measure blood flow at the single capillary level, we wish to undertake a study to increase our understanding of why finger blood flow is so reduced in patients with systemic sclerosis, and how responsiveness to GTN relates to changes in the structure of small blood vessels.
To do this, we plan to recruit 20 patients with systemic sclerosis (including 10 with severe digital vascular disease as defined by a history or previous digital ulceration, intravenous prostanoid infusions or digital amputations) and 20 healthy controls (with no history of any illness which could affect the vasculature e.g. diabetes or hypertension, and no vasoactive therapies).
Participants will attend Salford Royal NHS Foundation Trust for a single study visit lasting approximately one and a half hours. Consent will be obtained and clinical data will be collected on a case report form. Nailfold capillaroscopy will be carried out at baseline and then at several intervals post-GTN application.REC name
East of England - Cambridge South Research Ethics Committee
REC reference
18/EE/0229
Date of REC Opinion
7 Aug 2018
REC opinion
Further Information Favourable Opinion