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Vol 23, No 3 (2017)
Review paper
Published online: 2017-09-28

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Use of sulodexide for the treatment of disorders of peripheral microcirculation in patients with systemic sclerosis

Irena Walecka1, Patrycja Wislinska, Anna Kulak, Marek Roszkiewicz
Acta Angiologica 2017;23(3):139-143.

Abstract

Scleroderma (systemic sclerosis, scleroderma) is a chronic, progressive autoimmune disease characterized by damage to blood vessels, the presence of autoantibodies, progressive hardening, atrophy of the skin and subcutaneous tissue and damage to many internal organs. In scleroderma we observe peripheral microcirculation disorders, in which small peripheral vascular abnormalities play an important role. Raynaud’s phenomenon is the most common manifestation of peripheral microcirculation disorders in the course of systemic sclerosis and concerns mainly the fingers. Treatment of patients with systemic sclerosis should be comprehensive and include education of patients, use of medication and rehabilitation. Drugs of first choice for the treatment of peripheral microcirculation disorders include calcium channel blockers, phosphodiesterase inhibitors, and prostaglandins. From our clinical experience gained in the treatment of microvascular disorders, sulodexide [a mixture of heparin (80%) and dermatan sulfate (20%)] seems to be a good and safe drug worth recommending. It works as an anticoagulant, pro-fibrinolytic, anti-inflammatory, inhibits the fibrosis process, and has protective effects on the vascular endothelial cells. Sulodexide is a safe rheological drug successfully used to treat a number of diseases accompanied by microcirculation disorders, including scleroderma.

References

  1. Kowal-Bielecka O, Kuryliszyn-Moskal A. Twardzina układowa – zalecenia postępowania diagnostycznego i terapeutycznego. Przegl. Reumatol. 2012; 50(2): 124–129.
  2. LeRoy EC, Black C, Fleischmajer R, et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol. 1988; 15(2): 202–205.
  3. Wielosz E. Zajęcie nerek w twardzinie układowej. Przegl. Reumatol. 2008; 19: 3–4.
  4. Robak E, Gerlicz Z. [Pro-angiogenic cytokines in systemic sclerosis]. Postepy Hig Med Dosw (Online). 2014; 68: 1472–1482.
  5. Ogrodowicz A. Ocena częstości występowania i znaczenia klinicznego przeciwciał antyfosfolipidowych na twardzinę układową. [Dissertation], Poznań 2012: 100.
  6. Wojteczek A, Ziemkiewicz M, Zdrojewski Z. Objaw Raynauda – obraz kliniczny, diagnostyka, leczenie. Ann Acad. Med. Gedan. 2014; 44: 133–141.
  7. Araszkiewicz A, Mackiewicz-Wysocka M, Wierusz-Wysocka B. Skin dysfunction in diabetes. Part 2 — microangiopathy and neuropathy. Diabet. Klin. 2014; 3(3): 117–124.
  8. Kowal-Bielecka O, Fransen J, Avouac J, et al. EUSTAR Coauthors. Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis. 2017; 76(8): 1327–1339.
  9. Bręborowicz A. Sulodeksyd – mieszanina glikozaminoglikanów o protekcyjnym działaniu w stosunku do komórek śródbłonka naczyniowego. Acta Angiol. 2014; 20(3): 112–118.
  10. Połubińska A, Staniszewski R, Baum E, et al. Sulodexide modifies intravascular homeostasis what affects function of the endothelium. Adv Med Sci. 2013; 58(2): 304–310.
  11. Sosińska P, Baum E, Maćkowiak B, et al. Sulodexide Reduces the Proinflammatory Effect of Serum from Patients with Peripheral Artery Disease in Human Arterial Endothelial Cells. Cell Physiol Biochem. 2016; 40(5): 1005–1012.
  12. Sumińska-Jasińska K. Ocena działania sulodeksydu na czynność ludzkich komórek śródbłonka w warunkach hodowli in vitro. [Dissertation], Poznań 2012: 63.
  13. Kristová V, Lísková S, Sotníková R, et al. Sulodexide improves endothelial dysfunction in streptozotocin-induced diabetes in rats. Physiol Res. 2008; 57(3): 491–494.
  14. Gaddi A, Galetti C, Nascetti S. Meta-analysis of some results of clinical trials on sulodexide theraphy in peripheral occlusive arterial disease. J Int Med Res. 1996; 24: 389–406.
  15. Borawski J, Myśliwiec M. Nowe właściwości farmakologiczne heparyny i sulodeksydu. Post Nauk Med. 2009; 10: 764–770.
  16. Elleuch N, Zidi H, Bellamine Z, et al. CVD study investigators. Sulodexide in Patients with Chronic Venous Disease of the Lower Limbs: Clinical Efficacy and Impact on Quality of Life. Adv Ther. 2016; 33(9): 1536–1549.
  17. Olde Engberink RHG, Rorije NMG, Lambers Heerspink HJ, et al. The blood pressure lowering potential of sulodexide – a systematic review and meta-analysis. Br J Clin Pharmacol. 2015; 80(6): 1245–1253.
  18. CHPL Prostavasin 19.06.2012.
  19. Lis-Święty A, Brzezińska-Wcisło L. Systemic Sclerosis – prognostic factors disease activity and severity. Przegl Dermatol. 2010; 97: 398–405.
  20. Kużnik-Trocha K, Winsz-Szczotka K, Komosińska-Vasev K, et al. Komosińska-Vasev K. Diagn Lab. 2012; 4: 441–453.
  21. Suminska-Jasinska K, Polubinska A, Ciszewicz M, et al. Sulodexide reduces senescence-related changes in human endothelial cells. Med Sci Monit. 2011; 17(4): CR222–CR226.
  22. Burgdorf WHC, Plewig G, Wolff HH, Landthaler M. Dermatologia Braun-Falco. Vol. 2. Czelej, Lublin 2010.