Evaluación de la eficacia y seguridad de la terapia gravitacional en una cohorte de pacientes con esclerosis sistémica

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-11-01 DOI:10.1016/j.reuma.2024.07.006

Luisa Fernanda Servioli , Eugenia Isasi , Alejandra Pérez , Silvia Pouquette , María Eloísa Isasi

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Abstract

Background

The exposure to artificial gravity (AG) through human centrifugation is the basis of the treatment called gravity therapy (GT), in which the mechanical stimulation over the vessel wall, induces the synthesis and release of prostacyclin. It has been used for more than four decades in Uruguay in the treatment of different vascular-based pathologies. In patients with systemic sclerosis (SSc) it has shown good benefits and excellent safety profile over the years. However, there is a lack of knowledge in the scientific community about GT and its results.

Objective

To evaluate the effectiveness of GT in cutaneous and vascular involvement, in the quality of life and functional capacity and its safety profile in patients with SSc.

Methodology

It is a descriptive and retrospective study of patients with SSc assisted in an autoimmunity center in Montevideo, treated with GT in the last 10 years.

Results

Fifty patients were included, 48 women (96%) and 2 men (4%) with a mean age of 62 ± 12 years. The mean time of evolution of SSc at the time of inclusion in the study at the beginning of GT was 6.8 ± 3.2 years and 2.8 ± 3.2 years respectively. After GT, a significant improvement in the modified Rodnan skin score (mRSS) was observed (pre-GT 19.2 ± 8.7 vs post-GT 5.4 ± 5.0, P < .05), which was not related to the time of disease progression at the beginning of GT nor to the skin extension or immunological profile. The degree of improvement post-GT was related to a higher initial mRSS (R = 0.84, P < .05). Also, a significant improvement was observed in the number of patients with puffy fingers (pre-GT 50% vs post-GT 20% patients, P < .05), but not in telangiectasias, pitting scars or sclerodactyly. The severity of Raynaud's phenomenon significantly decreased (pre-GT: grade 3-4, 43/48 (89.6%) patients vs post-GT: grade ≤ 2, 42/47 (89.4%) patients, P < .05) as well as the vascular pain measured with VAS (0-10 scale) (pre-GT: 7.6 ± 2.2 vs post-TG: 1.4 ± 1.2, P < .05). The healing of digital ulcers was also recorded. Regarding the results reported by patients, 97% reported improvement in the quality of life and 89.5% improvement in the ability to carry out activities of daily living. No significant adverse effects were recorded.

Conclusions

GT improved cutaneous and vascular involvement, the quality of life and the functional capacity in patients with SSc with an excellent safety profile. Randomized, controlled clinical trials are needed to corroborate these observational results.

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评估重力疗法对一组系统性硬化症患者的疗效和安全性

背景通过人体离心暴露于人工重力（AG）是重力疗法（GT）的基础，通过对血管壁的机械刺激，诱导前列环素的合成和释放。在乌拉圭，该疗法用于治疗不同的血管性病症已有四十多年的历史。多年来，它在系统性硬化症（SSc）患者中显示出良好的疗效和出色的安全性。方法这是一项描述性和回顾性研究，研究对象是蒙得维的亚一家自身免疫中心的 SSc 患者，他们在过去 10 年中接受了 GT 治疗。结果共纳入 50 名患者，其中女性 48 名（96%），男性 2 名（4%），平均年龄为 62 ± 12 岁。纳入研究时的平均 SSc 病变时间为（6.8 ± 3.2）年，GT 治疗开始时的平均 SSc 病变时间为（2.8 ± 3.2）年。GT后，改良罗德南皮肤评分（mRSS）明显改善（GT前 19.2 ± 8.7 vs GT后 5.4 ± 5.0，P < .05），这与GT开始时的疾病进展时间无关，也与皮肤扩展或免疫学特征无关。GT后的改善程度与较高的初始mRSS有关（R = 0.84，P < .05）。此外，手指浮肿患者的数量也有明显改善（GT 前 50% 的患者与 GT 后 20% 的患者相比，P <.05），但毛细血管扩张、点状疤痕或硬皮挛缩的情况则没有明显改善。雷诺现象的严重程度明显减轻（GT 前：3-4 级，43/48（89.6%）名患者 vs GT 后：≤ 2 级，42/47（89.4%）名患者，P < .05），用 VAS（0-10 级）测量的血管疼痛也明显减轻（GT 前：7.6 ± 2.2 vs TG 后：1.4 ± 1.2，P < .05）。此外，还记录了数字溃疡的愈合情况。关于患者报告的结果，97%的患者表示生活质量有所改善，89.5%的患者表示日常生活能力有所提高。结论GT改善了SSc患者的皮肤和血管受累情况、生活质量和功能能力，安全性极佳。需要进行随机对照临床试验来证实这些观察结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.