EARLY EXPRESSION OF E-SELECTIN, TUMOR-NECROSIS-FACTOR-ALPHA, AND MAST-CELL INFILTRATION IN THE SALIVARY-GLANDS OF PATIENTS WITH SYSTEMIC-SCLEROSIS

Objective, To assess the predictive value of early endothelial E-selec tin and tumor necrosis factor a (TNF alpha) expression, as well as mas t cell infiltration, in the subsequent progression to systemic scleros is (SSc) in patients with Raynaud's phenomenon (RP) and abnormal nailf old capillaroscopic findings. Methods. Clinical criteria were evaluate d, and immunostaining was performed on lip biopsy samples from 22 pati ents with RP and abnormal capillaroscopic results, None of these patie nts initially fulfilled the American College of Rheumatology criteria for SSc. Results. E-selectin, TNF alpha, and mast cell infiltration we re found in 9, 10, and 8 of 11 patients, respectively, whose disease p rogressed to SSc, and in 0, 2, and 1 of 11 patients, respectively, who se disease did not progress to SSc (P < 0.001, P < 0.01, and P < 0.01, respectively). Conclusion, E-selectin, TNF alpha, and mast cell infil tration are detectable in the very early stages of SSc, prior to the o nset of skin changes.