TREATMENT OF SEVERE RAYNAUDS SYNDROME BY INJECTION OF AUTOLOGOUS BLOOD PRETREATED BY HEATING, OZONATION AND EXPOSURE TO ULTRAVIOLET-LIGHT (H-O-U) THERAPY

Objective. To determine the effect of re-injection of small samples of autologous blood, pretreated with heat, ozone and ultraviolet light ( H-O-U therapy) in patients with severe Raynaud's syndrome. Experimenta l design. Open trial in 4 patients. Setting. Temperature/humidity cont rolled vascular laboratory. Patients. Severe Raynaud's syndrome of mor e than 5 years duration and defined as more than 5 attacks daily or 10 attacks in one week, at least half of which were painful and lasting for more than 30 minutes. Three patients were refractory to infusions of Iloprost. Interventions. Patients were treated daily or on alternat e days for a two to three weeks period by re-injection of citrated aut ologous blood pre-treated with heat, ozone and ultraviolet light (H-O- U therapy). Measures. Clinical observations; mean equilibrated hand te mperature (infrared thermography); distributive and microcirculatory b lood-flow (venous occlusion strain-gauge plethysmography, infrared pho toplethysmography, laser Doppler flowmetry) iontophoresis of acetylcho line and sodium nitroprusside; estimations: serum levels of 6-keto-PGF (1 alpha), and serum levels of anti-hsp65 antibody. Results. Reduction or abolition of Raynaud's attacks for at least three months after tre atment. Mean equilibrated hand temperature increased but did not norma lise. Blood flow parameters improved but did not reach statistical sig nificance. Iontophoresis of acetylcholine showed an increase in laser Doppler flowmetry which was statistically significant. Serum levels of 6-keto-PGF(1 alpha), fell significantly in three patients. Serum leve ls of anti-hsp65 antibody fell in the one patient which was followed s equentially. Conclusions. H-O-U therapy may prove useful in patients w ith severe Raynaud's syndrome.