Vascular function in systemic sclerosis

Raynaud phenomenon is often the earliest manifestation of systemic sclerosi s. This fact highlights the role of vascular dysfunction early on in the di sease process. Although this review deals primarily with digital vasculatur e, recent research confirms that vascular dysfunction is widespread, and af fects large as well as small vessels. Abnormalities of vascular function an d structure are interdependent, and together result in the ischemic atrophy so characteristic of SSc. Key areas of research include the pathophysiolog y of the imbalance between vasodilation and vasoconstriction, with particul ar interest in understanding the relative contributions of endothelial-depe ndent and endothelial-independent: vasodilation, and the development of new methodologies by which to quantify vascular function. (C) 2000 Lippincott Williams & Wilkins, Inc.