Mediators in cardiovascular disease: association with Raynaud’s phenomenon

Raynaud’s phenomenon (RP), often the first presenting sign of SSc-related vasculopathy,is a frequently occurring disorder, and most studies in the general population reporteda prevalence rate of 3%–5%. Generally, vasculopathy is known to significantly impair patients’quality of life. Although vascular injury may directly arise from different etiologies,addressing risk factors associated with vasculopathy development is essential becausethis enables prevention. Vasculopathy plays an important role in the pathophysiology ofSSc, and it is believed to be caused by abnormal neovascularization and remodeling ofthe vessels. Although SSc-related vasculopathy is undoubtedly complex and only partiallyunderstood, oxidative stress has been implicated to play an important role in its initiationand progression. Despite considerable advances in the last decade,the inability to identify patients with Raynaud’s at increased risk of developing SSc remains a problem. Any therapy started later in the disease may only attenuate disease processes and symptoms without modifying the disease course and outcome. Although underlying systemic disease should be excluded in patients presenting with RP, other easily overlooked causes should be considered, such as low body weight or recentweight loss. This dissertation reveals these important factors as well as less traditionalfactors such as the role of oxidative stress. Additionally, the current thesis has providedvaluable insight into the significance of free thiols in the general population