Pneumologie 2009; 63(9): 497-507
DOI: 10.1055/s-0029-1214908
Übersicht

© Georg Thieme Verlag Stuttgart · New York

Lungenbeteiligung bei systemischer Sklerodermie

Lung Impairment in Systemic SclerosisH.  Knoop1 , U.  Arinir1 , A.  Kreuter2 , J.  W.  Walther1 , G.  Schultze-Werninghaus1 , G.  Rohde1
  • 1Medizinische Klinik III – Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin, Berufsgenossenschaftliche Universitätsklinik Bergmannsheil GmbH, Klinikum der Ruhr-Universität Bochum (Direktor: Prof. Dr. G. Schultze-Werninghaus)
  • 2Klinik für Dermatologie und Allergologie, St. Josef-Hospital, Klinikum der Ruhr-Universität Bochum (Direktor: Prof. Dr. P. Altmeyer)
Further Information

Publication History

eingereicht 29.5.2009

akzeptiert 4.6.2009

Publication Date:
25 August 2009 (online)

Zusammenfassung

Unter dem Oberbegriff Sklerodermie werden heterogene Autoimmunerkrankungen zusammengefasst, die verdickte, sklerotische Hautläsionen gemein haben. Die Sklerodermie zählt zum Formenkreis der Kollagenosen. Die systemische Form der Sklerodermie wird als Progressive Systemische Sklerose (PSS) oder systemische Sklerodermie (SSc) bezeichnet. Die Lungenbeteiligung bei SSc in Form von interstitieller Lungenerkrankung (ILD) und pulmonal-arterieller Hypertonie (PAH) ist eine der häufigsten Manifestationen der Erkrankung. Das Ziel dieser Arbeit besteht darin, einen Überblick über die Formen des Lungenbefalls bei SSc mit besonderem Augenmerk auf die interstitiellen Lungenerkrankungen zu geben – unter Berücksichtigung der bisher identifizierten pathogenetischen Mechanismen und der Therapieoptionen.

Abstract

Scleroderma is a generic term for autoimmunological diseases having thickened sclerotic skin lesions in common. Scleroderma belongs to a group of connective tissue diseases. The systemic form of scleroderma is called progressive systemic sclerosis (PSS) or systemic sclerosis (SSc). Lung impairments, namely interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH), are one of the most common manifestations in SSc. This article summarises the forms of lung impairment in SSc with special emphasis on interstitial lung diseases and draws attention to the so far identified pathogenetic mechanisms and the presently accepted therapeutic options.

Literatur

  • 1 Lorenz J. Pneumologie. Stuttgart; Thieme Verlag 2004: 379-381
  • 2 Gintrac M. Note sur la sclerodermie.  Rev Med Chir Paris. 1847;  2 263-281
  • 3 LeRoy E C, Black C, Fleischmajer R. et al . Scleroderma (systemic sclerosis): classification, subsets and pathogenesis.  J Rheumatol. 1988;  15 202-205
  • 4 LeRoy E C, Medsger Jr T A. Criteria for the classification of early systemic sclerosis.  J Rheumatol. 2001;  28 1573-1576
  • 5 Johnson S R, Feldman B M, Hawker G A. Classification criteria for systemic sclerosis subsets.  J Rheumatol. 2007;  34 1855-1863
  • 6 Black C M. The Aetiopathogenesis Of Systemic Sclerosis: Thick Skin – Thin Hypotheses. The Parkes Weber Lecture 1994.  JR Coll Physicians London. 1995;  29 119-130
  • 7 Arbeitsgemeinschaft dermatologische Forschung . Klinik der progressiven systemischen Sklerodermie (PSS).  Hautarzt. 1986;  37 320-324
  • 8 Subcommittee for Scleroderma Criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee . Preliminary criteria for the classification of systemic sclerosis (scleroderma).  Arthritis Rheum. 1980;  23 581-590
  • 9 Benan M, Hande I, Gul O. The natural course of progressive systemic sclerosis patients with interstitial lung involvement.  Clin Rheumatol. 2007;  26 349-354
  • 10 Clements P, Lachenbruch P, Seibold J R. et al . Inter- and intraobserver variability of total skin thickness score (modified Rodnan TSS) in systemic sclerosis.  J Rheumatol. 1995;  22 1281-1285
  • 11 Verrecchia F, Laboureau J, Verola O. et al . Skin involvement in scleroderma – where histological and clinical scores meet.  Rheumatology. 2007;  46 833-841
  • 12 Rodnan G P, Lipinski E, Luksick J. Skin thickness and collagen content in progressive systemic sclerosis and localized scleroderma.  Arthritis Rheum. 1979;  22 130-140
  • 13 Czirjak L, Nagy Z, Aringer M. et al . The EUSTAR model for teaching and implementing the modified Rodnan skin score in systemic sclerosis.  Ann Rheum Dis. 2007;  66 966-969
  • 14 Steen V D, Oddis C V, Conte C G. et al . Incidence of systemic sclerosis in allegheny county, Pennsylvania: A twenty-year study of hospital-diagnosed cases, 1963 – 1982.  Arthritis & Rheum. 1997;  40 441-445
  • 15 Mayes M D. Scleroderma epidemiology [review].  Rheum Dis Clin North Am. 2003;  29 239-254
  • 16 Vonk M C, Broers B, Heijdra Y F. et al . Systemic sclerosis and its pulmonary complications in the Netherlands an epidemiological study.  Ann Rheum Dis. 2009;  68 961-965
  • 17 Mayes M D, Lacey Jr J V, Beebe-Dimmer J. et al . Prevalence, incidence, survival, and disease characteristics of systemic sclerosis in a large US population.  Arthritis Rheum. 2003;  48 2246-2255
  • 18 Walker U A, Tyndall A, Czirjak L. et al . Clinical risk assessment of organ manifestations in systemic sclerosis: a report from the EULAR Scleroderma Trials and Research group database.  Ann Rheum Dis. 2007;  66 754-763
  • 19 Hunzelmann N, Genth E, Krieg T. et al . The registry of the German Network for Systemic Scleroderma: frequency of disease subsets and patterns of organ involvement.  Rheumatology (Oxford). 2008;  47 1185-1192
  • 20 Arnett F C, Cho M, Chatterjee S. et al . Familial occurrence frequencies and relative risks for systemic sclerosis (scleroderma) in three United States cohorts.  Arthritis Rheum. 2001;  44 1359-1362
  • 21 Shahin A A. Pulmonary involvement in systemic sclerosis.  Treat Respir Med. 2006;  5 429-436
  • 22 Pontifex E K, Hill C L, Roberts-Thomsen P. Risk factors for lung cancer in patients with scleroderma: a nested case-control study.  Ann Rheum Dis. 2007;  66 551-553
  • 23 Steen V D, Costantino J P, Shapiro A P. et al . Outcome of renal crisis in systemic sclerosis: relation to availability of angiotensin converting enzyme (ACE) inhibitors.  Ann Intern Med. 1990;  113 352-357
  • 24 Steen V D, Medsger T A. Changes in causes of death in systemic sclerosis, 1972 – 2002.  Ann Rheum Dis. 2007;  66 940-944
  • 25 Steen V D, Lucas M, Fertig N. et al . Pulmonary arterial hypertension and severe pulmonary fibrosis in systemic sclerosis patients with a nucleolar antibody.  J Rheumatol. 2007;  34 2230-2235
  • 26 Ferri C, Valentini G, Cozzi F. et al . Systemic sclerosis study group of the Italian Society of Rheumatology (SIR-GSSSc). Systemic sclerosis: demographic, clinical, and serological features and survival in 1012 Italian patients.  Medicine. 2002;  81 139
  • 27 Silver R M, Clements P J. Interstitial lung disease in systemic sclerosis: optimizing evaluation and management.  Scleroderma Care Research. 2003;  1 3-11
  • 28 D’Angelo W A, Fries J F, Masi A T. et al . Pathological observations in systemic sclerosis (scleroderma): a study of fifty-eight autopsy cases and fifty-eight matched controls.  Am J Med. 1969;  46 428-440
  • 29 Weaver A L, Divertie M B, Titus J L. Pulmonary scleroderma.  Dis Chest. 1968;  54 490-498
  • 30 McNearney T A, Reveille J D, Fischbach M. et al . Pulmonary involvement in systemic sclerosis: associations with genetic, serologic, sociodemographic, and behavioral factors.  Arthritis & Rheumatism. 2007;  57 318-326
  • 31 Mouthon L, Bérézne A, Brauner M. et al . [Interstitial lung disease in systemic sclerosis].  Rev Mal Respir. 2007;  24 1035-1046
  • 32 Hansell D M, Kerr I A. The role of high resolution computed tomography in the diagnosis of interstitial lung disease.  Thorax. 1991;  46 77-84
  • 33 Desai S R, Veeraraghavan S, Hansell D M. et al . CT features of lung disease in systemic sclerosis: comparison with idiopathic pulmonary fibrosis and non-specific interstitial pneumonia.  Radiology. 2004;  232 560-567
  • 34 Camiciottoli G, Orlandi I, Bartolucci M. et al . Lung CT densitometry in systemic sclerosis: correlation with lung function, exercise testing, and quality of life.  Chest. 2007;  131 672-681
  • 35 Bellia M, Cannizzaro F, Scichilone N. et al . HRCT and scleroderma: semiquantitative evaluation of lung damage and functional abnormalities.  Radiol Med. 2009;  114 190-203
  • 36 Clements P J, Goldin J G, Kleerup E C. et al . Regional differences in bronchoalveolar lavage and thoracic high-resolution computed tomography results in dyspneic patients with systemic sclerosis.  Arthritis & Rheum. 2004;  50 1909-1917
  • 37 Steen V D, Conte C, Owens G R. et al . Severe restrictive lung disease in systemic sclerosis.  Arthritis & Rheum. 1994;  37 1283-1289
  • 38 Marcisz C E, Kucharz J, Brzezinska-Wcislo L. et al . Pulmonary functional abnormalities in asymptomatic patients with systemic sclerosis.  Eur J Intern Med. 2003;  14 162-165
  • 39 Buch M H, Denton C P, Furst D E. et al . Submaximal exercise testing in the assessment of interstitial lung disease secondary to systemic sclerosis: reproducibility and correlations of the 6-min walk test.  Ann Rheum Dis. 2007;  66 169-173
  • 40 Garin M C, Highland K B, Silver R M. et al . Limitations of the 6-minute walk test in interstitial lung disease and pulmonary hypertension in scleroderma.  J Rheumatol. 2009;  36 330-336
  • 41 Ooi G C, Mok M Y, Tsang K W. et al . Interstitial lung disease in systemic sclerosis. An HRCT-clinical correlative study.  Acta Radiologica. 2003;  44 258-264
  • 42 Goh N S, Desai S R, Veeraraghavan S. et al . Interstitial lung disease in systemic sclerosis: a simple staging system.  Am J Respir Crit Care Med. 2008;  177 1248-1254
  • 43 Ravini M, Ferraro G, Barbieri B. et al . Changing strategies of lung biopsies in diffuse lung diseases: the impact of video-assisted thoracoscopy.  Eur Respir J. 1998;  11 99-103
  • 44 Badesch D B, Abman S H, Simmoneau G. et al . Medical therapy for pulmonary arterial hypertension: updated ACCP evidence-based clinical practice guidelines.  Chest. 2007;  131 1917-1928
  • 45 Hachulla E, Carpentier P, Gressin V. et al . Risk factors for death and the 3-year survival of patients with systemic sclerosis: the French ItinérAIR-Sclérodermie study.  Rheumatology (Oxford). 2009;  48 304-208
  • 46 American Thoracic Society/European Respiratory Society . American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias.  Am J Resp Crit Care Med. 2002;  165 277-304
  • 47 Bradley B, Branley H M, Egan J J. et al . Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society.  Thorax. 2008;  63 (Suppl. 5) v1-58
  • 48 Katzenstein A L, Fiorelli R F. Nonspecific interstitial pneumonia/fibrosis. Histologic features and clinical significance.  Am J Surg Pathol. 1995;  18 136-147
  • 49 Kim D S, Yoo B, Lee J S. et al . The major histopathologic pattern of pulmonary fibrosis in scleroderma is nonspecific interstitial pneumonia.  Sarcoidosis Vasc Diffuse Lung Dis. 2002;  19 121-127
  • 50 Bouros D, Wells A U, Nicholson A G. et al . Histopathologic subsets of fibrosing alveolitis in patients with systemic sclerosis and their relationship to outcome.  Am J Respir Crit Care Med. 2002;  165 1581-1586
  • 51 deCarvalho E F, Parra E R, deSouza R. et al . Arterial and interstitial remodelling processes in non-specific interstitial pneumonia: systemic sclerosis versus idiopathic.  Histopathology. 2008;  53 193-204
  • 52 Marie I, Dominique S, Levesque H. et al . Esophageal involvement and pulmonary manifestations in systemic sclerosis.  Arthritis Rheum. 2001;  45 346-354
  • 53 Marie I, Ducrotte P, Denis P. et al . Oesophageal mucosal involvement in patients with systemic sclerosis receiving proton pump inhibitor therapy.  Aliment Pharmacol Ther. 2006;  24 1593-1601
  • 54 Savarino E, Bazzica M, Zentilin P. et al . Gastroesophageal reflux and pulmonary fibrosis in scleroderma: a study using pH-impedance monitoring.  Am J Respir Crit Care Med. 2009;  179 408-413
  • 55 Jain R, Shaul P W, Borok Z. et al . Endothelin-1 induces alveolar epithelial-mesenchymal transition through endothelin type A receptor mediated production of TGF-beta 1.  Am J Respir Cell Mol Biol. 2007;  37 38-47
  • 56 Hagimoto N, Kuwano K, Nomoto Y. et al . Apoptosis and expression of Fas/Fas ligand mRNA in bleomycin-induced pulmonary fibrosis in mice.  Am J Respir Cell Mol Biol. 1997;  16 91-101
  • 57 Hoyles R K, Khan K, Shiwen X. et al . Fibroblast-specific perturbation of transforming growth factor beta signaling provides insight into potential pathogenic mechanisms of scleroderma-associated lung fibrosis: exaggerated response to alveolar epithelial injury in a novel mouse model.  Arthritis Rheum. 2008;  58 1175-1188
  • 58 Sonnylal S, Denton C P, Zheng B. et al . Postnatal induction of transforming growth factor beta signaling in fibroblasts of mice recapitulates clinical, histologic, and biochemical features of scleroderma.  Arthritis Rheum. 2007;  56 334-344
  • 59 Corrin B, Butcher D, McAnulty B J. et al . Immunohistochemical localization of TGF-β1 in the lungs of patients with systemic sclerosis, cryptogenic fibrosing alveolitis and other lung disorders.  Histopathology. 1994;  24 145-150
  • 60 Branley H M, du Bois R M, Wells A U. et al . PET scanning of macrophages in patients with scleroderma fibrosing alveolitis.  Nucl Med Biol. 2008;  35 901-909
  • 61 Gourh P, Tan F K, Assassi S. et al . Association of the PTPN22 R620W polymorphism with anti-topoisomerase I- and anticentromere antibody-positive systemic sclerosis.  Arthritis Rheum. 2006;  54 3945-3953
  • 62 Mattuzzi S, Barbi S, Carletto A. et al . Association of polymorphisms in the IL1B and IL2 genes with susceptibility and severity of systemic sclerosis.  J Rheumatol. 2007;  34 997-1004
  • 63 Fonseca C, Lindahl G E, Ponticos M. et al . A polymorphism in the CTGF promotor region associated with systemic sclerosis.  N Engl J Med. 2007;  357 1210-1220
  • 64 Ates O, Müsellim B, Ongen G. et al . NRAMP1 (SLC11A1): A plausible candidate gene for systemic sclerosis (SSc) with interstitial lung involvement.  J Clin Immunol. 2008;  28 73-77
  • 65 Sumita Y, Sugiura T, Kawaguchi Y. et al . Genetic polymorphisms in the surfactant proteins in systemic sclerosis in Japanese: T/T genotype at 1580 C/T (Thr131Ile) in the SP-B gene reduces the risk of interstitial lung disease.  Rheumatology (Oxford). 2008;  47 289-291
  • 66 Dieudé P, Guedj W, Wipff J. et al . Association between the IRF5 rs2004640 functional polymorphism and systemic sclerosis: a new perspective for pulmonary fibrosis.  Arthritis Rheum. 2009;  60 225-233
  • 67 Renzoni E, Lympany P, Sestini P. et al . Distribution of novel polymorphisms of the interleukin-8 and cxc receptor 1 und 2 genes in systemic sclerosis and cryptogenic fibrosing alveolitis.  Arthritis & Rheumatism. 2000;  43 1633-1640
  • 68 Ates O, Müsellim B, Ongen G. et al . Association between interleukin 10 gene (IL10) polymorphisms and systemic sclerosis with interstitial lung involvement.  Rheumatol Int. 2008;  28 1123-1126
  • 69 Bredemeier M, Chies J A, Wieck A. et al . TCRBV20S1 and TCRBV3S1 Gene Segment Polymorphisms in Systemic Sclerosis.  J Rheumatol. 2008;  35 1058-1063
  • 70 Goh N S, Veeraraghavan S, Desai S R. et al . Bronchoalveolar lavage cellular profiles in patients with systemic sclerosis-associated interstitial lung disease are not predictive of disease progression.  Arthritis Rheum. 2007;  56 2005-2012
  • 71 Martinez J A, Nishimura C, Guatura S B. et al . Elevation of soluble interleukin-2 receptor levels in the bronchoalveolar lavage from patients with systemic sclerosis.  Rheumatol Int. 2001;  21 122-126
  • 72 Andersen G N, Nilsson K, Pourazar J. et al . Bronchoalveolar matrix metalloproteinase 9 relates to restrictive lung function impairment in systemic sclerosis.  Respir Med. 2007;  101 2199-2206
  • 73 Scheja A, Larsen K, Todorova L. et al . BALF-derived fibroblasts differ from biopsy-derived fibroblasts in systemic sclerosis.  Eur Respir J. 2007;  29 446-452
  • 74 Strange C, Bolster M B, Roth M D. et al . Bronchoalveolar lavage and response to cyclophosphamide in scleroderma interstitial lung disease.  Am J Respir Crit Care Med. 2008;  177 91-98
  • 75 Steen V D. The many faces of scleroderma.  Rheum Dis Clin North Am. 2008;  34 1-15; v.
  • 76 Kuwana M, Medsger Jr T A, Wright T M. T cell proliferative response induced by DNA topoisomerase I in patients with systemic sclerosis and healthy donors.  J Clin Invest. 1995;  96 586-596
  • 77 Ioannidis J P, Vlachoyiannopoulos P G, Haidich A B. et al . Mortality in systemic sclerosis: an international meta-analysis of individual patient data.  Am J Med. 2005;  118 2-10
  • 78 Hu P Q, Hurwitz A A, Oppenheim J J. Immunization with DNA topoisomerase I induces autoimmune responses but not scleroderma-like pathologies in mice.  J Rheumatol. 2007;  34 2243-2252
  • 79 Takahashi H, Kuroki Y, Tanaka H. et al . Serum levels of surfactant proteins A and D are useful biomarkers for interstitial lung disease in patients with systemic sclerosis.  Am J Respir Crit Care Med. 2000;  162 258-263
  • 80 Yanaba K, Hasegawa M, Hamaguchi Y. et al . Longitudinal analysis of serum KL-6 levels in patients with systemic sclerosis: association with the activity of pulmonary fibrosis.  Clin Exp Rheumatol. 2003;  21 429-436
  • 81 Kumánovics G, Minier T, Radics J. et al . Comprehensive investigation of novel serum markers of pulmonary fibrosis associated with systemic sclerosis and dermato/polymyositis.  Clin Exp Rheumatol. 2008;  26 414-420
  • 82 Hara T, Ogawa F, Yanaba K. et al . Elevated serum concentrations of polymorphonuclear neutrophilic leukocyte elastase in systemic sclerosis: association with pulmonary fibrosis.  J Rheumatol. 2009;  36 99-105
  • 83 Nomura S, Inami N, Ozaki Y. et al . Significance of microparticles in progressive systemic sclerosis with interstitial pneumonia.  Platelets. 2008;  19 192-198
  • 84 Malerba M, Radaeli A, Ragnoli B. et al . Exhaled nitric oxide levels in systemic sclerosis with and without pulmonary involvement.  Chest. 2007;  132 575-580
  • 85 Tiev K P, Cabane J, Aubourg F. et al . Severity of scleroderma lung disease is related to alveolar concentration of nitric oxide.  Eur Respir J. 2007;  30 26-30
  • 86 Tashkin D P, Elashoff R, Clements P J. et al . Cyclophosphamide versus placebo in scleroderma lung disease.  N Engl J Med. 2006;  354 2655-2666
  • 87 Tashkin D P, Elashoff R, Clements P J. et al . Effects of 1-year treatment with cyclophosphamid on outcomes at 2 years in scleroderma lung disease.  Am J Respir Crit Care Med. 2007;  176 1026-1034
  • 88 Tzelepis G E, Plastiras S C, Karadimitrakis S P. et al . Determinants of pulmonary function improvement in patients with scleroderma and interstitial lung disease.  Clin Exp Rheumatol. 2007;  25 734-739
  • 89 Hoyles R K, Ross W E, Wellsbury J. et al . A multicenter, prospective, randomized, double-blind, placebo-controlled trial of corticosteroids and intravenous Cyclophosphamide followed by oral Azathioprine for the treatment of pulmonary fibrosis in scleroderma.  Arthritis & Rheumatism. 2006;  54 3962-3970
  • 90 Bérézne A, Ranque B, Valeyre D. et al . Therapeutic strategy combining intravenous cyclophosphamide followed by oral azathioprine to treat worsening interstitial lung disease associated with systemic sclerosis: a retrospective multicenter open-label study.  J Rheumatol. 2008;  35 1064-1072
  • 91 Dheda K, Lalloo U G, Casim B. et al . Experience with azathioprine in systemic sclerosis associated with interstitial lung disease.  Clin Rheumatol. 2004;  23 306-309
  • 92 Sabnani I, Zucker M J, Rosenstein E D. et al . A novel therapeutic approach to the treatment of scleroderma-associated pulmonary complications: safety and efficacy of combination therapy with imatinib and cyclophosphamid.  Rheumatology (Oxford). 2009;  48 49-52
  • 93 Paniagua R T, Sharpe O, Ho P P. et al . Selective tyrosine kinase inhibition by imatinib mesylate for the treatment of autoimmune arthritis.  J Clin Invest. 2006;  116 2633-2642
  • 94 Baroni S S, Santillo M, Bevilacqua F. et al . Stimulatory autoantibodies to the PDGF receptor in systemic sclerosis.  N Engl J Med. 2006;  354 2667-2676
  • 95 Kallenberg C G, Jansen H M, Elema J D. et al . Steroid-responsive interstitial pulmonary disease in systemic sclerosis. Monitoring by bronchoalveolar lavage.  Chest. 1984;  86 489-492
  • 96 Krishna Sumanth M, Sharma V K, Khaitan B K. et al . Evaluation of oral methotrexate in the treatment of systemic sclerosis.  International Journal of Dermatology. 2007;  46 218-223
  • 97 Imokawa S, Colby T, Leslie K O. et al . Methotrexate pneumonitis: review of the literature and histopathological findings in nine patients.  Eur Respir J. 2000;  15 373-381
  • 98 Au K, Khanna D, Clements P J. et al . Current concepts in disease-modifying therapy for systemic sclerosis-associated interstitial lung disease: lessons from clinical trials.  Curr Rheumatol Rep. 2009;  11 111-119
  • 99 Nash R A, McSweeney P A, Crofford L J. et al . High-dose immunosuppressive therapy (HDIT) and autologous hematopoietic cell transplantation for severe systemic sclerosis: long-term follow-up of the US multicenter pilot study.  Blood. 2007;  110 1388-1396
  • 100 Shiratsuchi M, Motomura S, Abe Y. et al . Long-term follow-up after nonmyeloablative allogeneic hematopoietic stem cell transplantation for systemic sclerosis.  Clin Rheumatol. 2008;  27 1207-1209
  • 101 Williams T J, Wilson J W. Challenges in pulmonary fibrosis: 7-novel therapies and lung transplantation.  Thorax. 2008;  63 277-284
  • 102 Schachna L, Medsger Jr T A, Dauber J H. et al . Lung transplantation in scleroderma compared with idiopathic pulmonary fibrosis and idiopathic pulmonary arterial hypertension.  Arthritis Rheum. 2006;  54 3954-3961
  • 103 Galiè N, Torbicki A, Barst R. et al . Guidelines on diagnosis and treatment of pulmonary arterial hypertension. The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology.  Eur Heart J. 2004;  25 2243-2278
  • 104 Olschewski H, Hoeper M M, Borst M M. et al . [Diagnosis and therapy of chronic pulmonary hypertension].  Pneumologie. 2006;  60 749-771
  • 105 Hachulla E, Gressin V, Guillevin . et al . Early detection of pulmonary arterial hypertension in systemic sclerosis: a French nationwide prospective multicenter study.  Arthritis Rheum. 2005;  52 3792-3800
  • 106 Murakoshi N, Miyauchi T, Kakinuma Y. et al . Vascular endothelin-B receptor system in vivo plays a favourable inhibitory role in vascular remodeling after injury revealed by endothelin-B receptor-knockout mice.  Circulation. 2002;  106 1991-1998
  • 107 Kulasekaren P, Scavone C A, Rogers D S. et al . Endothelin-1 and TGF-{beta} independently induce fibroblast resistance to apoptosis via AKT activation.  Am J Respir Cell Mol Biol. 2009;  (im Druck)
  • 108 King Jr T E, Behr J, Brown K K. et al . BUILD-1: a randomized placebo-controlled trial of bosentan in idiopathic pulmonary fibrosis.  Am J Respir Crit Care Med. 2008;  177 75-81
  • 109 Seibold J R, Black C M, Denton C P. et al . Bosentan versus placebo in interstitial lung disease secondary to systemic sclerosis (SSc): the BUILD-2 Study [abstract].  Proc Am Thorac Soc. 2006;  3 A243
  • 110 D’Alonzo G E, Barst R J, Ayres S M. et al . Survival in patients with primary pulmonary hypertension. Results form a national prospective registry.  Ann Intern Med. 1991;  115 343-349
  • 111 Rubin L J, Badesch D B, Barst R J. et al . Bosentan therapy for pulmonary arterial hypertension.  N Engl J Med. 2002;  346 896-903
  • 112 McLaughlin V V. Survival in patients with pulmonary hypertension treated with first-line bosentan.  Eur J Clin Invest. 2006;  36 (Suppl. 3) 10-15
  • 113 Barst R J, Langleben D, Badesch D. et al . Treatment of pulmonary arterial hypertension with the selective endothelin-A receptor antagonist sitaxsentan.  J Am Coll Cardiol. 2006;  47 2049-2056
  • 114 Girgis R E, Frost A E, Hill N S. et al . Selective endothelinA receptor antagonism with sitaxsentan for pulmonary arterial hypertension associated with connective tissue disease.  Ann Rheum Dis. 2007;  66 1467-1472
  • 115 Benza R L, Barst R J, Galié N. et al . Sitaxsentan for the treatment of pulmonary arterial hypertension: a 1-year, prospective, open-label observation of outcome and survival.  Chest. 2008;  134 775-782
  • 116 Galiè N, Olschewski H, Oudiz R J. et al . Ambrisentan for the treatment of pulmonary arterial hypertension: results of the ambrisentan in pulmonary arterial hypertension, randomized, double-blind, placebo-controlled, multicenter, efficacy (ARIES) study 1 and 2.  Circulation. 2008;  117 3010-3019
  • 117 Badesch D B, Hill N S, Burgess G. et al . Sildenafil for pulmonary arterial hypertension associated with connective tissue disease.  J Rheumatol. 2007;  34 2417-2422
  • 118 Galiè N, Rubin L J, Hoeper M M. et al . Treatment of patients with mildly symptomatic pulmonary arterial hypertension with bosentan (EARLY study): a double-blind, randomised controlled trial.  Lancet. 2008;  371 2093-2100
  • 119 Olschewski H, Simonneau G, Galie N. et al . Inhaled iloprost for severe pulmonary hypertension.  N Engl J Med. 2002;  347 322-329
  • 120 Hoeper M M, Markevych I, Spiekerkoetter E. et al . Goal-oriented treatment and combination therapy for pulmonary arterial hypertension.  Eur Respir J. 2005;  26 858-863
  • 121 Porhownik N R, Al-Sharif H, Bshouty Z. Addition of sildenafil in patients with pulmonary arterial hypertension with inadequate response to bosentan monotherapy.  Can Respir J. 2008;  15 427-430
  • 122 Dimitroulas T, Giannakoulas G, Karvounis H. et al . N-terminal probrain natriuretic peptide as a biochemical marker in the evaluation of bosentan treatment in systemic-sclerosis-related pulmonary arterial hypertension.  Clin Rheumatol. 2008;  27 655-658
  • 123 Trad S, Amoura Z, Beigelman C. et al . Pulmonary arterial hypertension is a major mortality factor in diffuse systemic sclerosis, independent of interstitial lung disease.  Arthritis Rheum. 2006;  54 184-191
  • 124 Mathai S C, Hummers L K, Champion H C. et al . Survival in pulmonary hypertension associated with the scleroderma spectrum of diseases: impact of interstitial lung disease.  Arthritis Rheum. 2009;  60 569-577
  • 125 Girgis R E, Mathai S C, Krishnan J A. et al . Long-term outcome of bosentan treatment in idiopathic pulmonary arterial hypertension and pulmonary arterial hypertension associated with the scleroderma spectrum of diseases.  J Heart Lung Transplant. 2005;  24 1626-1631
  • 126 Huez S, Roufosse F, Vachiéry J-L. et al . Isolated right ventricular dysfunction in systemic sclerosis: latent pulmonary hypertension?.  Eur Respir J. 2007;  30 928-936
  • 127 Steen V D, Chou M, Shanmugam V. et al . Exercise-induced pulmonary arterial hypertension in patients with systemic sclerosis.  Chest. 2008;  134 146-151
  • 128 Hanitsch L G, Burmester G-R, Witt C. et al . Skin sclerosis is only of limited value to identify SSc patients with severe manifestations – an analysis of a distinct patient subgroup of the German Systemic Sclerosis Network (DNSS) Register.  Rheumatology (Oxford). 2009;  48 70-73
  • 129 Denton C P, Merkel P A, Furst D E. et al . Recombinant human anti-transforming growth factor beta1 antibody in systemic sclerosis: a multicenter, randomized, placebo-controlled phase I/II trial of CAT-192.  Arthritis Rheum. 2007;  56 323-333
  • 130 Hancock A, Armstrong L, Gama R. et al . Production of interleukin 13 by alveolar macrophages from normal and fibrotic lung.  Am J Respir Cell Mol Biol. 1998;  18 60-65
  • 131 Granel B, Allanore Y, Chevillard C. et al . IL13RA2 gene polymorphisms are associated with systemic sclerosis.  J Rheumatol. 2006;  33 2015-2019

Dr. Heiko Knoop

Medizinische Klinik III – Pneumologie, Allergologie, Schlaf- und Beatmungsmedizin
Berufsgenossenschaftliche Universitätsklinik Bergmannsheil GmbH
Klinikum der Ruhr-Universität Bochum

Bürkle-de-la-Camp-Platz 1
44789 Bochum

Email: Heiko.Knoop@ruhr-uni-bochum.de