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Review
. 2010 Apr 15:6:207-14.
doi: 10.2147/vhrm.s5255.

Recent achievements in the management of Raynaud's phenomenon

Magnus Baumhäkel  1 , Michael Böhm
Affiliations
Review

Recent achievements in the management of Raynaud's phenomenon

Magnus Baumhäkel et al. Vasc Health Risk Manag. .

Abstract

Raynaud's phenomenon is a clinical disorder with episodic digital ischemic vasospasm triggered by cold- or emotional-stress. It was first mentioned by Maurice Raynaud in 1862 describing "a local asphyxia of the extremities" and was further divided into primary Raynaud's disease and secondary Raynaud's phenomenon, which is often related to connective tissue diseases, but also physical or chemical strain. Though pathophysiology of Raynaud's phenomenon is still poorly understood, systemic and local vascular effects are most likely to be involved in primary Raynaud's disease. In secondary Raynaud's phenomenon additional abnormalities in vascular structure and function may play the major role. Thus, medical treatment of Raynaud's phenomenon remains unsatisfactory, due to limited understanding of pathophysiological mechanisms. This review addresses current evidence for medical treatment of primary and secondary Raynaud's phenomenon with regard to pathophysiological mechanisms as well as future perspectives.

Keywords: Raynaud’s disease; mechanisms; treatment.

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Figures

Figure 1
Figure 1
Imbalance of vasoconstriction and vasodilation in Raynaud’s disease. Vasodilators as nitric oxide and prostaglandins act via activation of adenylat- or guanylat-cyclase modulating protein kinase A/G. Vasoconstriction by endothelin or thromboxane is mediated by g-coupled specific receptors and is suggested to be increased in Raynaud’s phenomenon. Abbreviations: cAMP, cyclic adenosine monophosphate; cGMP, cyclic guanylate monophosphate; DAG, diacylglycerol; GTP, guanylate triphosphate; IP3, inositol triphosphate; NO, nitric oxide; PIP2, phosphatidyl inositol biphosphate; PKA, protein kinase A; PKG, protein kinase G; PLC, phospholipase C.
Figure 2
Figure 2
Treatment algorithm for Raynaud’s phenomenon.
See this image and copyright information in PMC

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