Serum levels of biomarkers related to severity staging of Raynaud's phenomenon, neurosensory manifestations, and vibration exposure in patients with hand-arm vibration injury

Abstract

Our aim was to explore possible relationships between serum levels of biomarkers in patients with hand-arm vibration injury in relation to the severity of the vascular, i.e., Raynaud's phenomenon (RP), and neurosensory manifestations, the current exposure level, and the duration of exposure. This study was of case series design and involved 92 patients diagnosed with hand-arm vibration injury. Jonckheere's trend test was used to assess any association between serum levels of biomarkers and RP as well as neurosensory manifestations, graded by the International Consensus Criteria. Generalized linear models with adjustment for possible confounders were also used for associations between serum levels of biomarkers and; (1) severity of RP recorded as the extent of finger blanching calculated with Griffin score, (2) vibration perception thresholds, (3) magnitude of current exposure as [A(8); (m/s²)] value, and (4) the duration of exposure in years. Serum levels of thrombomodulin, von Willebrand factor, calcitonin gene related peptide (CGRP), heat shock protein 27, and caspase-3 were positively associated with severity of RP. Serum levels of CGRP were positively associated with the neurosensory component. No associations with exposure were shown for these biomarkers. For Intercellular adhesion molecule 1 and monocyte chemoattractant protein 1, no associations were found with neither severity nor exposure. Levels of serum biomarkers associated with endothelial injury or dysfunction, inflammation, vasodilation, neuroprotection, and apoptosis were positively associated with the severity of hand-arm vibration injury.

Keywords: Aβ fibers; Aδ fibers; C-fibers; Cold intolerance; Endothelial dysfunction; Grading of injury; Hand-arm vibration syndrome (HAVS); Neuroprotection; Occupational; Serum biomarkers; Vibration exposure.

Figure 1

The scheme of the studies.

Figure 2

Distribution of serum levels of (a) thrombomodulin (TM), (b) von Willebrand factor (vWf), (c) and (f) calcitonin gene-related peptide (CGRP), (d) heat shock protein 27 (HSP27), (e) caspase-3 in relation to severity of vascular (blue boxes, 82 patients) and sensorineural manifestations (green boxes, 92 patients), as graded by the International Classification Criteria ICC. Medians are indicated with a line. Boxes represent interquartile ranges. Values that are more than 1.5 (circles) or 3 times (stars) higher than the third quartile are indicated as outliers. Error bars indicate min–max values that are not outliers. One patient with S-CGRP 3700 pg/mL; ICC 2 V and 1N, one with S-HSP27 45 ng/mL; ICC 0 V, one with caspase-3 85 ng/mL; ICC 0 V and one with caspase-3 61 ng/mL; ICC 3 V, are not shown as the axes are cut.