Studies on Raynauds Phenomenon

Overview

Every year, academic studies are published on Raynaud's phenomenon or related conditions. Broadly speaking, there are two types of studies. The first are peer reviewed. Generally, the content of these studies has been reviewed by scientists or physicians. Peer-reviewed studies are typically published in scientific journals and are usually available at medical libraries. The second type of studies is non-peer reviewed. These works include summary articles that do not use or report scientific results. These often appear in the popular press, newsletters, or similar periodicals.

In this chapter, we will show you how to locate peer-reviewed references and studies on Raynaud's phenomenon. We will begin by discussing research that has been summarized and is free to view by the public via the Internet. We then show you how to generate a bibliography on Raynaud's phenomenon and teach you how to keep current on new studies as they are published or undertaken by the scientific community.

Federally Funded Research on Raynaud's Phenomenon

The U.S. Government supports a variety of research studies relating to Raynaud's phenomenon and associated conditions. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.18 CRISP (Computerized Retrieval of Information on Scientific

18 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control

Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Visit CRISP at http://commons.cit.nih.gov/crisp3/Crisp_Query.Generate_Screen. You can perform targeted searches by various criteria including geography, date, as well as topics related to Raynaud's phenomenon and related conditions.

For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore Raynaud's phenomenon and related conditions. In some cases, therefore, it may be difficult to understand how some basic or fundamental research could eventually translate into medical practice. The following sample is typical of the type of information found when searching the CRISP database for Raynaud's phenomenon:

• Project Title: DORSAL SPINAL CORD STIMULATION-VASODILATOR MECHANISMS

Principal Investigator & Institution: Foreman, Robert D.; Physiology; University of Oklahoma Hlth Sciences Ctr Health Sciences Center Oklahoma City, Ok 73190

Timing: Fiscal Year 2001; Project Start 1-JUL-1999; Project End 0-JUN-2003

Summary: (Adapted from the applicant's abstract): Electrical stimulation of the dorsal spinal cord (SCS) is used to provide pain relief in patients with peripheral vascular disease (PVD). Clinical and basic science studies indicate that the beneficial effect of SCS in PVD is associated with increased blood flow to the extremities. Previous work from the applicant's laboratory has demonstrated that SCS-induced vasodilation is mediated by antidromic activation of primary afferent neurons resulting in release of a vasodilator peptide from peripheral sensory nerve endings. The overall goal of this proposal is to investigate the antidromic mediated mechanisms involved in the peripheral vascular responses to SCS. Four Specific Aims are proposed to address this hypothesis. In Specific Aim 1 the investigators will test the hypothesis that antidromic release of vasoactive peptides is the primary mechanism of SCS-induced vasodilation at clinically relevant intensities. This protocol will be examined in anesthetized and in conscious, freely moving animals. Specific Aim 2 will test the hypothesis that SCS-induced antidromic activation of afferent nerves can be directly demonstrated through and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

measurement of increased electrical activity in sensory nerves. This protocol involves assessment of afferent nerve activity in response to SCS. In Specific Aim 3 the investigators will test the hypothesis that the antidromic mediated effects of SCS produce increased vascular permeability, and the increased permeability is due to activation of neurokinin-1 receptors by Substance P release from sensory nerve endings in the peripheral vasculature. This protocol involves assessment of changes in peripheral vascular permeability through examination of Evan's blue extravasation and translocation of Monastral blue from intravascular to extravascular spaces. The investigators also will examine the contribution of calcitonin gene-related peptide on permeability changes due to SCS. In Specific Aim 4 they hypothesize that the antidromic effects of SCS require activation of synaptic pathways in the spinal cord. This protocol addresses the peripheral vasodilator effects of SCS before and after intraspinal microinjection of pharmacological antagonists of gamma-aminobutyric acid and excitatory amino acids. Results of the overall investigation will further define the antidromic effects of SCS related to peripheral vascular mechanisms and spinal pathways involved in eliciting this effect. The results also will demonstrate the importance of using SCS as a tool to investigate the effects of antidromic-induced release of vasoactive substances from sensory nerve endings. Ultimately, information obtained from these studies has potential clinical application not only to peripheral vascular disease but also to diverse processes such as wound healing, tissue inflammation, angina pectoris, autonomic dysreflexia and Raynaud's phenomenon.

Website: http:// commons.cit.nih.gov/ crisp3/Crisp_Query.Generate_Screen

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