Sildenafil increases digital skin blood flow during all phases of local cooling in primary Raynauds phenomenon

摘要

Digital skin vasoconstriction on local cooling is exaggerated in primary Raynaud’s phenomenon (RP) compared to controls. A significant part of such vasoconstriction relies on the nitric oxide (NO) pathway inhibition. We tested the effect of PDE5 inhibitor sildenafil, which potentiates the effect of NO, on skin blood flow. We recruited 15 patients with primary RP, performing local cooling without sildenafil (day 1), after a single 50 mg oral dose (day 2), and 100 mg (day 3). Skin blood flow, skin temperature and arterial pressure were recorded, and data were expressed as cutaneous vascular conductance (CVC). Sildenafil at 100 mg, but not 50 mg, significantly lessened the cooling-induced decrease in CVC. It also increased resting CVC and skin temperature. These data suggest that 100 mg sildenafil improves digital skin blood flow to local cooling in primary RP. The benefit of sildenafil “as required” should be confirmed in a randomized controlled trial.