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Vol. 21. Issue 5.
(May 2025)
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Vol. 21. Issue 5.
(May 2025)
Special Article
Some aspects of body thermoregulation, environmental temperature and vascular hypothesis in systemic sclerosis patients
Algunos aspectos de la termorregulación corporal, de la temperatura ambiental y de la hipótesis vascular en pacientes con esclerosis sistémica
Francisco Javier Olmedo Garzón
Clínica Amstrong Internacional, Calle Guzmán el Bueno, 102, 28003 Madrid, Spain
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Abstract

In line with vascular hypothesis of systemic sclerosis (SSc), it is proposed that visceral Raynaud's phenomenon (RP)/endothelial dysfunction causes severe oxygen supply/consumption imbalance in internal organs, leading to visceral ischemic failure in early SSc, especially with cold environmental temperature (Te) and severe RP. There would also be a decrease in body thermogenesis and a decrease in heat loss caused by chronic visceral ischemia and by systemic vasculopathy, respectively. At any given time, these disorders could produce low core temperature (Tc). Hence, SSc is proposed as a candidate cause of secondary hypothermia. It is suggested that SSc could be an adaptive response in cold Te to systemic endothelial damage with secondary chronic visceral ischemia/slow metabolism. This pathophysiological mechanism is proposed in early visceral failure, prognosis, SSc phenotype according to ethnicity, and other manifestations. The impact of Te and Tc on SSc warrants further investigations.

Keywords:
Temperature and scleroderma
Body core temperature and scleroderma
Raynaud's phenomenon and scleroderma
Resumen

Siguiendo la hipótesis vascular de la esclerosis sistémica (ES), se propone que el fenómeno de Raynaud (FR) visceral y la disfunción endotelial producen un desajuste entre el aporte de oxígeno y su consumo en las vísceras, produciendo isquemia/insuficiencia visceral en la ES precoz con temperaturas ambiente (Ta) frías y FR severo. Habría también una disminución de la termogénesis corporal y de la pérdida de calor causadas respectivamente por la isquemia visceral crónica y por la vasculopatía sistémica. Estas alteraciones podrían producir en un momento dado un descenso de la temperatura central corporal (Tc), postulándose la ES como causa candidata de hipotermia secundaria. Se sugiere que la ES podría ser una respuesta adaptativa en ambientes fríos al daño endotelial sistémico con isquemia visceral crónica y metabolismo lento secundarios. Esta fisiopatología de la ES se propone en la insuficiencia visceral precoz, su pronóstico, fenotipo étnico y en otras manifestaciones. La influencia de la Ta y la Tc sobre la ES requiere más investigaciones.

Palabras clave:
Temperatura y esclerodermia
Temperatura corporal central y esclerodermia
Fenómeno de Raynaud y esclerodermia

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