Eicosanoids and rheumatology: inflammatory and vascular aspects.

Eicosanoids are not only involved in inflammation but also are important in the maintenance of blood vessel tone and blood flow. This may be relevant in the rheumatological disorders of vasculitis and RS. Although little work has been carried out in vasculitis, the beneficial effects of the natural and synthetic antiplatelet vasodilator PGs in RS are well documented. Less well tested has been the effects of manipulation of AA metabolism. It should be remembered however that many patients with Raynaud's Phenomenon do not have an associated rheumatological disorder. Conservative management with vasodilators such as the calcium channel blockers may be very successful (119). At the present time PG treatment should be reserved for patients with severe RS, particularly those whose Raynaud's is complicated by digital ulceration.