Biomarkers for skin involvement and fibrotic activity in scleroderma

Area of Science:

• Rheumatology
• Dermatology
• Immunology

Background:

• Systemic sclerosis (SSc), or scleroderma, is a severe, heterogeneous autoimmune disease with variable skin and organ manifestations.
• Its pathogenesis involves vascular damage, inflammation, and excessive collagen deposition (fibrosis).
• Monitoring disease activity and fibrotic progression in SSc is challenging due to its heterogeneity.

Purpose of the Study:

• To review non-invasive physical and laboratory biomarkers for assessing skin involvement in SSc.
• To identify methods for monitoring fibrotic activity and therapeutic response in scleroderma patients.
• To explore biomarkers reflecting inflammation and fibrosis in SSc skin.

Main Methods:

• Review of physical examination methods: modified Rodnan skin score (mRSS), durometer, ultrasound for skin thickness.
• Analysis of laboratory biomarkers: growth factors, cytokines, proteases, inhibitors, extracellular matrix (ECM) proteins (e.g., collagens).
• Assessment of molecular techniques: PCR for mRNA levels, gene expression analysis in skin biopsies and serum samples.

Main Results:

• Skin involvement in SSc correlates with fibrosis in other organs, making skin biomarkers valuable.
• Various biomarkers, including proteins and their gene expression, can indicate inflammatory and fibrotic activity.
• Physical and laboratory assessments aid in identifying high-risk patients and monitoring treatment efficacy.

Conclusions:

• Non-invasive biomarkers are crucial for understanding and managing SSc.
• Effective monitoring of fibrotic activity can improve patient stratification and treatment strategies.
• Further research into these biomarkers may lead to better therapeutic options for systemic sclerosis.