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Toward personalized medicine in scleroderma: classification of scleroderma patients into stable "inflammatory" and

Andrew Leask1

  • 1Department of Dentistry, Dental Sciences Building, Western University, London, Ontario, Canada. Andrew.leask@schulich.uwo.ca

The Journal of Investigative Dermatology
|April 14, 2012
PubMed

Insights

Scleroderma patients have distinct gene expression profiles that remain stable over time. This finding suggests personalized treatment strategies targeting either inflammation or fibrosis for better patient outcomes.

Area of Science:

  • Rheumatology
  • Genomics
  • Immunology

Background:

  • Scleroderma treatment remains challenging due to a lack of universally agreed-upon therapies.
  • Recent research has elucidated fundamental disease mechanisms, suggesting anti-inflammatory and anti-fibrotic agents as potential treatments.
  • Translating this knowledge into clinical practice has been limited.

Purpose of the Study:

  • To investigate the stability of gene expression profiles in scleroderma patients over time.
  • To determine if inflammatory profiles in scleroderma patients evolve into fibroproliferative profiles.
  • To explore the potential of gene expression profiling for guiding scleroderma treatment strategies.

Main Methods:

  • Genome-wide expression profiling was utilized to analyze gene expression patterns in scleroderma patients.
  • Patient samples were categorized based on previously identified 'inflammatory' and 'fibroproliferative' gene expression profiles.
  • Longitudinal analysis was performed to assess the stability of these profiles over time.

Main Results:

  • The study found that scleroderma patients' gene expression profiles are fixed and do not change over time.
  • Patients with an 'inflammatory' profile did not transition to a 'fibroproliferative' profile, and vice versa.
  • This stability suggests distinct disease subtypes within scleroderma.

Conclusions:

  • Gene expression profiling can identify distinct, stable patient subgroups in scleroderma.
  • These stable profiles may enable the design of targeted clinical trials.
  • Inflammatory scleroderma subtypes could benefit from anti-inflammatory agents, while fibroproliferative subtypes may respond to anti-fibrotic agents.

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