Rheopheresis as a causal therapy option for systemic scleroderma (SSc)

Area of Science:

• Rheumatology
• Immunology
• Vascular Biology

Background:

• Systemic sclerosis is a complex collagenosis characterized by vasculopathy, autoinflammation, and fibroblast dysfunction.
• Vasculopathy is clinically more significant in systemic sclerosis than autoinflammation, unlike other collagenoses such as Lupus erythematosus.

Observation:

• Classical immunosuppressants show limited efficacy, suggesting autoinflammation is not the primary driver of systemic sclerosis.
• Therapeutic strategies focusing on vasculopathy demonstrate greater effectiveness.

Findings:

• Apheresis methods, such as plasmapheresis, reduce plasma proteins including fibrinogen, C-reactive protein, and cytokines.
• Interleukin-6, a key cytokine, is significantly reduced by apheresis, indicating its potential central role.

Implications:

• Targeting interleukin-6 and other plasma proteins via apheresis may offer a novel therapeutic approach for systemic sclerosis.
• Further research into apheresis mechanisms could elucidate the pathomechanism of systemic sclerosis and improve treatment outcomes.