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Serum CCL18 May Reflect Multiorgan Involvement with Poor Outcome in Systemic Sclerosis.

Kristóf Filipánits1, Gabriella Nagy1, Dávid Kurszán Jász1

  • 1Department of Rheumatology and Immunology, Medical School, University of Pécs, 7632 Pécs, Hungary.

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Summary
This summary is machine-generated.

Elevated serum C-C motif chemokine ligand 18 (seCCL18) in systemic sclerosis (SSc) indicates a more severe, multisystem disease and predicts poorer long-term survival. This biomarker may help identify SSc patients needing closer monitoring and intervention.

Keywords:
CCL18disease activityinterstitial lung diseasemultiorgan involvementprognosisserum biomarkersurvivalsystemic sclerosis

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Area of Science:

  • Rheumatology
  • Immunology
  • Biomarker Discovery

Background:

  • Serum C-C motif chemokine ligand 18 (seCCL18) is linked to interstitial lung disease and mortality in systemic sclerosis (SSc).
  • Its role in non-pulmonary organ involvement, disease activity, and long-term outcomes in SSc remains under-evaluated.

Purpose of the Study:

  • To investigate the clinical relevance of seCCL18 in a systemic sclerosis (SSc) cohort.
  • To assess the association of seCCL18 with organ involvement, disease activity, and survival.

Main Methods:

  • Enzyme-linked immunosorbent assay (ELISA) measured seCCL18 in 151 SSc patients and 47 healthy controls (HCs).
  • Elevated seCCL18 was defined as >130 ng/mL.
  • Organ involvement, disease activity (EUSTAR-AI), and survival were assessed longitudinally.

Main Results:

  • SSc patients exhibited significantly higher seCCL18 levels than HCs (p < 0.01).
  • Elevated seCCL18 correlated with SSc-ILD, reduced lung function (FVC, DLCO), myocardial disease, diastolic dysfunction, and oesophageal involvement.
  • Higher seCCL18 was associated with tendon friction rubs, active disease, and elevated inflammatory markers (CRP, ESR).
  • Elevated seCCL18 independently predicted mortality (HR 1.789, p = 0.013) during 87-month follow-up.

Conclusions:

  • Elevated seCCL18 identifies SSc patients with severe multisystem involvement (cardiopulmonary, gastrointestinal, musculoskeletal) and increased inflammation.
  • seCCL18 may serve as a prognostic biomarker for widespread SSc beyond lung involvement.
  • Further validation in prospective, multicentre studies is needed to establish a definitive cut-off value.