Biomarker patterns across skin-lung-gut burden in systemic sclerosis

Area of Science:

• Immunology
• Rheumatology
• Biomarker Discovery

Background:

• Systemic sclerosis (SSc) is a multisystem autoimmune disease.
• Skin, lung, and gastrointestinal involvement frequently co-occur in SSc patients.
• The relationship between increasing organ co-involvement and circulating biomarker patterns in SSc is not well understood.

Purpose of the Study:

• To investigate immune, inflammatory, and nutritional biomarker patterns in relation to the burden of skin, lung, and gastrointestinal involvement in SSc.
• To identify specific biomarkers that correlate with the extent of multisystem involvement in SSc.

Main Methods:

• Retrospective cross-sectional study of 314 SSc patients.
• Patients classified into 0-Axis, 1-Axis, 2-Axis, and 3-Axis groups based on skin, lung, and gastrointestinal involvement.
• Biomarker distributions (including Anti-Scl-70, hs-CRP, albumin, total cholesterol) compared across groups.
• Multinomial logistic regression and unsupervised clustering used for analysis.

Main Results:

• Anti-Scl-70 positivity significantly increased with higher organ burden (p<0.001).
• Lower albumin levels were associated with increased organ involvement (p=0.005).
• Higher burden groups showed distinct patterns in Anti-Scl-70, albumin, and total cholesterol levels.

Conclusions:

• Increasing skin-lung-gut co-involvement in SSc is linked to structured circulating biomarker patterns.
• Anti-Scl-70 positivity and lower albumin are key biomarkers associated with higher disease burden.
• Findings support a biomarker-informed approach to understanding multisystem involvement in SSc.