Abstract
patient samples. Results: Luminex array profiling of the dermal blister fluid showed increased inflammatory cytokines (mean IL-6 in SSc-77.2 pg/ml, HC17.8 pg/ml, P1⁄40.009, mean IL-17 in SSc-0.61 pg/ml, HC0 pg/ml, P1⁄40.03),and vascular growth factors (VEGF21.7 pg/ml in SSc, HC13.5 pg/ml (P1⁄40.26), PDGF-aa 16.4 pg/ml in SSc, HC-0.97 pg/ml, P1⁄40.049). Additionally MCP-3(CCL7), IL-15 and IFN-g were all significantly increased in SSc compared with HC (P<0.05). Within the serum, Luminex array profiling highlighted a significant increase in mean IL-12p40 (SSc-31.7 pg/ml, HC-2.05 pg/ml, P1⁄40.012) and mean IL-1a (SSc-21.15 pg/ml, HC-2.25 pg/ml, P1⁄4 0.029) in SSc compared with controls. There was no significant difference for other cytokines. Comparing the luminex array profiling of the dermal blister fluid from those with SSc, with the paired serum samples, the only significant correlation was in MCP-3 (r1⁄40.31, P1⁄40.013). Other proinflammatory cytokines [IL-6 (r1⁄40.083, P1⁄40.23), IL-17 (r1⁄40.02, P1⁄40.56)] and growth factors [VEGF (r1⁄40.03, P1⁄40.47), PDGF (r1⁄40.08, P1⁄4 0.22)] showed no correlation between serum samples and dermal blister fluid. Interestingly, the healthy controls showed greater correlation between the Luminex array results from the dermal blister fluid and serum samples, with many reaching significance (IL-10, MCP-3, IL1ra, FGF-2). Conclusion: Our results confirm the potential utility of dermal blister fluid to define local biological processes in SSc, and identifies profibrotic, angiogenic and T-cell derived factors expressed locally within the skin lesions. In contrast, analysis plasma samples revealed elevation of monocyte derived inflammatory proteins. Absence of correlation between the interstitial fluid samples and paired serum samples suggests that the dermal blister sampling method reflects local dermal protein expression rather than exudates from the plasma into the skin. This dermal suction method offers an opportunity to profile the local inflammatory process occurring within the skin and has potential to complement clinical and gene expression based classification to facilitate targeted therapy, as well as providing potential markers of disease activity or treatment effect. Disclosure statement: The authors have declared no conflicts of interest.
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