Abstract

BackgroundEndothelial damage and activation may play central roles in the pathogenesis of systemic sclerosis (SSc) and are reflected by microparticles (MPs) and soluble selectins. The objective of this study was to determine if these potential biomarkers are associated with specific organ involvements or cutaneous subgroups of SSc patients.MethodMPs in platelet-poor plasma from 121 patients with SSc, 79 and 42 with limited and diffuse cutaneous disease, respectively, were characterized by flow cytometry for their capacity to bind annexin V in combination with surface markers of either platelets (PMPs), leukocytes (LMPs) or endothelial cells (EMPs). Soluble E- and P-selectin levels were determined in plasma. By correlation analyses, this was held against involvement of skin, lung function, lung fibrosis, pulmonary artery hypertension, and serology.ResultsNone of the markers were associated with cutaneous subgroups of SSc. Concentrations of annexin V non-binding EMPs and annexin V non-binding LMPs were negatively correlated to pulmonary diffusing capacity (DLCO) (r = -0.28; p = 0.003; r = -0.26; p = 0.005) and forced vital capacity (FVC) (r = -0.24; p = 0.009; r = -0.29; p = 0.002), driven by patients with limited and diffuse cutaneous disease, respectively. Soluble E-selectin levels correlated negatively to DLCO (r = -0.21, p = 0.03) and FVC (r = -0.25; p = 0.007); and soluble P-selectin correlated negatively to DLCO (r = -0.23, p = 0.01).ConclusionNegative correlations between annexin V non-binding EMP and LMP concentrations with lung function parameters (DLCO and FVC) differed between limited and diffuse cutaneous subsets of SSc, indicative of various pathogeneses of lung involvement in SSc, possibly with a differential role of MPs.

Highlights

  • Endothelial damage and activation may play central roles in the pathogenesis of systemic sclerosis (SSc) and are reflected by microparticles (MPs) and soluble selectins

  • In this study, we found the concentration of AnxV− EMPs and AnxV− LMPs to be inversely correlated with the lung function in SSc patients as measured by DLCO and forced vital capacity (FVC)

  • In this study of a large number of clinically wellcharacterized SSc patients that were sampled under controlled and identical conditions, we find that levels of circulating AnxV− EMPs and AnxV− LMPs are inversely correlated with the lung function as measured by DLCO and FVC

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Summary

Introduction

Endothelial damage and activation may play central roles in the pathogenesis of systemic sclerosis (SSc) and are reflected by microparticles (MPs) and soluble selectins. SSc is classified according to the extent of skin involvement in a limited cutaneous (lcSSc) and a diffuse cutaneous (dcSSc) type, which may have different pathogenesis, clinical courses and prognoses [1]. Lung function tests showing an isolated reduction of the diffusing capacity is most commonly seen in lcSSc while restrictive lung disease is more typical of dcSSc [3, 4, 7]. These two patterns of abnormal lung function may represent different types of pathogenesis rather than different stages of development

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