The relationship between vascular biomarkers and disease characteristics in systemic sclerosis: elevated MCP-1 is predominantly associated with fibrotic manifestations.

OBJECTIVES: To determine the relationship between vascular biomarkers reflecting the vascular injury and organ involvement in systemic sclerosis (SSc).

METHODS: Seventy-two SSc patients (66 female) fulfilling 2013 ACR/EULAR Criteria were evaluated. Serum samples of patients were collected for flow-cytometric analysis of sCD40L, tPA, MCP-1, sE-selectin, IL-8, IL-6, VEGF, sP-selectin, TGF-β1 and VCAM levels (Bender MedSystems) in SSc patients and 20 healthy controls. Results were compared with Pearson chi-square/Fisher's and Mann Whitney tests.

RESULTS: Levels of MCP-1 were found to be elevated in patients with diffuse cutaneous SSc, flexion contractures, FVC<80%, DLCO<80%, pulmonary fibrosis and high acute phase response (p=0.002, p=0.005, p=0.045, p=0.005, p=0.036, p=0.006, respectively), TGF-β1 in patients receiving immunosupressives (p=0.001), sE-selectin in patients with high acute phase response (p=0.028), sCD40L in patients with lcSSc (p=0.011) and smoking habitus (p=0.032). MCP-1 and sE-selectin levels were correlated with disease activity score (r=0.243, p=0.040 and r=0.303, p=0.010), MCP-1 and TGF-β1 were correlated with severity of pulmonary involvement (r=0.323, p=0.006 and r=0.312, p=0.008).

CONCLUSIONS: MCP-1 was the prominent biomarker correlated with the manifestations related to fibrosis, disease activity score and severity of pulmonary involvement. Treatment and smoking may have an effect on cytokine profile. Vascular biomarkers can be used to predict the characteristics and severity of SSc warranting prospective studies.