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Aim of the work: This study aims to assess Growth differentiation factor-15 (GDF-15) level in Scleroderma patients and its relation to disease manifestations. Patients and methods: This study included 55 scleroderma patients and 40 age and sex matched healthy volunteers. All patients were subjected to full history taking, thorough clinical examination, and laboratory investigations. GDF-15 serum levels were analyzed in patients and controls using human GDF-15 immunoassay Quantikine ELISA kit. Results: The GDF-15 serum level was significantly higher in Systemic sclerosis (SSc) patients in comparison to healthy control individuals, p-value = 0.004. In addition, the GDF-15 serum levels increased in a significant way in patients with diffuse SSc than those with limited SSc, p = 0.026. Also, we had discovered a significant positive correlation between serum GDF-15 levels and the modified Rodnan score of the SSc patients, r = 0.442, p = 0.001 and a significant association was found between high GDF-15 level and SSc patients with interstitial pulmonary fibrosis (IPF) as compared to healthy controls (p = 0.002). However, no significant difference was found between SSc patients without IPF and healthy subjects regarding GDF-15 level (p = 0.106). Conclusion: GDF-15 serum levels were elevated in patients with SSc and correlated with the extent of skin fibrosis, and it was found to be higher in SSc patients with IPF. Such results may suggest a pivotal role of GDF-15 in fibrotic changes in SSc, and GDF-15 could be a treatment target in SSc patients in future. [ABSTRACT FROM PUBLISHER]

Objective. To evaluate the clinical significance of anti-angiogenic receptor cluster of differentiation 36 (CD36) in serum of patients with SSc.Methods. We studied 47 SSc patients (28 with lcSSC and 19 with dcSSC) and 38 age- and gender-matched healthy controls. Demographic, clinical, autoantibodies and serological data were prospectively assessed. Peripheral vascular affection was classified into mild, moderate, severe or end-stage based on a vascular severity scale. Soluble CD36 (sCD36) serum levels were measured using ELISA.Results. Serum sCD36 levels were significantly higher in patients with SSc compared with healthy controls (P = 0.045). When the patients were divided into clinical subsets, sCD36 was higher in lcSSc than in healthy controls (P = 0.03). Levels of sCD36 were found to be positively correlated with pulmonary artery systolic pressure (PASP) and negatively correlated with percentage diffusing lung capacity for carbon monoxide (DLCO). In the multivariate analysis, 50% of the variation of sCD36 levels could be explained by elevated PASP (0.000), telangiectasias (0.026) and increasing vascular severity (P = 0.003).Conclusion. Serum sCD36 levels were higher in SSc patients (particularly the limited subset) than in healthy controls and were found to be correlated with PASP and vascular severity. We conclude that sCD36 may be a marker for elevated PASP and vascular involvement in SSc. To confirm our results we propose that larger scale, multicentre studies with longer evaluation periods are needed. [ABSTRACT FROM PUBLISHER]

Abstract: Objective: A proliferation-inducing ligand (APRIL) is a new member of the tumour necrosis factor family which is intimately connected to the regulation of cellular pathways. The aim of this study was to assess serum concentrations of APRIL in systemic sclerosis patients, and to correlate them with the main clinical and serological features of the disease. Methods: Sera from 35 patients with systemic sclerosis, 25 had limited cutaneous and 10 had diffuse cutaneous subtypes, and 35 normal healthy subjects were assayed for APRIL by Enzyme Linked Immunosorbant Assay. Demographic, clinical, autoantibodies and serological data were prospectively assessed. Results: Serum APRIL concentrations were higher in patients with systemic sclerosis and in both its subtypes compared to the healthy controls (p <0.0001 in all). Patients with elevated APRIL levels had significantly higher incidences of myositis than those with normal levels (p =0.04). We did not find significant differences in other organ involvement prevalence between systemic sclerosis patients with elevated vs. normal APRIL levels. In addition, the frequencies of autoantibodies (i.e., anti-topoisomerase I, anti-centromere) were comparable between both groups. Serum APRIL levels were correlated with serum γ-globulins concentrations (r =0.404, p =0.016) but not with C-reactive protein, skin score, nor pulmonary functions. Serum APRIL was also correlated with creatine kinase levels only in systemic sclerosis patients with myositis (r =0.786, p =0.02). Conclusion: Our preliminary results suggest increased serum APRIL levels in systemic sclerosis patients, particularly in those associated with myositis and hypergammaglobinemia. To confirm our results, we propose that larger scale, multicentre studies with longer evaluation periods are needed. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to search for a possible pathological involvement of renal arteries among patients with systemic sclerosis (SSc) and to correlate the findings with renal functions. Patients and methods: Fourteen female patients with SSc were recruited for this study. The diagnosis and classification of SSc was based on the 1980 American College of Rheumatology criteria for classification of SSc. Nine patients had diffuse-type SSc, and the remaining five belonged to the limited type of the disease. All patients were evaluated by history-taking, clinical examination, laboratory investigations and renal angiography. Results: Three out of the nine patients (33.3%) with diffuse SSc had tortuous renal arteries, but there were none in the limited type. Two patients (22.2%) with diffuse SSc had ectatic renal arteries and three (33.3%) had osteal renal artery stenosis. Tortuous abdominal aorta was detected in one patient (11.1%) with diffuse SSc and congenital double renal artery in another (11.1%). Two out of the five patients with limited-type disease (40%) had osteal renal artery stenosis that was bilateral in one case. Bilateral renal artery affection was observed in 3/14 studied patients (21.42%), and two of these had diffuse disease and one had limited disease. Three patients had hypertension (two had diffuse pattern and one had limited pattern). Conclusion: We consider that renal artery stenosis is the most important among all the findings detected and should be considered in SSc patients presenting with renal crisis because use of angiotensin converting enzyme (ACE) inhibitors in this situation may be deleterious rather than beneficial. [ABSTRACT FROM AUTHOR]