AB0668 Calcinosis cutis and its association of serum levels of osteonectin, osteonectin, nitric oxide and tgf-b in systemic sclerosis

Abstract

BackgroundSystemic sclerosis (SSc) is characterized by fibrosis, autoimmunity and vasculopathy. ES is classified subtypes: diffuse (dSSc) and limited (ISSc). More than 35% develop calcinosis. Calcium, phosphorus, parathormone, vitamin D, TGF-β, nitric oxide and osteonectin and osteopontin involved in bone mineralization.ObjectivesThe aim was to compare osteonectin (ON), osteopontin (OP), TGF-β, nitric oxide (NO), Paratohormone (PTH), Vitamin D and minerals concentrations in ES with and without calcinosis.MethodsCross-sectional study in ES patients (ACR criteria). We quantified OP, ON, TGF-β, ON, Calcium, Phosphorus, PTH and vitamin D in serum by ELISA. We performed descriptive statistics, Student t, Pearson correlation (significance p<0.05) in SPSSv21 program.ResultsWe included 71 patients, age 52.94 (± 11.47); 28 (40%) with calcinosis (18 dSSc/10 lSSc), and 43 (60%) without calcinosis (13 dSSc/30 lSSc). Biochemical parameters between two groups. In the whole population the higher PCR had moderate positive correlation (r =0.41, p=0.042), and serum calcium level had a moderate negative correlation (r = -0.47, p=0.021); ON increased in direct relation to OP (r =0.3, p=0.014) and the serum levels of VitD had lower indirect relation with the evolution time of SSc (r = -0.28, P=0.025) and the ON increase in direct relation to serum creatinine (r =0.039, p=0.006).ConclusionsPatients with a longer time evolution of SSc have less serum levels of VitD and those with higher inflammation (PCR) have a higher TGF-β than a potent inducer of fibrosis. PCR and TGF-B have a moderate direct correlation, PCR and Calcium have moderate indirect correlation, ON and OP have a low direct correlation, VitD and evolution of diseases (years) had a low indirect correlation and NO and creatinine had a very low direct correlation.References Fueki H, Hino R, Yoshioka M, Nakamura M, Tokura Y.Calcinosis cutis associated with primary Sjogren's syndrome: strong expression of osteonectin and matrix Gla protein.Rheumatology (Oxford) 2011; 50(12):2318–20.Kim SY, Choi HY, Myung KB, Choi YW.The expression of molecular mediators in the idiopathic cutaneous calcification and ossification. J Cutan Pathol 2008; 35(9):826–31.Ahmed S, O'Neill KD, Hood AF, Evan AP, Moe SM. Calciphylaxis is associated with hyperphosphatemia and increased osteopontin expression by vascular smooth muscle cells. Am J Kidney Dis 2001;37(6):1267–76.Kawakami T, Soma Y, Mizoguchi M, Saito R. Immunohistochemical expression of transforming growth factor beta3 in calcinosis in a patient with systemic sclerosis and CREST syndrome. Br J Dermatol. 2000;143(5):1098–100. Disclosure of InterestNone declared