The Clinical Significance of Salusins in Systemic Sclerosis—A Cross-Sectional Study

Abstract

Background: Systemic sclerosis (SSc) is a connective tissue disease manifesting with progressive fibrosis of the skin and internal organs. Its pathogenesis is strictly associated with vascular disfunction and damage. Salusin-α and salusin-β, endogenous peptides regulating secretion of pro-inflammatory cytokines and vascular smooth muscle proliferation, may potentially play a role in SSc pathogenesis. Objectives: The aim of this study was to assess the concentration of salusins in sera of patients with SSc and healthy controls and to evaluate correlations between the salusins levels and selected clinical parameters within the study group. Materials and methods: 48 patients with SSc (44 women; mean age, 56.4, standard deviation, 11.4) and 25 adult healthy volunteers (25 women; mean age, 55.2, standard deviation, 11.2) were enrolled. All patients with SSc were treated with vasodilators and twenty-seven of them (56%) also received immunosuppressive therapy. Results: Circulating salusin-α was significantly elevated in patients with SSc in comparison to healthy controls (U = 350.5, p = 0.004). Patients with SSc receiving immunosuppression had higher serum salusin-α concentrations compared with those without immunosuppressive therapy (U = 176.0, p = 0.026). No correlation was observed between salusins concentrations and skin or internal organ involvement parameters. Conclusions: Salusin-α, a bioactive peptide mitigating the endothelial disfunction, was elevated in patients with systemic sclerosis receiving vasodilators and immunosuppressants. Increased salusin-α concertation may be associated with the initiation of atheroprotective processes in patients with SSc managed pharmacologically, which requires verification in future studies.

Biomarkers in Systemic Sclerosis: An Overview

“…Recent studies have shown how vast and ever-expanding the field of biomarkers is in SSc. Biomarkers will become increasingly important in research and, consequently, in the diagnosis and therapeutic approach to SSc [30][31][32][33][34][35][36][59][60][61][62][63][64][65][66][67]. Several studies have demonstrated the involvement of at least 240 pathways and numerous dysregulated proteins in the pathogenesis of SSc, so the field of biomarkers in this disease is complex and evolving [30][31][32][33][34][35][36][59][60][61][62][63][64][65][66][67].…”

“…Biomarkers will become increasingly important in research and, consequently, in the diagnosis and therapeutic approach to SSc [30][31][32][33][34][35][36][59][60][61][62][63][64][65][66][67]. Several studies have demonstrated the involvement of at least 240 pathways and numerous dysregulated proteins in the pathogenesis of SSc, so the field of biomarkers in this disease is complex and evolving [30][31][32][33][34][35][36][59][60][61][62][63][64][65][66][67]. Cytokeratin 17 (CK17), marginal zone protein B1 (MZB1), and leucine-rich α2-glycoprotein-1 (LRG1) appear to be potential biomarkers for SSc, with CK17 negatively associated with disease severity and higher values of CK17 protective [37,[59][60][61][62][63][64][65][66][67].…”

“…Several studies have demonstrated the involvement of at least 240 pathways and numerous dysregulated proteins in the pathogenesis of SSc, so the field of biomarkers in this disease is complex and evolving [30][31][32][33][34][35][36][59][60][61][62][63][64][65][66][67]. Cytokeratin 17 (CK17), marginal zone protein B1 (MZB1), and leucine-rich α2-glycoprotein-1 (LRG1) appear to be potential biomarkers for SSc, with CK17 negatively associated with disease severity and higher values of CK17 protective [37,[59][60][61][62][63][64][65][66][67]. A potential therapeutic target could be endostatin, which is associated with vascular manifestations in SSc and is specifically elevated in progressive SSc; it has been considered a marker of disease severity [38,[62][63][64][65][66][67].…”

“…Cytokeratin 17 (CK17), marginal zone protein B1 (MZB1), and leucine-rich α2-glycoprotein-1 (LRG1) appear to be potential biomarkers for SSc, with CK17 negatively associated with disease severity and higher values of CK17 protective [37,[59][60][61][62][63][64][65][66][67]. A potential therapeutic target could be endostatin, which is associated with vascular manifestations in SSc and is specifically elevated in progressive SSc; it has been considered a marker of disease severity [38,[62][63][64][65][66][67].…”

“…Nail fold video capillaroscopy (NVC) plays an important role because it is a noninvasive and reliable method to detect microvascular involvement. NVC is now formally used to classify SSc because it plays a diagnostic role in recognizing microvascular involvement [3,4,26,[60][61][62][63][64][65][66][67][68]. Indeed, the presence of capillaroscopic abnormalities of the nail fold, together with the presence of ANA and recurrent Raynaud's phenomenon, are predictive factors for progression to definitive SSc.…”