The association between changes in skin echogenicity and the fibroblast production of biglycan and versican in systemic sclerosis.
OBJECTIVE
To investigate a possible association between the longitudinal changes in skin involvement and the fibroblast production of proteoglycans in vitro, among patients with early and untreated systemic sclerosis (SSc).


METHODS
In 11 patients, 6 with diffuse cutaneous systemic sclerosis (dSSc) and 5 with limited cutaneous systemic sclerosis (ISSc), and in 6 controls skin thickness and skin echogenicity of the forearm was measured by high frequency (20 MHz) ultrasound. A skin biopsy was taken from the area of the ultrasound measurements, and from cultivated fibroblasts the production of the proteoglycans versican, perlecan, biglycan and decorin were measured. To investigate longitudinal changes in skin involvement, the ultrasound examination was repeated after 1-3 years.


RESULTS
Compared to controls, SSc patients had increased skin thickness at the first evaluation. Patients with dSSc had lower skin echogenicity than both patients with lSSc and the controls. Patients with greater changes in skin thickness and skin echogenicity produced more versican, whereas the production of biglycan and decorin was higher only in patients with greater changes in skin echogenicity. There was a negative correlation between fibroblast production of biglycan and disease duration.


CONCLUSIONS
High fibroblast synthesis of the proteoglycans versican and biglycan is associated with changes in skin echogenicity and may predict more progressive skin sclerosis in SSc.
Hesselstrand
R
R
Department of Rheumatology, Lund University Hospital, Sweden. r.hesselstrand@telia.com
Westergren-Thorsson
G
G
Scheja
A
A
Wildt
M
M
Akesson
A
A
D000328:Adult; D000368:Aged; D058578:Biglycan; D001706:Biopsy; D002478:Cells, Cultured; D011508:Chondroitin Sulfate Proteoglycans / Q000096:biosynthesis*; D015331:Cohort Studies; D058575:Decorin; D016326:Extracellular Matrix Proteins; D005260:Female; D005347:Fibroblasts / Q000378:metabolism* / Q000473:pathology; D019812:Heparan Sulfate Proteoglycans / Q000096:biosynthesis; D006801:Humans; D037181:Lectins, C-Type; D008297:Male; D008875:Middle Aged; D011509:Proteoglycans / Q000096:biosynthesis*; D012595:Scleroderma, Systemic / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology*; D012867:Skin / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D014463:Ultrasonography; D053675:Versicans
C546884:BGN protein, human; D058578:Biglycan; D011508:Chondroitin Sulfate Proteoglycans; C546878:DCN protein, human; D058575:Decorin; D016326:Extracellular Matrix Proteins; D019812:Heparan Sulfate Proteoglycans; D037181:Lectins, C-Type; D011509:Proteoglycans; C508322:VCAN protein, human; D053675:Versicans; C071927:perlecan