title: The relationship between vascular biomarkers and disease characteristics in systemic sclerosis: elevated MCP-1 is predominantly associated with fibrotic manifestations.
abstract: OBJECTIVE
  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.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Turkey. yasemin_sahinkaya@hotmail.com.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Yalçinkaya
authors.affiliation: Department of Immunology, Institute of Experimental Research (DETAE), Istanbul University, Turkey.
authors.forename: Suzan
authors.initials: S
authors.lastname: Çinar
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Turkey.
authors.forename: Bahar
authors.initials: B
authors.lastname: Artim-Esen
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Turkey.
authors.forename: Sevil
authors.initials: S
authors.lastname: Kamali
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Turkey.
authors.forename: Lale
authors.initials: L
authors.lastname: Öcal
authors.affiliation: Department of Immunology, Institute of Experimental Research (DETAE), Istanbul University, Turkey.
authors.forename: Günnur
authors.initials: G
authors.lastname: Deniz
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Inanç
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000097:blood*; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D005355:Fibrosis; D005434:Flow Cytometry; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011658:Pulmonary Fibrosis / Q000097:blood* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D045743:Scleroderma, Diffuse / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D012595:Scleroderma, Systemic / Q000097:blood* / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D012907:Smoking / Q000009:adverse effects; D013710:Tendons / Q000473:pathology*; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; C111835:CCL2 protein, human; D018932:Chemokine CCL2; D007166:Immunosuppressive Agents