145 results on '"Skin sclerosis"'
Search Results
2. Application of integrated traditional chinese and western medicine in treatment of systemic sclerosis: A case report.
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Wang, Xiao-han, Zhang, Jia-qian, Kong, Qi, Tu, Wen-zhen, Chen, Li-ming, and Zhao, Yin-huan
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- 2023
- Full Text
- View/download PDF
3. A Study of the Efficacy and Safety of Rituximab in Participants With Systemic Sclerosis (DesiReS)
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Japan Agency for Medical Research and Development, Zenyaku Kogyo Co., Ltd., and Ayumi Yoshizaki, Principal Investigator
- Published
- 2020
4. Drug-induced scleroderma-like lesion
- Author
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Yasuhito Hamaguchi
- Subjects
Drug ,Fibrosis ,Morphea ,Scleroderma ,Skin sclerosis ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Drug-induced scleroderma-like lesion is a condition in which administration of a drug induces skin sclerotic lesions similar to systemic sclerosis or morphea. The clinical manifestations of drug-induced scleroderma-like lesion can be divided into two types: scleroderma-like lesions and morphea-like plaques. A wide variety of drugs can cause drug-induced scleroderma-like lesion. Bleomycin, L-tryptophan, vinyl chloride, and phytonadione (vitamin K1) have been reported, but in recent years, cases due to chemotherapeutic agents, such as taxane-based agents, gemcitabine, and tegafur-uracil, and immune checkpoint inhibitors have increased. Drug-induced scleroderma-like lesion differs from systemic sclerosis in that it does not include Raynaud's phenomenon, nail-fold capillary abnormality, organ involvement, such as reflux esophagitis, interstitial pneumonia, renal crisis, or anti-nuclear Abs. On the other hand, there are reports of cases in which Raynaud's phenomenon, positive conversion of anti-nuclear Abs, and development of skin sclerosis from the fingers developed after initiation of the drug. Whether the skin sclerosis improves after discontinuation of the drug depends on the patient. In patients with severe skin sclerosis, functional impairment, such as flexion contracture of the fingers, may occur, and systemic therapy, such as steroids, may be necessary. When treating patients with skin sclerosis, it is important to keep in mind the possibility that the sclerotic lesion may be induced by a drug.
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- 2022
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5. Drug-induced scleroderma-like lesion.
- Author
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Hamaguchi, Yasuhito
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NAIL diseases , *DRUG side effects , *RAYNAUD'S disease , *TOPICAL drug administration , *SCLERODERMA (Disease) , *IMMUNE checkpoint inhibitors , *SYSTEMIC scleroderma - Abstract
Drug-induced scleroderma-like lesion is a condition in which administration of a drug induces skin sclerotic lesions similar to systemic sclerosis or morphea. The clinical manifestations of drug-induced scleroderma-like lesion can be divided into two types: scleroderma-like lesions and morphea-like plaques. A wide variety of drugs can cause drug-induced scleroderma-like lesion. Bleomycin, L -tryptophan, vinyl chloride, and phytonadione (vitamin K 1) have been reported, but in recent years, cases due to chemotherapeutic agents, such as taxane-based agents, gemcitabine, and tegafur-uracil, and immune checkpoint inhibitors have increased. Drug-induced scleroderma-like lesion differs from systemic sclerosis in that it does not include Raynaud's phenomenon, nail-fold capillary abnormality, organ involvement, such as reflux esophagitis, interstitial pneumonia, renal crisis, or anti-nuclear Abs. On the other hand, there are reports of cases in which Raynaud's phenomenon, positive conversion of anti-nuclear Abs, and development of skin sclerosis from the fingers developed after initiation of the drug. Whether the skin sclerosis improves after discontinuation of the drug depends on the patient. In patients with severe skin sclerosis, functional impairment, such as flexion contracture of the fingers, may occur, and systemic therapy, such as steroids, may be necessary. When treating patients with skin sclerosis, it is important to keep in mind the possibility that the sclerotic lesion may be induced by a drug. [ABSTRACT FROM AUTHOR]
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- 2022
- Full Text
- View/download PDF
6. Serum vasohibin‐1 levels: A potential marker of dermal and pulmonary fibrosis in systemic sclerosis.
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Fukui, Yuki, Nakamura, Kouki, Hirabayashi, Megumi, Miyagawa, Takuya, Toyama, Satoshi, Omatsu, Jun, Awaji, Kentaro, Ikawa, Tetsuya, Norimatsu, Yuta, Yoshizaki, Ayumi, Sato, Shinichi, and Asano, Yoshihide
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SYSTEMIC scleroderma , *PULMONARY fibrosis , *PULMONARY surfactant-associated protein D , *INTERSTITIAL lung diseases , *VITAL capacity (Respiration) - Abstract
Vasohibin‐1 (VASH‐1) is a potent anti‐angiogenic factor mainly produced by endothelial cells. In addition, VASH‐1 prevents TGF‐β–dependent activation of renal fibroblasts. Since systemic sclerosis (SSc) is an autoimmune disease characterized by vasculopathy and fibrosis of multiple organs, VASH‐1 may be involved in the development of this disease. In this study, we investigated the potential role of VASH‐1 in SSc by evaluating the clinical correlation between serum VASH‐1 levels and the expression of VASH‐1 in SSc‐involved skin. Serum VASH‐1 levels were higher in SSc patients, especially those with diffuse cutaneous involvement, than in healthy controls and positively correlated with skin score. Furthermore, SSc patients with interstitial lung disease had significantly elevated levels of serum VASH‐1 as compared to those without. Importantly, serum VASH‐1 levels correlated inversely with both the percentage of predicted vital capacity and the percentage of predicted diffusion lung capacity for carbon monoxide and positively with serum KL‐6 levels, but not serum surfactant protein D levels. In SSc‐involved skin, VASH1 mRNA was remarkably upregulated compared with healthy control skin, but the major source of VASH‐1 was not clear. Fli1 deficiency, a predisposing factor inducing SSc‐like endothelial properties, did not affect VASH‐1 expression in human dermal microvascular endothelial cells. Collectively, these results suggest that VASH‐1 upregulation in the skin and sera is linked to dermal and pulmonary fibrotic changes in SSc, while the contribution of VASH‐1 to SSc vasculopathy seems to be limited. [ABSTRACT FROM AUTHOR]
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- 2021
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7. Initial predictors of skin thickness progression in patients with diffuse cutaneous systemic sclerosis: Results from a multicentre prospective cohort in Japan.
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Masataka Kuwana, Minoru Hasegawa, Ryosuke Fukue, Yuichiro Shirai, Osamu Ishikawa, Hirahito Endo, Fumihide Ogawa, Daisuke Goto, Yasushi Kawaguchi, Shinichi Satoh, Hironobu Ihn, and Kazuhiko Takehara
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SKIN diseases , *SYSTEMIC scleroderma , *PREDICTION models , *DISEASE progression - Abstract
Objective: To identify initial parameters that predict worsening of skin thickening in patients with diffuse cutaneous systemic sclerosis (dcSSc) using a multicentre, prospective, observational cohort in Japan. Methods: A total of 171 patients with dcSSc were selected from a prospective cohort database based on the following criteria: dcSSc, modified Rodnan total skin thickness score (mRSS) ≥7, disease duration <60 months, and valid mRSS data at one year. Worsening of skin thickness was defined as an increase in mRSS ≥3 points and an increase ≥25% from baseline to one year. Initial demographic and clinical parameters useful for predicting the progression of skin thickness were identified using univariate and multivariable analysis, and prediction models of skin thickening progression were built based on combinations of independent predictive parameters. Results: Only 23 patients (13.5%) experienced worsening mRSSs at one year. Short disease duration, low mRSS, absence of nailfold bleeding, arthritis, and a high erythrocyte sedimentation rate at diagnosis were identified as predictors of subsequent worsening of the mRSS even after adjusting for the treatment. Assessment of the best predictive model revealed that patients with a disease duration ≤12 months and mRSS ≤19 had a risk of mRSS worsening within one year, with a sensitivity of 73.9% and specificity of 81.1%. Conclusion: Identification of predictors of subsequent worsening of skin thickness in dcSSc patients is useful for identifying patients who require intensive treatment with potential disease-modifying agents and for improving clinical trial design by characterizing eligible progressors in the Japanese population. [ABSTRACT FROM AUTHOR]
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- 2021
- Full Text
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8. Clinical course of Japanese patients with early systemic sclerosis: A multicenter, prospective, observational study.
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Akira Utsunomiya, Minoru Hasegawa, Noritaka Oyama, Yoshihide Asano, Hirahito Endo, Manabu Fujimoto, Daisuke Goto, Osamu Ishikawa, Yasushi Kawaguchi, Masataka Kuwana, Fumihide Ogawa, Hiroki Takahashi, Sumiaki Tanaka, Shinichi Sato, Kazuhiko Takehara, and Hironobu Ihn
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SYSTEMIC scleroderma , *INTERSTITIAL lung diseases , *IMMUNOSUPPRESSIVE agents , *VASODILATORS , *PULMONARY arterial hypertension , *HEALTH outcome assessment - Abstract
Objectives: To investigate the clinical course of Japanese patients with early diffuse cutaneous systemic sclerosis (dcSSc) and early SSc with interstitial lung disease (ILD). Methods: We prospectively analyzed the clinical features of 207 Japanese patients with early dcSSc (n=150) and limited cutaneous SSc (lcSSc) with ILD (n=57) in 10 medical centers every year for 7 consecutive years. Results: Mean modified Rodnan total skin thickness score (mRSS) was 18.3 and 67.4% of the cohort had ILD. Most patients started immunosuppressive therapy and vasodilators during 7 years (83.4% and 87.9%, respectively). Mean value of mRSS of total patients was significantly reduced from the initial registration after the first year. However, other parameters for physical function associated with skin sclerosis including fist closure, hand extension, and oral aperture were not so ameliorated during the study period. Health Assessment Questionnaire-disability index and serum KL-6 levels were constant throughout the course. Percent vital capacity and the presence of ILD, clinically suspected pulmonary arterial hypertension, and digital ulcers were gradually exacerbated during the period. Conclusion: In Japanese early dcSSc patients and SSc patients with ILD, mRSS was continuously reduced during 7 years of follow-up, but there was little improvement of physical disability and organ involvement. [ABSTRACT FROM AUTHOR]
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- 2021
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9. Clinical significance of endothelial vasodilatory function evaluated by EndoPAT in patients with systemic sclerosis.
- Author
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Aozasa, Naohiko, Hatano, Masaru, Saigusa, Ryosuke, Nakamura, Kouki, Takahashi, Takehiro, Toyama, Tetsuo, Sumida, Hayakazu, Tamaki, Zenshiro, Maki, Hisataka, Minatsuki, Shun, Komuro, Issei, Sato, Shinichi, and Asano, Yoshihide
- Abstract
Endothelial dysfunction is a hallmark of vasculopathy associated with systemic sclerosis (SSc). Reactive hyperemia peripheral arterial tonometry is a rapid and non‐invasive technique to assess peripheral microvascular endothelial function by measuring changes in digital pulse volume during reactive hyperemia. Low scores of the reactive hyperemia index (RHI) imply an impaired vasodilatory response and, accordingly, impaired endothelial and vascular health. To investigate the clinical significance of the RHI in SSc patients, RHI values were measured in 43 SSc patients and 10 healthy controls. In diffuse cutaneous SSc (dcSSc) patients, RHI values were significantly decreased compared with healthy controls, and inversely correlated with disease duration. In total SSc patients, there was a significant inverse correlation between RHI values and skin score, and interstitial lung disease was associated with the decrease in RHI values. Among vascular symptoms, the current and past history of digital ulcers was seen more frequently in patients with decreased RHI values than in those with normal RHI values. Although no SSc patients had pulmonary arterial hypertension, an inverse correlation was evident between RHI values and mean pulmonary arterial pressure measured by right heart catheterization. These results indicate that the decrease in RHI values is associated with skin fibrosis, interstitial lung disease, digital ulcers and pulmonary vascular involvement leading to pulmonary arterial hypertension, supporting the canonical idea that endothelial dysfunction is a critical event underlying the development of tissue fibrosis and vascular complications in SSc. [ABSTRACT FROM AUTHOR]
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- 2020
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10. Rituximab therapy is more effective than cyclophosphamide therapy for Japanese patients with anti‐topoisomerase I‐positive systemic sclerosis‐associated interstitial lung disease.
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Ebata, Satoshi, Yoshizaki, Ayumi, Fukasawa, Takemichi, Miura, Shunsuke, Takahashi, Takehiro, Sumida, Hayakazu, Asano, Yoshihide, and Sato, Shinichi
- Abstract
Systemic sclerosis‐associated interstitial lung disease (SSc‐ILD) is the most frequent cause of death for SSc but there is still no sufficient treatment available. Although cyclophosphamide (CYC) therapy is a common treatment which has shown statistical efficacy against SSc‐ILD to date, its effects are temporary and not enough. Rituximab (RTX), the anti‐CD20 monoclonal antibody, has recently shown efficacy in many autoimmune diseases. In SSc‐ILD, RTX is also considered to be one of the novel treatment candidates. However, studies of SSc‐ILD in Japanese treated with RTX have only a few case reports. Therefore, in this study, we retrospectively compared nine patients treated with RTX and 30 patients treated with CYC to investigate the efficacy of RTX treatment for Japanese anti‐topoisomerase I‐positive SSc‐ILD patients. At the 24‐month evaluation, the improvement rates of percent predicted of forced vital capacity and percent predicted of diffusing capacity of the lung carbon monoxide in the RTX‐treated group were significantly higher than those in the CYC‐treated group (20.6 ± 8.8% vs 1.1 ± 3.9%; P < 0.05 and 34.0 ± 6.0% vs −1.5 ± 2.8%; P < 0.01, respectively). In addition, skin thickness scores also showed a marked improvement from 13.5 points before the start of treatment to 5.8 points after 24 months by RTX therapy (P < 0.05). These results suggest that RTX treatment is more effective for Japanese SSc‐ILD patients than CYC treatment. In the future, it is expected that large‐scale clinical trials will show the usefulness of RTX treatment for SSc‐ILD. [ABSTRACT FROM AUTHOR]
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- 2019
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11. Recent advances in the treatment of skin involvement in systemic sclerosis
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Yoshihide Asano
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Interstitial Lung Disease ,Dermal Fibroblast ,Tocilizumab ,Skin Fibrosis ,Skin Sclerosis ,Pathology ,RB1-214 - Abstract
Abstract Skin fibrosis is a devastating clinical condition commonly seen in skin-restricted and systemic disorders. The goal of skin fibrosis treatment is the restoration of abnormally activated dermal fibroblasts producing the excessive amount of extracellular matrix, which is generally a final consequence of the complex disease process including the activation of vascular and immune systems. Among various skin fibrotic conditions, the molecular mechanisms underlying dermal fibroblast activation have been mostly well studied in systemic sclerosis (SSc). SSc is a multisystem autoimmune and vascular disease resulting in extensive fibrosis of the skin and various internal organs. Since SSc pathogenesis is believed to include all the critical components regulating tissue fibrosis, the studies on anti-fibrotic drugs against SSc provide us much useful information regarding the strategy for the treatment of various skin fibrotic conditions. In the recent decade, as is the case with other autoimmune and inflammatory diseases, the molecular targeting therapy with monoclonal antibody has been clinically well examined in SSc. Promising clinical outcomes are so far reported in tocilizumab (an anti-IL-6 receptor antibody), rituximab (an anti-CD20 antibody), and fresolimumab (an anti-TGF-β antibody). The analysis of gene expression profiles in skin lesions of SSc patients treated with tocilizumab or fresolimumab revealed a critical role of monocyte-macrophage lineage cells in the development of skin fibrosis and the involvement of IL-6 and TGF-β in the activation of those cells. Considering that B cells modulate the differentiation and activation of macrophages, favorable clinical outcomes of rituximab treatment imply the central role of B cell/monocyte-macrophage lineage cell axis in the pathogenesis of SSc. This scenario may be applicable at least partly to other skin fibrotic conditions. In this review article, the currently available data on these drugs are summarized and the future directions are discussed.
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- 2017
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12. Skin Manifestations of Systemic Sclerosis
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Valentini, Gabriele, Cuomo, Giovanna, Matucci-Cerinic, Marco, editor, Furst, Daniel, editor, and Fiorentino, David, editor
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- 2014
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13. Possible association of decreased serum CXCL14 levels with digital ulcers in patients with systemic sclerosis.
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Fukui, Yuki, Miyagawa, Takuya, Hirabayashi, Megumi, Yamashita, Takashi, Saigusa, Ryosuke, Miura, Shunsuke, Nakamura, Kouki, Yoshizaki, Ayumi, Sato, Shinichi, and Asano, Yoshihide
- Abstract
CXCL14 serves as a chemoattractant for activated macrophages, immature dendritic cells and natural killer cells, as well as an antiangiogenic factor by preventing the migration of endothelial cells. CXCL14 also exerts an inhibitory effect on the CXCL12/CXCR4 signaling pathway, which is involved in the maintenance of T‐helper (Th)2 bias, and promotes Th1 immune response under the physiological and pathological conditions. Because CXCL14‐mediated biological processes seem to be involved in the development of systemic sclerosis (SSc), which is characterized by Th2/Th17‐skewed immune polarization and impaired neovascularization, we investigated the clinical correlation of serum CXCL14 levels in patients with this disease. Serum CXCL14 levels were significantly decreased in SSc patients compared with healthy individuals and in diffuse cutaneous SSc patients relative to limited cutaneous SSc patients. SSc patients with digital ulcers had serum CXCL14 levels significantly lower than those without. Furthermore, i.v. cyclophosphamide pulse significantly increased serum CXCL14 levels as compared with the baseline in SSc patients with interstitial lung disease successfully treated with this therapy. These results indicate that decreased CXCL14 expression may contribute to the maintenance of Th2‐skewed immune polarization and dysregulated neovascularization, both of which underlie the developmental process of SSc. [ABSTRACT FROM AUTHOR]
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- 2019
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14. Long-Term Safety and Efficacy of Tocilizumab in Early Systemic Sclerosis–Interstitial Lung Disease: Open-Label Extension of a Phase 3 Randomized Controlled Trial
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Celia J. F. Lin, Fernando J. Martinez, Ganesh Raghu, Bridget Wagner, Dinesh Khanna, Jonathan G. Goldin, Mauro Zucchetto, Jeffrey Siegel, Christopher P. Denton, and Daniel E. Furst
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Adult ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Vital Capacity ,Antibodies, Monoclonal, Humanized ,Critical Care and Intensive Care Medicine ,Gastroenterology ,law.invention ,chemistry.chemical_compound ,Tocilizumab ,Double-Blind Method ,Randomized controlled trial ,law ,Internal medicine ,Humans ,Medicine ,In patient ,Lung function ,Scleroderma, Systemic ,Sclerosis ,business.industry ,Interstitial lung disease ,medicine.disease ,Treatment Outcome ,chemistry ,Skin sclerosis ,Long term safety ,Open label ,Lung Diseases, Interstitial ,business - Abstract
Rationale: Tocilizumab, an anti–interleukin-6 receptor antibody, had no statistically significant effect on skin sclerosis but preserved lung function over 48 weeks in patients with early systemic ...
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- 2022
15. High burden of skin sclerosis is associated with severe organ involvement in patients with systemic sclerosis and systemic sclerosis overlap syndrome.
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Wannarong, Thapat and Muangchan, Chayawee
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SYSTEMIC scleroderma , *SCLERODERMA (Disease) , *ARITHMETIC mean , *HEMOGLOBINS , *ALBUMINS , *SKIN diseases - Abstract
The objective of this study is to investigate the impact of skin sclerosis burden on an internal organ involvement over a 1-year period, as measured by time-adjusted accrual-modified Rodnan skin score (TA-mRSS), and to evaluate association between TA-mRSS patterns and laboratory tests in patients with systemic sclerosis (SSc). This prospective study was conducted at Siriraj Hospital (Bangkok, Thailand) during the November 2013-November 2016. SSc patients by ACR/EULAR 2013 or ACR 1980 criteria were eligible. TA-mRSS was classified as low, intermediate, or high, and then compared between groups. Correlation between the arithmetic mean of laboratory tests and TA-mRSS was assessed by multiple linear regression analysis. A total of 118 patients, with 81.4% women, median (IQR) age 49.8 (43.8, 55.1) years, disease duration from onset of non-Raynaud symptoms to first visit of 3.3 (1, 6.8) years, 78% dcSSc, and 75.3% anti-Scl-70 positivity, were analyzed. TA-mRSS over 1 year ranged from 0 to 37.44. The high skin sclerosis burden group had a median TA-mRSS > 7.26 (> 67th percentile). Patients with high TA-mRSS were dcSSc, high initial and average mRSS, and had tendon friction rub, digital ischemic complications, usual interstitial pneumonia, diastolic dysfunction, gastrointestinal dysmotility, and low serum albumin. In multiple linear regression analysis, the arithmetic mean of hemoglobin (B = − 1.007, 95% CI − 1.779 to − 0.236), erythrocyte sedimentation rate (B = − 0.078, 95% CI − 0.126 to − 0.029), serum glutamic oxaloacetic transaminase (B = 0.073, 95% CI 0.026-0.12), creatine phosphokinase (B = 0.012, 95% CI 0.003-0.021), and albumin (B = − 4.117, 95% CI − 6.958 to − 1.276) were associated with TA-mRSS. This study found a higher cumulative course of mRSS over a 1-year period to be significantly associated with severe internal organ involvement. [ABSTRACT FROM AUTHOR]
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- 2018
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16. Breast contracture and skin sclerosis following 20 years of polyacrylamide hydrogel migration in a patient with familial vitiligo: a case report
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Jiaming Sun, Bin Wang, and Jing Tong
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Polyacrylamide Hydrogel ,medicine.medical_specialty ,China ,Contracture ,Acrylic Resins ,Vitiligo ,lcsh:Surgery ,Case Report ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Rare case ,medicine ,Humans ,Family history ,skin and connective tissue diseases ,Breast augmentation ,Sclerosis ,integumentary system ,business.industry ,Polyacrylamide hydrogel injection ,Breathing problems ,General Medicine ,lcsh:RD1-811 ,Middle Aged ,medicine.disease ,Surgery ,030220 oncology & carcinogenesis ,Skin sclerosis ,Female ,medicine.symptom ,business ,Breast contracture - Abstract
Background Breast augmentation with polyacrylamide gel (PAAG) injection was approved in China in 1998 and later banned in 2006. The ban ensued numerous complaints from patients such as pain, induration, deformation, infection, displacement, and milk deposition associated with PAAG injection. To date, no study has investigated the long-term effect of PAAG migration on autoimmune diseases. Case presentation We report a rare case of a 49-year-old female patient with familial vitiligo who receiving PAAG injection for breast augmentation. The patient reported to have felt persistent movement of PAAG in her thoracoabdominal area for almost 20 years. Furthermore, the PAAG-induced chronic inflammation that aggravated vitiligo, which in turn promoted skin sclerosis. This damaged the breast contracture, increased chest tightness and induced mild breathing problems. Conclusion Here, we present a rare case in which a patient with a family history of vitiligo experienced long-term complications after receiving PAAG injection for breast augmentation. This case highlights the relationship between vitiligo, migration of PAAG and tissue hardening and skin contraction. Level of evidence: Level V
- Published
- 2021
17. Hyperspectral Imaging Assessment of Systemic Sclerosis Using the Soft Abundance Score and Band Selection
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Chiu-Chin Sung, Hsin-Hua Chen, Jun-Peng Chen, Kuo-Lung Lai, Hsian-Min Chen, and Yi-Ming Chen
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medicine.medical_specialty ,General Computer Science ,integumentary system ,skin thickness ,business.industry ,General Engineering ,systemic sclerosis (SSc) ,Hyperspectral imaging ,Spectral bands ,medicine.disease ,band selection (BS) ,TK1-9971 ,Correlation ,Band selection ,SKIN TIGHTNESS ,medicine ,General Materials Science ,Skin sclerosis ,Radiology ,Electrical engineering. Electronics. Nuclear engineering ,Medical diagnosis ,business ,Hyperspectral imaging soft abundance score (HSISAS) ,Progressive disease - Abstract
Hyperspectral imaging (HSI) is an optical remote sensing technology that has the advantages of high spatial and spectral resolution. Aside from its use in geographical research, HSI has been widely used in medical diagnosis. Systemic sclerosis (SSc) is a multiorgan autoimmune disease that leads to skin tightness, thickness, and fibrosis. Internal organ involvement and mortality in this progressive disease are strongly correlated with the extent and severity of abnormal skin thickness. Our prior study demonstrated that HSI can outperform conventional assessment tools as a diagnostic modality to evaluate the severity of skin sclerosis in SSc patients. However, the analysis algorithm has its limitations. This study aimed to investigate a novel soft abundance score for HSI. We also explored the influence of band selection on the HSI analysis of SSc patients. In total, we enrolled 30 SSc patients (male: 10; female: 20, median age±range, 49.9±17.0 years) and 24 healthy controls (male: 12; female: 12, median age±range, 37.0±11.0 years). We found that most of the spectral bands generated by different band selection methods were similar. Moreover, in the task of distinguishing SSc patients from healthy controls, the soft abundance scores calculated from these bands exhibited greater discriminative power than a spectral angle mapper (SAM), skin scores determined by clinical assessments, or skin thickness determined through ultrasonography. Our results suggest that the spectral bands selected in this study should be taken into consideration to guide future hardware improvement. The analytic algorithm can also be applied as a new clinical method.
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- 2021
18. Early- and late-stage morphea subtypes with deep tissue involvement is treatable with Abatacept (Orencia).
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Adeeb, Fahd, Anjum, Shakeel, Hodnett, Philip, Kashif, Ahmad, Brady, Mary, Morrissey, Siobhan, Devlin, Joseph, and Fraser, Alexander Duncan
- Abstract
Objectives This case series explores the potential efficacy of Abatacept in patients presenting with morphea subtypes and deep tissue involvement. Methods Three patients with established morphea subtypes and deep tissue involvement and with no contraindication to Abatacept were included in this prospective open-label study. The index patient was exceptionally severely affected with a mean Modified Rodnan Skin Score (MRSS) of 38/51. At baseline, whole-body MRI and skin biopsy were performed which confirmed classical deposition of dense fibrous tissue in the appropriate layer of the skin. MRSS was performed independently by three clinicians and VAS scores (10 cm) were measured at baseline for Patient Global Disease Activity (PGDA), Patient Global Pain (PGP), Patient Day Pain (PDP), Patient Night Pain (PNP), and Physician Global Disease Activity (PhGDA). Patients 2 and 3 were similarly screened at baseline except for MRI. Patients were commenced on Abatacept as per body weight (10 mg/kg) given intravenously with concomitant tapering dose of oral prednisolone. All three were re-assessed at 6 months and the index case was further re-assessed at 18 months. Results All patients tolerated the Abatacept well and showed dramatic improvement. The index patient’s clinical signs and symptoms, whole-body MRI, and mean Modified Rodnan Skin Score improved dramatically from baseline by 37% at 6 months and by 74% at 18 months. There were no clinically significant adverse outcomes noted. Conclusion We present three cases, one with exceptionally severe disease, which demonstrated excellent clinical response to Abatacept. Abatacept is a promising option for the treatment of severe or resistant morphea, especially in those with deep tissue involvement. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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19. Possible association of elevated serum collagen type IV level with skin sclerosis in systemic sclerosis.
- Author
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Motegi, Sei‐ichiro, Sekiguchi, Akiko, Fujiwara, Chisako, Toki, Sayaka, and Ishikawa, Osamu
- Abstract
Collagen type IV is the primary collagen in the basement membranes around blood vessels and in the dermoepidermal junction in the skin. Perivascular collagen type IV is synthesized by endothelial cells and pericytes, and contributes to the homeostasis and remodeling of blood vessels. It has been well recognized that elevated serum collagen type IV levels are associated with the liver fibrosis. The objective was to examine serum collagen type IV levels and their clinical associations in patients with systemic sclerosis ( SSc), and to examine the expression of collagen type IV in the fibrotic skin in SSc. Serum collagen type IV levels in SSc patients and diffuse cutaneous type SSc patients were significantly higher than those in healthy individuals. Serum collagen type IV levels were positively correlated with modified Rodnan total skin score. Serum collagen type IV levels in early stage (disease duration ≤3 years) diffuse cutaneous SSc patients were significantly elevated. Serum collagen type IV levels in SSc patients with digital ulcers ( DU) were significantly elevated. In immunohistochemical staining, the expression of collagen type IV around dermal small vessels in the affected skin was reduced compared with those of normal individuals. These results suggest that elevated serum collagen type IV levels may be associated with the skin sclerosis in the early stage of SSc. The measurement of serum collagen type IV levels in SSc patients may be useful as a disease activity marker in skin sclerosis and DU. [ABSTRACT FROM AUTHOR]
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- 2017
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20. Clinical significance of serum soluble T-cell immunoglobulin and mucin domain 3 levels in systemic sclerosis: Association with disease severity.
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Chiba, Miki, Yanaba, Koichi, Hayashi, Mitsuha, Yoshihara, Yuki, and Nakagawa, Hidemi
- Abstract
T-cell immunoglobulin and mucin domain 3 ( TIM-3) has been thought to play a crucial role in the negative regulation of immune responses. Here, we examined the levels of serum soluble TIM-3 ( sTIM-3) in patients with systemic sclerosis ( SSc) and evaluated the results with respect to the clinical features of the disease. Patients with diffuse cutaneous SSc (dc SSc) had higher levels of sTIM-3 than those with limited cutaneous SSc and healthy individuals. Serum sTIM-3 levels were positively correlated with the severity of skin sclerosis in early phase dc SSc. Moreover, serum sTIM-3 levels were increased more often in patients with renal crisis and cardiac involvement than in those with normal sTIM-3 levels. These results suggest that serum sTIM-3 levels may be increased in patients with early phase dc SSc and associated with cardiac involvement and renal crisis. Measurement of serum sTIM-3 may be useful for risk stratification in the early stage of the disease. [ABSTRACT FROM AUTHOR]
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- 2017
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21. Application of integrated traditional chinese and western medicine in treatment of systemic sclerosis: A case report.
- Author
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Wang XH, Zhang JQ, Kong Q, Tu WZ, Chen LM, and Zhao YH
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- Humans, Medicine, Chinese Traditional, Drugs, Chinese Herbal therapeutic use, Medicine, Scleroderma, Systemic therapy
- Published
- 2023
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22. The Treatment of Systemic Sclerosis
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Black, C. M., Mallia, Carmel, editor, and Uitto, Jouni, editor
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- 1999
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23. Clinical course of Japanese patients with early systemic sclerosis: A multicenter, prospective, observational study
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Hiroki Takahashi, Sumiaki Tanaka, Kazuhiko Takehara, Masataka Kuwana, Hironobu Ihn, Daisuke Goto, Akira Utsunomiya, Shinichi Sato, Noritaka Oyama, Hirahito Endo, Yoshihide Asano, Yasushi Kawaguchi, Minoru Hasegawa, Manabu Fujimoto, Fumihide Ogawa, and Osamu Ishikawa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Vital Capacity ,Treatment outcome ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Rheumatology ,Internal medicine ,Humans ,Medicine ,030212 general & internal medicine ,Skin ,Pressure Ulcer ,030203 arthritis & rheumatology ,business.industry ,Interstitial lung disease ,Clinical course ,Middle Aged ,respiratory system ,Hand ,medicine.disease ,respiratory tract diseases ,body regions ,Scleroderma, Diffuse ,Female ,Observational study ,Skin sclerosis ,Lung Diseases, Interstitial ,business ,Immunosuppressive Agents - Abstract
To investigate the clinical course of Japanese patients with early diffuse cutaneous systemic sclerosis (dcSSc) and early SSc with interstitial lung disease (ILD).We prospectively analyzed the clinical features of 207 Japanese patients with early dcSSc (n = 150) and limited cutaneous SSc (lcSSc) with ILD (n = 57) in 10 medical centers every year for 7 consecutive years.Mean modified Rodnan total skin thickness score (mRSS) was 18.3 and 67.4% of the cohort had ILD. Most patients started immunosuppressive therapy and vasodilators during 7 years (83.4% and 87.9%, respectively). Mean value of mRSS of total patients was significantly reduced from the initial registration after the first year. However, other parameters for physical function associated with skin sclerosis including fist closure, hand extension, and oral aperture were not so ameliorated during the study period. Health Assessment Questionnaire-disability index and serum KL-6 levels were constant throughout the course. Percent vital capacity and the presence of ILD, clinically suspected pulmonary arterial hypertension, and digital ulcers were gradually exacerbated during the period.In Japanese early dcSSc patients and SSc patients with ILD, mRSS was continuously reduced during 7 years of follow-up, but there was little improvement of physical disability and organ involvement.
- Published
- 2020
24. Role of Immunocompetent Cells in Skin Sclerosis and Autoimmunity in Tight Skin Mice
- Author
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Bona, Constantin, Shibata, Shinobu, Daian, Christian, Kasturi, Kuppuswamy, and Zouali, Moncef, editor
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- 1994
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25. Serum levels of soluble programmed death-1 and programmed death ligand-1 in systemic sclerosis: Association with extent of skin sclerosis.
- Author
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Yanaba, Koichi, Hayashi, Mitsuha, Yoshihara, Yuki, and Nakagawa, Hidemi
- Abstract
The interaction of programmed death-1 ( PD-1) with its ligand, programmed death ligand-1 ( PD-L1), has been considered to play a key role in the negative regulation of immune responses. Patients with diffuse cutaneous systemic sclerosis ( SSc) had higher levels of soluble PD-1 ( sPD-1) than those with limited cutaneous SSc and healthy individuals. Serum sPD-1 levels positively correlated with the severity of skin sclerosis. In contrast, serum sPD-L1 levels were significantly increased in patients with SSc compared with healthy individuals. Moreover, serum sPD-L1 levels were not associated with the extent of skin sclerosis and were elevated not only in patients with diffuse cutaneous SSc, but also in those with limited cutaneous SSc. These results suggested that serum sPD-1 levels may increase in patients with SSc and correlate with the severity of skin sclerosis. PD-1/ PD-L1 interaction may contribute to the development of skin sclerosis in SSc. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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26. Rituximab in the treatment of patients with systemic sclerosis. Our experience and review of the literature.
- Author
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Giuggioli, Dilia, Lumetti, Federica, Colaci, Michele, Fallahi, Poupak, Antonelli, Alessandro, and Ferri, Clodoveo
- Subjects
- *
RITUXIMAB , *SYSTEMIC scleroderma , *B cells , *GENETIC overexpression , *AUTOIMMUNE diseases , *THERAPEUTICS - Abstract
Background The treatment of systemic sclerosis (SSc) represents a great clinical challenge because of the complex disease pathogenesis including vascular, fibrotic, and immune T- and B-lymphocyte-mediated alterations. Therefore, SSc should be treated by combined or sequential therapies according to prevalent clinico-pathogenetic phenotypes. Some preliminary data suggest that rituximab (RTX) may downregulate the B-cell over expression and correlated immunological abnormalities. Methods Here, we describe a series of 10 SSc patients (4 M and 6 F, mean age 46 ± 13.5SD years, mean disease duration 6.3 ± 2.7SD years; 5 pts had limited and 5 diffuse SSc cutaneous subset) treated with one or more cycles of RTX (4 weekly infusions of 375 mg/m 2 ). The main indications to RTX were interstitial lung fibrosis, cutaneous, and/or articular manifestations unresponsive to previous therapies; ongoing treatments remained unchanged in all cases. The effects of RTX were evaluated after 6 months of the first cycle and at the end of long-term follow-up period (37 ± 21SD months, range 18–72 months). An updated review of the world literature was also done. Results RTX significantly improved the extent of skin sclerosis in patients with diffuse SSc at 6 months evaluation (modified Rodnan skin score from 25 ± 4.3 to 17.2 ± 4.6; p = .022). A clinical improvement of other cutaneous manifestations, namely hypermelanosis (7/7), pruritus (6/8), and calcinosis (3/6) was observed. Moreover, arthritis revealed particularly responsive to RTX showing a clear-cut reduction of swollen and tender joints in 7/8 patients; while lung fibrosis detected in 8/10 remained stable in 6/8 and worsened in 2/8 at the end of follow-up. Pro-inflammatory cytokines, namely IL6, IL15, IL17, and IL23, evaluated in 3 patients with diffuse cutaneous SSc, showed a more or less pronounced reduction after the first RTX cycle. These observations are in keeping with the majority of previous studies including 6 single case reports and 10 SSc series (from 5 to 43 pts), which frequently reported the beneficial effects of RTX on some SSc manifestations, particularly cutaneous sclerosis, along with the improvement/stabilization of lung fibrosis. Possible discrepancies among different clinical studies can be related to the etiopathogenetic complexity of SSc and not secondarily to the patients' selection and disease duration at the time of the study. Conclusion The present study and previous clinical trials suggest a possible therapeutical role of RTX in SSc, along with its good safety profile. The specific activity of RTX on B-cell-driven autoimmunity might explain its beneficial effects on some particular SSc clinical symptoms, namely the improvement of skin and articular involvement, and possibly the attenuation of lung fibrosis. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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27. Elevated plasma homocysteine level is possibly associated with skin sclerosis in a series of Japanese patients with systemic sclerosis.
- Author
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Motegi, Sei‐ichiro, Toki, Sayaka, Yamada, Kazuya, Uchiyama, Akihiko, and Ishikawa, Osamu
- Abstract
Homocysteine is a sulfhydryl-containing amino acid that is derived from dietary methionine, and there has been increasing evidence that elevated plasma homocysteine levels are associated with increased risk of cardiovascular diseases, including carotid, coronary and peripheral arterial disease ( PAD). The association of plasma homocysteine levels with peripheral vascular involvements, such as Raynaud phenomenon ( RP), digital ulcers ( DU) in systemic sclerosis ( SSc) patients has not been well studied. The objective of this study was to examine plasma homocysteine levels and their clinical associations in patients with SSc. Plasma homocysteine levels in 151 Japanese patients with SSc and 20 healthy controls were examined. No significant differences were observed in plasma homocysteine levels between SSc patients and healthy individuals. Demographic and clinical features of the SSc patients revealed that severe skin sclerosis, anti-topoisomerase I antibody positivity, complications of DU, acro-osteolysis ( AO) and interstitial lung disease ( ILD) were significantly more prevalent among the patients with elevated plasma homocysteine levels. The plasma homocysteine levels were positively correlated with modified Rodnan total skin score. The plasma homocysteine levels in the SSc patients with DU, AO and ILD were significantly higher than those in the SSc without DU, AO and ILD, respectively. Plasma homocysteine levels did not correlate with either the mean or max intima-media thickness ( IMT) or plaque score, suggesting that plasma homocysteine levels might not be associated with carotid artery atherosclerosis in SSc patients. The measurement of plasma homocysteine levels in SSc patients might be useful for the risk stratifications of severe skin sclerosis, DU and AO. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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28. Serum Angiopoietin-like Protein 3 Levels: Possible Correlation with Progressive Skin Sclerosis, Digital Ulcers and Pulmonary Vascular Involvement in Patients with Systemic Sclerosis.
- Author
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Yohei ICHIMURA, Yoshihide ASANO, Kaname AKAMATA, Naohiko AOZASA, Shinji NODA, Takashi TANIGUCHI, Takehiro TAKAHASHI, Tetsuo TOYAMA, Hayakazu SUMIDA, Yoshihiro KUWANO, Koichi YANABA, Yayoi TADA, Makoto SUGAYA, Shinichi SATO, and Takafumi KADONO
- Subjects
- *
ANGIOPOIETIN-like proteins , *NEOVASCULARIZATION , *LIPID metabolism , *SYSTEMIC scleroderma , *ENZYME-linked immunosorbent assay , *ULCERS , *SYSTOLIC blood pressure - Abstract
Angiopoietin-like protein 3 (ANGPTL3), which is part of a family of secreted glycoproteins that are structurally similar to angiopoietins, is principally expressed in the liver and is involved in lipid metabolism and angiogenesis. The aim of this study was to determine the clinical significance of serum ANGPTL3 levels, measured with a specific enzyme-linked immunosorbent assay, in patients with systemic sclerosis. Serum ANGPTL3 levels correlated positively with skin score in diffuse cutaneous systemic sclerosis with a disease duration ≤ 6 years. Furthermore, the prevalence of digital ulcers was significantly higher in patients with elevated serum ANGPTL3 levels than in other patients. Moreover, among patients excluding diffuse cutaneous systemic sclerosis with disease duration ≤ 6 years, serum ANGPTL3 levels correlated positively with estimated right ventricular systolic pressure. In conclusion, ANGPTL3 may contribute to the development of progressive skin sclerosis and proliferative obliterative vasculopathy, such as digital ulcers and pulmonary vascular involvement leading to pulmonary arterial hypertension, in systemic sclerosis. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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29. Successful Treatment of Pulmonary Arterial Hypertension in Systemic Sclerosis with Anticentriole Antibody
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Yoko Fujita, Yusho Ishii, Yosuke Hoshi, Hiroshi Fujii, Tomonori Ishii, Yuko Shirota, Hiroaki Shimokawa, Hideo Harigae, Koichiro Sugimura, and Tsuyoshi Shirai
- Subjects
medicine.medical_specialty ,biology ,Cyclophosphamide ,integumentary system ,business.industry ,Autoantibody ,Hemodynamics ,Vasodilation ,Case Report ,General Medicine ,Diseases of the musculoskeletal system ,Gastroenterology ,Titer ,RC925-935 ,Internal medicine ,biology.protein ,medicine ,Prednisolone ,Skin sclerosis ,Antibody ,business ,skin and connective tissue diseases ,medicine.drug - Abstract
Systemic sclerosis (SSc) is characterized by skin sclerosis and multiple organ damages which may cause mortality and is usually accompanied with several specific autoantibodies, each of which is associated with characteristic complications. Among them, anticentriole antibody is recently reported to be highly associated with SSc-associated pulmonary arterial hypertension (SSc-PAH). In general, several vasodilators are used as therapeutic drugs for SSc-PAH, whereas immunosuppressive therapies are not. Here, we report the case of a 62-year-old female with anticentriole antibody-positive SSc-PAH treated with immunosuppressants and vasodilators. She presented with two-year exertional dyspnea and was diagnosed with PAH and SSc owing to the centriole staining pattern and other symptoms without digital sclerosis. Oral vasodilators were initially administered but were not sufficiently effective on dyspnea. Immunosuppressants such as prednisolone and cyclophosphamide were started. Both of them improved mean pulmonary arterial pressure and 6-minute walk distance, and the anticentriole antibody also disappeared. In this case, SSc-PAH with anticentriole antibody was properly diagnosed and immunosuppressants and vasodilators improved the hemodynamics of PAH with anticentriole antibody and stably maintained it and, in addition, reduced the titer of anticentriole antibody. This indicates that anticentriole antibody might represent a good responsive group to therapies among subgroups of patients with SSc-PAH.
- Published
- 2020
30. Initial predictors of skin thickness progression in patients with diffuse cutaneous systemic sclerosis: Results from a multicentre prospective cohort in Japan
- Author
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Hironobu Ihn, Yuichiro Shirai, Hirahito Endo, Kazuhiko Takehara, Shinichi Sato, Daisuke Goto, Ryosuke Fukue, Masataka Kuwana, Fumihide Ogawa, Osamu Ishikawa, Yasushi Kawaguchi, and Minoru Hasegawa
- Subjects
Adult ,Male ,medicine.medical_specialty ,Blood Sedimentation ,Skin thickness ,Severity of Illness Index ,Scleroderma ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Japan ,Medicine ,Humans ,In patient ,030212 general & internal medicine ,Prospective cohort study ,Skin ,030203 arthritis & rheumatology ,business.industry ,Skin thickening ,Middle Aged ,medicine.disease ,Dermatology ,Cohort ,Scleroderma, Diffuse ,Disease Progression ,Observational study ,Skin sclerosis ,Female ,business - Abstract
To identify initial parameters that predict worsening of skin thickening in patients with diffuse cutaneous systemic sclerosis (dcSSc) using a multicentre, prospective, observational cohort in Japan. A total of 171 patients with dcSSc were selected from a prospective cohort database based on the following criteria: dcSSc, modified Rodnan total skin thickness score (mRSS) ≥7, disease duration
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- 2020
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31. Rapid progression of skin sclerosis precipitated by a pheochromocytoma in a patient with systemic sclerosis
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Jongtaek Lee, Hyun-Sook Kim, Yunsuek Kim, and Yoonmi Jin
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Pheochromocytoma ,medicine.medical_specialty ,Text mining ,business.industry ,medicine ,Skin sclerosis ,General Medicine ,medicine.disease ,business ,Letter to the Editor ,Dermatology - Published
- 2019
32. Skin sclerosis as a manifestation of POEMS syndrome.
- Author
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HASEGAWA, Minoru, ORITO, Hidemitsu, YAMAMOTO, Keiko, MATSUSHITA, Takashi, HAMAGUCHI, Yasuhito, FUJIMOTO, Manabu, and TAKEHARA, Kazuhiko
- Abstract
ABSTRACT We report a case of a 64-year-old man with POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy and skin changes) syndrome that had been previously misdiagnosed as systemic sclerosis. He had typical symptoms of POEMS syndrome, however, the existence of skin sclerosis, contracture of fingers and pigmentation were similar to that of systemic sclerosis. Ten patients, including the patient discussed in this case, visited our department between 1990 and 2011. Among them, five patients had skin sclerosis. Therefore, we compared skin lesions and clinical/laboratory features of POEMS syndrome and systemic sclerosis in an attempt to distinguish these disorders. Regarding the cutaneous and laboratory findings, the existence of hemangioma or hypertrichosis is indicative of POEMS syndrome. By contrast, the existence of systemic sclerosis-specific autoantibodies, nail fold bleeding, digital ulcer/digital pitting scar or telangiectasia is highly suggestive of systemic sclerosis. To our knowledge, this is the first report to discuss in detail the differentiation between POEMS syndrome and systemic sclerosis. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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33. Investigation of prognostic factors for skin sclerosis and lung function in Japanese patients with early systemic sclerosis: a multicentre prospective observational study.
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Hasegawa, Minoru, Asano, Yoshihide, Endo, Hirahito, Fujimoto, Manabu, Goto, Daisuke, Ihn, Hironobu, Inoue, Katsumi, Ishikawa, Osamu, Kawaguchi, Yasushi, Kuwana, Masataka, Muro, Yoshinao, Ogawa, Fumihide, Sasaki, Tetsuo, Takahashi, Hiroki, Tanaka, Sumiaki, Takehara, Kazuhiko, and Sato, Shinichi
- Subjects
- *
INTERSTITIAL lung diseases , *BLOOD testing , *IMMUNOGLOBULINS , *LONGITUDINAL method , *MEDICAL cooperation , *MULTIVARIATE analysis , *SCIENTIFIC observation , *PHYSICAL diagnosis , *PULMONARY function tests , *REGRESSION analysis , *RESEARCH , *SYSTEMIC scleroderma , *DATA analysis software , *PROGNOSIS - Abstract
Objective. To clarify the clinical course of SSc in Japanese patients with early-onset disease. It is well known that ethnic variations exist in the clinical features and severity of SSc. However, neither the clinical course nor prognostic factors have been thoroughly investigated in the Japanese population.Methods. Ninety-three Japanese patients of early-onset SSc (disease duration: <3 years) with diffuse skin sclerosis and/or interstitial lung disease were registered in a multi-centre observational study. All patients had a physical examination with laboratory tests at their first visit and at each of the three subsequent years. Factors that could predict the severity of skin sclerosis and lung involvement were examined statistically by multiple regression analysis.Results. Two patients died from SSc-related myocardial involvement and four patients died from other complications during the 3-year study. Among various clinical data assessed, the initial modified Rodnan total skin thickness score (MRSS) and maximal oral aperture were associated positively and negatively with MRSS at Year 3, respectively. Additionally, initial ESR tended to be associated with final MRSS. Pulmonary vital capacity (VC) in the third year was significantly associated with initial %VC. Furthermore, patients with anti-topo I antibody tended to show reduced %VC at Year 3.Conclusions. Several possible prognostic factors for skin sclerosis and lung function were detected in Japanese patients with early SSc. Further longitudinal studies of larger populations will be needed to confirm these findings. [ABSTRACT FROM PUBLISHER]
- Published
- 2012
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34. Systemic sclerosis and the gastrointestinal tract
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Irena Walecka
- Subjects
Pathology ,medicine.medical_specialty ,gastrointestinal involvement ,systemic sclerosis ,autoantibodies ,lcsh:Medicine ,Disease ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Medicine ,030203 arthritis & rheumatology ,Review Paper ,Gastrointestinal tract ,integumentary system ,business.industry ,lcsh:R ,Gastroenterology ,Autoantibody ,medicine.disease ,030211 gastroenterology & hepatology ,Skin sclerosis ,business ,Complication ,Rare disease - Abstract
Systemic sclerosis (SSc) is an autoimmunological disease of unknown origin with complex pathogenesis and multiple organ involvement. It is characterised by vascular and immunological abnormalities leading to fibrosis of the skin and internal organs. It is a rather rare disease with a prevalence of around 20 per 100,000. The disease results in heterogeneous clinical findings and different courses. Systemic sclerosis usually begins with the onset of Raynaud’s phenomenon (RP), followed by skin sclerosis and internal organ involvement, although it may appear synchronously with RP. Gastrointestinal involvement is a serious and prevalent complication of SSc, and the oesophagus is the most frequently affected organ. Both limited and diffuse cutaneous SSc involve internal organs, with the involvement of the gastrointestinal tract as a leading cause of morbidity. At present, treatment is mainly symptomatic with no disease-modifying drugs.
- Published
- 2017
35. Inhibition of skin sclerosis by 15deoxy Δ12,14-prostaglandin J2 and retrovirally transfected prostaglandin D synthase in a mouse model of bleomycin-induced scleroderma.
- Author
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Shizuka Kohno, Hirahito Endo, Atsushi Hashimoto, Izumi Hayashi, Yusuke Murakami, Hidero Kitasato, Fumiaki Kojima, Shinichi Kawai, and Hirobumi Kondo
- Subjects
- *
CHEMICAL inhibitors , *CELLULAR control mechanisms , *GROWTH factors , *CYTOKINES - Abstract
Hematopoietic prostaglandin D synthase (PGDS) is a key enzyme involved in production of the PGD and J series, which have various role in inflammation and immunity. We evaluated the effect of treatment with 15-deoxy-Δ12,14-prostaglandin J2 (15d-PGJ2) or the injection of prostaglandin D2 synthase (PGDS) cDNA expressing-retrovirally transfected fibroblasts on bleomycin (BLM)-induced scleroderma-like skin sclerosis. Daily injection of BLM (30 μg) for 4 weeks induced histological evidence of dermal sclerosis in C3H mice. We examined the effect of injection of 15d-PGJ2 (30 ng twice a day) or PGDS expressing-retrovirally transfected fibroblast on BLM-induced dermal sclerosis. Administration of 15d-PGJ2 (a nonenzymatic metabolite of PGD2) injection of PGDS cDNA-expressing fibroblasts significantly reduced dermal sclerosis, the hydroxyproline content, and dermal thickness. Moreover, 15-d PGJ2 down-regulation of the expression of transforming growth factor β1 and connective tissue growth factor which had been induced by BLM. Mast cells were also increased in the skin by BLM injection and there was prominent degranulation of these mast cells along with elevated plasma histamine levels. 15-d PGJ2 and PGDS-expressing cells also suppressed degranulation of cultured mast cells and histamine release by these cells. These results show that 15-d PGJ2 and PGDS-expressing cells can prevent experimental skin sclerosis induced by BLM and raise the possibility of therapeutic approaches targeting of PPARγ for the skin lesion of scleroderma. [Copyright &y& Elsevier]
- Published
- 2006
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36. Keratinocyte-derived cytokines after photodynamic therapy and their paracrine induction of matrix metalloproteinases in fibroblasts.
- Author
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Karrer, S., Bosserhoff, A.K., Weiderer, P., Landthaler, M., and Szeimies, R.-M.
- Subjects
- *
CYTOKINES , *PHOTOCHEMOTHERAPY , *KERATINOCYTES , *PARACRINE mechanisms , *METALLOPROTEINASES , *FIBROBLASTS - Abstract
Recent studies have shown that collagen-degrading matrix metalloproteinase (MMP)-1 and MMP-3 are produced by fibroblasts in response to photodynamic therapy (PDT) with 5-aminolaevulinic acid (ALA) and are considered to be involved in the antisclerotic effects of ALA-PDT observed in the treatment of localized scleroderma.As the primary target of topical PDT is epidermal keratinocytes, we studied the indirect participation of keratinocytes in the production of MMPs and collagen by dermal fibroblasts.Keratinocytes were treated with sublethal doses of ALA (100 µmol L−1) and red light. The conditioned media were collected 24 h after PDT and primary human fibroblasts were exposed to these media for 6–48 h. Further, a coculture model, keratinocytes seeded on to collagen type IV-coated transwells in the upper chamber and fibroblasts in the lower chamber, was used to study paracrine effects of keratinocytes after PDT.Keratinocyte supernatants after PDT showed a significant, up to 10-fold increase of interleukin (IL)-1α and a 2·5-fold increase of tumour necrosis factor-α as determined by enzyme-linked immunosorbent assay, while IL-6, MMP-1 and MMP-3 were not altered significantly. Fibroblasts treated with keratinocyte-conditioned media after PDT showed an induction of MMP-1 and MMP-3 protein levels up to threefold in both models used, suggesting that ALA-PDT modulates MMP-1 and MMP-3 production via indirect mechanisms. Collagen type I mRNA expression by fibroblasts was not altered significantly in either model. The addition of an IL-1 receptor antagonist to the keratinocyte-conditioned media completely inhibited the induction of MMP-1 and MMP-3 in stimulated fibroblasts, suggesting that IL-1 is mainly responsible for the observed paracrine effects.We present evidence that PDT can trigger MMP production in dermal fibroblasts not only directly as has been already shown, but also by an indirect paracrine loop mediated by soluble factors released by epidermal keratinocytes. [ABSTRACT FROM AUTHOR]
- Published
- 2004
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37. Influence of 5-Aminolevulinic Acid and Red Light on Collagen Metabolism of Human Dermal Fibroblasts.
- Author
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Karrer, Sigrid, Bosserhoff, Anja Kathrin, Weiderer, Petra, Landthaler, Michael, and Szeimies, Rolf-Markus
- Subjects
- *
SCLERODERMA (Disease) treatment , *COLLAGEN - Abstract
Patients with localized scleroderma receiving topical photodynamic therapy with 5-aminolevulinic acid show a reduction in skin tightness, suggesting that this therapy reduces skin sclerosis. To investigate potential mechanisms, the effects of 5-aminolevulinic acid and light on collagen metabolism were studied in vitro . Normal and scleroderma fibroblasts were treated with sublethal doses of 5-aminolevulinic acid and red light and transferred to three-dimensional collagen lattices. Cell supernatants were taken 6–72 h after photodynamic therapy to determine protein levels of the matrix metalloproteinases 1, 2, and 3, and of their inhibitors, tissue inhibitor of metalloproteinase 1 and 2 by enzyme-linked immunosorbent assay. Cellular mRNA expression of these proteins and of collagen type I and III was measured by quantitative real-time polymerase chain reaction. A significant, time-dependent induction of matrix metalloproteinase 1 (up to 2.4-fold after 48 h) and matrix metalloproteinase 3 (up to 4.3-fold after 48 h) protein levels was seen after 5-aminolevulinic acid-photodynamic therapy. Irradiation with ultraviolet A light, used as a positive control, showed a similar induction of matrix metalloproteinase 1 (2.3-fold after 48 h). The mRNA levels of matrix metalloproteinase 1 and matrix metalloproteinase 3 were significantly increased 12 h after irradiation, whereas collagen type I mRNA was strongly decreased already 6 h following irradiation. Collagen type III, tissue inhibitor of metalloproteinase 1, and matrix metalloproteinase 2 did not change after photodynamic therapy. Addition of nontoxic concentrations of sodium azide, a singlet-oxygen quencher, significantly inhibited induction of matrix metalloproteinase 1 by 5-aminolevulinic acid and light. These data show that 5-aminolevulinic acid and light induce matrix metalloproteinase 1 and matrix metalloproteinase 3 expression in normal and scleroderma fibroblasts in a singlet oxygen-dependent way while... [ABSTRACT FROM AUTHOR]
- Published
- 2003
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38. Multiple External Root Resorption of Teeth as a New Manifestation of Systemic Sclerosis—A Cross-Sectional Study in Japan
- Author
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Tomohiro Sugimoto, Hidemi Kurihara, Hiromi Nishi, Shinji Matsuda, Kazuhisa Ouhara, Tsuyoshi Fujita, Noriyoshi Mizuno, Hiroyuki Kawaguchi, Mikihito Kajiya, Takumi Memida, Eiji Sugiyama, Yusuke Yoshida, and Shintaro Hirata
- Subjects
medicine.medical_specialty ,Cross-sectional study ,systemic sclerosis ,lcsh:Medicine ,Root resorption ,Gastroenterology ,Article ,03 medical and health sciences ,0302 clinical medicine ,Calcinosis ,Tongue ,Internal medicine ,medicine ,In patient ,Facial region ,030203 arthritis & rheumatology ,business.industry ,lcsh:R ,Temporomandibular disorder ,food and beverages ,multiple external root resorption ,030206 dentistry ,General Medicine ,medicine.disease ,oral manifestations ,medicine.anatomical_structure ,Skin sclerosis ,business - Abstract
Background: Multiple external root resorption (MERR) has been reported in systemic sclerosis (SSc) patients in Japan and Spain. To establish whether MERR is a new manifestation, we investigated the prevalence of MERR and systemic and oral manifestations to be associated with MERR in patients with SSc. Methods: Root resorption was detected by dental X-rays, panoramagraphy or cone beam computed tomography (CBCT). The prevalence of systemic and oral manifestations was examined by rheumatologists and dentists, respectively. Autoantibodies were investigated using laboratory tests. Results: MERR was detected in four out of the 41 patients (9.8%) who participated in the present study. The prevalence of digital ulcers was significantly higher in patients with MERR (MERR vs non-MERR, 75% vs 16.2%, p <, 0.05), whereas that of other systemic manifestations was not. The prevalence of face skin sclerosis (100% vs 10.8%, p <, 0.01), calcinosis at the facial region (75% vs 0%, p <, 0.01), limited mouth opening (75% vs 18.9% p <, 0.05), temporomandibular disorder symptoms (50% vs 2.7%, p <, 0.05), and tongue rigidity (75% vs 2.7%, p <, 0.05) was significantly higher in patients with MERR. Conclusion: SSc patients with MERR had highly homogenous maxillofacial manifestations. Further clinical and basic studies are needed to elucidate the mechanisms underlying MERR in SSc patients.
- Published
- 2019
39. Effect of monthly cyclophosphamide pulses on skin sclerosis in systemic sclerosis
- Author
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Sureshan Deepthi Nalini, Anza Khader, Biju George, Bindu Valiaveetil, Marjaan Marunnan Abdul Nazeer, Neeraj Manikath, and Sarita Sasidharanpillai
- Subjects
Adult ,Male ,medicine.medical_specialty ,Scleroderma, Systemic ,Cyclophosphamide ,business.industry ,MEDLINE ,Dermatology ,Middle Aged ,Drug Administration Schedule ,Cohort Studies ,Infectious Diseases ,Treatment Outcome ,medicine ,Humans ,Skin sclerosis ,Female ,business ,Immunosuppressive Agents ,medicine.drug ,Aged - Published
- 2019
40. Systemic Sclerosis and Systemic Lupus Erythematosus Overlap Syndrome with Pulmonary Arterial Hypertension Successfully Treated with Immunosuppressive Therapy and Riociguat
- Author
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Yukihiko Saeki, Masato Matsushita, Kentaro Kuzuya, S. Tsuji, and Shiro Ohshima
- Subjects
medicine.medical_specialty ,Tricuspid valve ,integumentary system ,business.industry ,General Engineering ,Overlap syndrome ,030204 cardiovascular system & hematology ,medicine.disease ,Soluble Guanylate Cyclase Stimulator ,Riociguat ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Mixed connective tissue disease ,Internal medicine ,Cardiology ,Medicine ,Skin sclerosis ,Exertion ,skin and connective tissue diseases ,business ,Pulmonary wedge pressure ,030217 neurology & neurosurgery ,medicine.drug - Abstract
We report the case of a 40-year-old patient with systemic sclerosis (SSc) and systemic lupus erythematosus (SLE) overlap syndrome with pulmonary arterial hypertension (overlap-PAH) that was successfully treated with a combination of immunosuppressive therapy and the soluble guanylate cyclase stimulator riociguat. She was diagnosed with mixed connective tissue disease (MCTD) two years prior to admission. She was admitted to our hospital with dyspnea on exertion and progressive skin sclerosis. She fulfilled both SLE and SSc classification criteria and was re-diagnosed with overlap syndrome. The tricuspid valve pressure gradient (TRPG) on echocardiography was 64 mmHg at admission. On right heart catheterization, mean pulmonary arterial pressure (mPAP) was 43 mmHg and pulmonary capillary wedge pressure was 15 mmHg. We diagnosed her with SSc-SLE overlap-PAH and started treatment with corticosteroids and intravenous cyclophosphamide. We also started treatment with riociguat because we speculated she had a component of SSc-PAH and that immunosuppressive therapy alone may be insufficient. We chose riociguat because of its favorable treatment effect on SSc-PAH. Two months after treatment, her TRPG improved to 33 mmHg and the skin sclerosis improved dramatically, suggesting the efficacy of multi-drug treatment and the importance of early intervention.
- Published
- 2019
41. Serum levels of soluble programmed death-1 and programmed death ligand-1 in systemic sclerosis: Association with extent of skin sclerosis
- Author
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Hidemi Nakagawa, Mitsuha Hayashi, Yuki Yoshihara, and Koichi Yanaba
- Subjects
Adult ,Male ,0301 basic medicine ,Programmed Cell Death 1 Receptor ,Dermatology ,Severity of Illness Index ,B7-H1 Antigen ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Scleroderma, Limited ,mental disorders ,Severity of illness ,Humans ,Medicine ,In patient ,skin and connective tissue diseases ,Aged ,integumentary system ,business.industry ,Case-control study ,General Medicine ,Middle Aged ,Ligand (biochemistry) ,030104 developmental biology ,Case-Control Studies ,030220 oncology & carcinogenesis ,Scleroderma, Diffuse ,Immunology ,Female ,Skin sclerosis ,Programmed death 1 ,business ,Programmed death - Abstract
The interaction of programmed death-1 (PD-1) with its ligand, programmed death ligand-1 (PD-L1), has been considered to play a key role in the negative regulation of immune responses. Patients with diffuse cutaneous systemic sclerosis (SSc) had higher levels of soluble PD-1 (sPD-1) than those with limited cutaneous SSc and healthy individuals. Serum sPD-1 levels positively correlated with the severity of skin sclerosis. In contrast, serum sPD-L1 levels were significantly increased in patients with SSc compared with healthy individuals. Moreover, serum sPD-L1 levels were not associated with the extent of skin sclerosis and were elevated not only in patients with diffuse cutaneous SSc, but also in those with limited cutaneous SSc. These results suggested that serum sPD-1 levels may increase in patients with SSc and correlate with the severity of skin sclerosis. PD-1/PD-L1 interaction may contribute to the development of skin sclerosis in SSc.
- Published
- 2016
42. Augmented production of chemokines (monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1α (MIP-1α) and MIP-1β) in patients with systemic sclerosis: MCP-1 and MIP-1α may be involved in the development of pulm...
- Author
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HASEGAWA, SATO, TAKEHARA, and Sato, Shinichi
- Subjects
- *
CHEMOKINES , *SYSTEMIC scleroderma - Abstract
To determine the role of chemokines in the pathogenesis of systemic sclerosis (SSc), we examined serum levels, spontaneous production by peripheral blood mononuclear cells (PBMC), and histological distribution in the affected skin, of MCP-1, MIP-1α and MIP-1β in SSc patients. Serum levels of these chemokines were examined by ELISA in 58 patients with SSc and 20 normal controls. The levels of these chemokines in culture supernatants from PBMC were also measured by ELISA. Serum levels and spontaneous production levels by PBMC of MCP-1, MIP-1α, and MIP-1β were significantly elevated in patients with SSc compared with normal controls. Elevated serum levels of MCP-1 and MIP-1α significantly correlated with the presence of pulmonary fibrosis. MCP-1 expression in the skin of SSc was immunohistochemically examined using anti-MCP-1 MoAb. MCP-1 was strongly expressed in the epidermis, inflammatory mononuclear cells, and vascular endothelial cells in the sclerotic skin of SSc patients, but not expressed in any control skin. Furthermore, the MCP-1 expression in inflammatory mononuclear cells and endothelial cells significantly correlated with earlier onset of SSc. Thus, MCP-1, MIP-1α and MIP-1β may be involved in the disease process, possibly by augmenting leucocyte migration into the affected tissues in SSc. Furthermore, MCP-1 and MIP-1α may play an important role in the development of pulmonary fibrosis in SSc. [ABSTRACT FROM AUTHOR]
- Published
- 1999
- Full Text
- View/download PDF
43. Hand Impairment in Systemic Sclerosis: Various Manifestations and Currently Available Treatment
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Young, Amber, Namas, Rajaie, Dodge, Carole, and Khanna, Dinesh
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- 2016
- Full Text
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44. Novel Disease-Modifying Drugs against Skin Fibrosis of Systemic Sclerosis
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Masatoshi Jinnin, Yuki Yamamoto, and Mana Nishiguchi
- Subjects
medicine.medical_specialty ,integumentary system ,business.industry ,Immunology ,Disease ,medicine.disease ,Dermatology ,Scleroderma ,Extracellular matrix ,medicine.anatomical_structure ,Oncology ,Dermis ,Fibrosis ,medicine ,Etiology ,Immunology and Allergy ,Pharmacology (medical) ,Skin sclerosis ,Adverse effect ,business - Abstract
Systemic sclerosis (SSc) or scleroderma is an autoimmune disorder characterized by tissue fibrosis of the skin and internal organs. The etiology of the skin fibrosis is thought to be thickened dermis due to uncontrolled excessive deposition of various extracellular matrix, mainly type I collagen.Systemic treatments with anti-inflammatory and cytotoxic immunosuppressive properties, such as corticosteroids and immunosuppressants, are usually considered for skin sclerosis of patients with SSc. However, their approach must be initiated at the early stage, before the fibrosis is completed, and the effects of the corticosteroids and immunosuppressants are known to be reduced in the late stages of the sclerosis. Furthermore, various significant adverse effects of these treatments must be considered.This paper discusses the present day understanding of therapeutic options using disease-modifying drugs against skin sclerosis of SSc patients and the possible mechanisms.
- Published
- 2020
45. Therapeutic efficacy of combined glucocorticoid, intravenous cyclophosphamide, and double-filtration plasmapheresis for skin sclerosis in diffuse systemic sclerosis
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Yuko Takahashi, Hiroshi Kaneko, Hiroyuki Yamashita, Daisuke Katagiri, Kensuke Suga, and Fumihiko Hinoshita
- Subjects
Male ,medicine.medical_specialty ,Vital capacity ,systemic sclerosis ,Prednisolone ,medicine.medical_treatment ,Vital Capacity ,Administration, Oral ,Observational Study ,Gastroenterology ,Scleroderma ,03 medical and health sciences ,FEV1/FVC ratio ,0302 clinical medicine ,DLCO ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Infusions, Intravenous ,Prospective cohort study ,Cyclophosphamide ,Glucocorticoids ,Aged ,Retrospective Studies ,business.industry ,Cumulative dose ,Mucin-1 ,intravenous cyclophosphamide ,Plasmapheresis ,General Medicine ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Treatment Outcome ,double-filtration plasmapheresis ,skin sclerosis ,030220 oncology & carcinogenesis ,Scleroderma, Diffuse ,Pulmonary Diffusing Capacity ,Female ,glucocorticoid ,business ,Immunosuppressive Agents ,Glucocorticoid ,Research Article ,medicine.drug - Abstract
We treated skin sclerosis with triple therapy consisting of a glucocorticoid, intravenous cyclophosphamide, and double-filtration plasmapheresis. The objective of this study was to analyze its effectiveness in a case series of patients who received triple therapy. We enrolled 8 patients with diffuse cutaneous systemic sclerosis (dcSSc) who received triple therapy at our hospital from 2008 to 2016. We analyzed the mean change in the modified Rodnan skin score (mRSS), percentage of the predicted forced vital capacity (%FVC), percentage of the predicted carbon monoxide diffusing capacity (%DLCO), and serum KL-6 levels from baseline to follow-up. All patients were treated with an intermediate dose of oral prednisolone (30.6 ± 2.1 mg/day) initially. The mean cumulative dose of intravenous cyclophosphamide was 1.4 ± 0.2 g. The mean mRSS decreased significantly at follow-up compared with that at baseline (27.0 ± 3.3 vs 15.8 ± 3.5; P = .03). At the end of the treatment, the mean %FVC and %DLCO were improved moderately, although the differences were not significant. The serum KL-6 levels decreased from 578.9 ± 146.5 to 205.3 ± 43.1 U/ml (P = .02). No significant correlation was found between the change in mRSS or disease duration and the initial skin score severity. Triple therapy may improve skin sclerosis, with effectiveness equal or superior to other reported treatments. This preliminary case series demonstrates the potential of triple therapy for treating dcSSc. However, prospective studies with long-term follow-up should be performed to assess its role.
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- 2020
46. Evaluation of Serum Vitamin D Levels in Patients with Systemic Sclerosis and Healthy Controls: Results of a Pilot Study
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Ritu Rawat, Vikram K Mahajan, Karaninder S Mehta, Vikas Sharma, Pushpinder S Chauhan, Sarita Gupta, Satya Bhushan, and Rajinder S Yadav
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medicine.medical_specialty ,dysphagia ,Gastroenterology ,Scleroderma ,vitamin D deficiency ,Pathogenesis ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Vitamin D and neurology ,lcsh:Dermatology ,In patient ,scleroderma ,030212 general & internal medicine ,030203 arthritis & rheumatology ,Serum vitamin ,integumentary system ,business.industry ,lcsh:RL1-803 ,Autoimmune disorders ,dyspnea ,medicine.disease ,Dysphagia ,Raynaud's phenomenon ,Skin sclerosis ,Original Article ,medicine.symptom ,connective tissue diseases ,business - Abstract
Background: The anti-inflammatory, immunomodulatory, and anti-proliferative effects of vitamin D in pathogenesis of autoimmune diseases have been highlighted in recent years but implications of vitamin D deficiency in systemic sclerosis (SSc) remain understudied. Objectives: To evaluate serum vitamin D levels in SSc patients and matched controls. Materials and Methods: Serum vitamin D levels were estimated in 38 (M:F 5:33) patients aged 23–70 years of untreated SSc and age and gender matched healthy controls. Clinical and investigative evaluation for skin sclerosis by modified Rodnan skin score (mRSS), presence of digital ulcers, Raynaud's phenomenon, type of auto-antibodies, systemic involvement, and serum vitamin D levels were performed. Serum vitamin D levels were defined as normal (30–100 ng/ml), insufficient (10–30 ng/ml), and deficient (
- Published
- 2018
47. Long-term follow-up of finger passive range of motion in Japanese systemic sclerosis patients treated with self-administered stretching
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Hirokazu Okita, Sachie Oohata, Kazuhiko Takehara, Yasuhito Hamaguchi, Naoki Mugii, Takashi Matsushita, Minoru Hasegawa, Fujiko Someya, Tetsutarou Yahata, and Manabu Fujimoto
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Adult ,Male ,medicine.medical_specialty ,Long term follow up ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,Rheumatology ,Finger Joint ,Muscle Stretching Exercises ,medicine ,Humans ,In patient ,030212 general & internal medicine ,Range of Motion, Articular ,skin and connective tissue diseases ,030203 arthritis & rheumatology ,Rehabilitation ,Hand function ,Scleroderma, Systemic ,integumentary system ,business.industry ,food and beverages ,Middle Aged ,Skin sclerosis ,Female ,sense organs ,Range of motion ,business - Abstract
Severe skin sclerosis in patients with systemic sclerosis (SSc) can result in a loss of hand function. The aim of this study is to examine the long-term changes of finger passive range of motion (ROM) in Japanese SSc patients treated with self-administered stretching.This is a single-center, retrospective, observational cohort study. Forty-three Japanese patients with SSc were given instructions on self-administered stretching. ROM was assessed using a goniometer on their first visit and after 1 year, 3 years, 5 years and 9 years. Hand function was assessed by the Health Assessment Questionnaire disability index (HAQ-DI) at their first visit and after 9 years.Total passive ROM significantly improved in each finger after 3 years of finger stretching. Most patients (37 of 43 patients, 86%) improved or maintained total passive ROM and hand function within 9 years after their first visit. However, significant improvement of total passive ROM was lost in 6 of 43 SSc patients (14%) 9 years after their first visit. The HAQ-DI also was increased in these six patients. Multivariable analyses revealed that re-elevation of modified Rodnan total skin thickness score during the clinical course (OR = 5.260e + 7, 95% CI 1.52e + 150-uncalculated p = .0096) was the independent factor associated with deterioration of total passive ROM at 9 years.Patients with progressive skin sclerosis during the clinical course need multimodality therapy to maintain finger joint motion, since the effect of self-administered stretching is limited in these patients.
- Published
- 2018
48. Serum Calponin 3 Levels in Patients with Systemic Sclerosis: Possible Association with Skin Sclerosis and Arthralgia.
- Author
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Kotani, Hirohito, Yoshizaki, Ayumi, Matsuda, Kazuki M., Norimatsu, Yuta, Kuzumi, Ai, Fukayama, Maiko, Fukasawa, Takemichi, Ebata, Satoshi, Yoshizaki-Ogawa, Asako, Asano, Yoshihide, Oba, Koji, and Sato, Shinichi
- Subjects
- *
SYSTEMIC scleroderma , *JOINT pain , *CONNECTIVE tissue diseases , *ENZYME-linked immunosorbent assay , *SERUM , *FIBROSIS - Abstract
Systemic sclerosis (SSc) is a connective tissue disease characterized by tissue fibrosis and vasculopathy in various organs with a background of inflammation initiated by autoimmune abnormalities. Calponin 3 plays a role in the cell motility and contractibility of fibroblasts during wound healing in the skin. We aimed to evaluate serum calponin 3 levels in SSc patients and their association with clinical manifestations of SSc. Serum samples were collected from 68 patients with SSc and 20 healthy controls. Serum calponin 3 levels were examined using enzyme-linked immunosorbent assay kits, and their association with clinical features of SSc was statistically analyzed. The upper limit of the 95% confidence interval of serum calponin 3 levels in healthy controls was utilized as the cut-off value when dividing SSc patients into the elevated and normal groups. Serum calponin 3 levels were significantly higher in SSc patients than in healthy controls (mean (95% confidence interval), 15.38 (14.66–16.11) vs. 13.56 (12.75–14.38) ng/mL, p < 0.05). The modified Rodnan total skin thickness score was significantly higher in the elevated serum calponin 3 level group than in the normal level group (median (25–75th percentiles), 10.0 (2.0–16.0) vs. 6.5 (3.25–8.75), p < 0.05). Moreover, SSc patients with increased serum calponin 3 levels also had a higher frequency of arthralgia (40% vs. 9%, p < 0.05). Elevated serum calponin 3 levels were associated with skin sclerosis and arthralgia in SSc patients. Serum calponin 3 levels might be a biomarker that reflects the severity of skin sclerosis and joint involvement in SSc. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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49. Calcific Uremic Arteriolopathy Revisited
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Anna Jovanovich and Michel Chonchol
- Subjects
Calciphylaxis ,medicine.medical_specialty ,business.industry ,030232 urology & nephrology ,Inflammation ,General Medicine ,medicine.disease ,Dermatology ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Nephrology ,Chronic dialysis ,Coronary artery calcification ,medicine ,Skin sclerosis ,030212 general & internal medicine ,medicine.symptom ,business ,Sensitization ,Calcification - Abstract
Calciphylaxis was first described in the early 1960s by dermatologist Hans Selye et al. [1][1] as local cutaneous calcification leading to inflammation and skin sclerosis, which is provoked by a mechanical or chemical “challenger” after sensitization with a “systemic calcifying factor.” In
- Published
- 2016
50. Vitiligo-like depigmentation with perifollicular pigment retention in systemic sclerosis treated successfully with suplatast tosilate
- Author
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Noriki Fujimoto, Yasuhito Hamaguchi, and Toshihiro Tanaka
- Subjects
0301 basic medicine ,Upper Arms ,medicine.medical_specialty ,Pathology ,integumentary system ,medicine.diagnostic_test ,business.industry ,Physical examination ,Sclerodactyly ,Dermatology ,Vitiligo ,medicine.disease ,Scleroderma ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Suplatast tosilate ,030104 developmental biology ,0302 clinical medicine ,Depigmentation ,medicine ,Skin sclerosis ,medicine.symptom ,business - Abstract
A 26-year-old woman noticed swollen fingers and depigmentation on her chest and back three months previously and was subsequently referred to our hospital for digital ulcers in 2009. Physical examination showed sclerodactyly and moderate skin sclerosis up to the upper arms with Raynaud's phenomenon. Slightly pruritic depigmented macules, excluding the perifollicular area, were observed on her chest, back and face (figures 1A, B), where the sclerotic lesion was absent. Laboratory investigations showed [...]
- Published
- 2016
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