Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Viale Benedetto XV, No 6, 16132, Genoa, Italy.
Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.
Rheumatol Int. 2019 Aug;39(8):1369-1376. doi: 10.1007/s00296-019-04315-7. Epub 2019 May 6.
The objective is to detect any possible correlation between the modified Rodnan skin score (mRSS) and dermal thickness (DT) measured by skin high-frequency ultrasound (US) and the percentage of circulating fibrocytes in patients with limited cutaneous systemic sclerosis (lcSSc). Eight lcSSc patients and five healthy subjects (control group, CNT) were enrolled. The skin involvement was evaluated by mRSS and US (18 and 22 MHz probes) in all 13 subjects in the 17 standard skin areas evaluated by mRss. Circulating fibrocytes were isolated from the peripheral blood mononuclear cells (PBMCs) of all lcSSc patients and the CNT group to analyze their percentage at baseline time (T0) when the experiments started with PBMCs' isolation and collection and after 8 days of culture (T8). Non-parametric tests were used for the statistical analysis. A positive correlation between the percentage of circulating fibrocytes at T0, mRSS (p = 0.04 r = 0.96), and DT-US, evaluated by the 22 MHz and the 18 MHz probes (p = 0.03, r = 0.66 and p = 0.05, r = 0.52, respectively), was observed in lcSSc patients. Conversely, at T8, there was no correlation (p > 0.05) between these parameters in lcSSc group. In the CNT group, no correlations between mRSS or DT-US and the percentage of circulating fibrocytes were observed both at T0 and T8. The study shows the presence of a significant relationship between the percentage of circulating fibrocytes and DT, as evidenced by both mRSS and US, in limited cutaneus SSc. This observation may well suggest the reasonable hypothesis of a crucial contribution of circulating fibrocytes to skin fibrosis progression, which might be considered as further biomarkers.
目的是检测改良的罗德南皮肤评分（mRSS）和皮肤高频超声（US）测量的真皮厚度（DT）与局限性皮肤系统性硬化症（lcSSc）患者循环成纤维细胞百分比之间是否存在任何可能的相关性。共纳入 8 例 lcSSc 患者和 5 名健康受试者（对照组，CNT）。在所有 13 例受试者的 17 个标准皮肤区域，使用 mRSS 和 US（18 和 22 MHz 探头）评估皮肤受累情况。从所有 lcSSc 患者和 CNT 组的外周血单核细胞（PBMCs）中分离循环成纤维细胞，以分析其在实验开始时（T0），即从 PBMCs 分离和收集时的百分比，以及培养 8 天后（T8）的百分比。采用非参数检验进行统计学分析。在 lcSSc 患者中，T0 时循环成纤维细胞的百分比与 mRSS（p=0.04，r=0.96）和 DT-US 呈正相关，用 22 MHz 和 18 MHz 探头评估（p=0.03，r=0.66 和 p=0.05，r=0.52）。相反，在 lcSSc 组中，在 T8 时这些参数之间没有相关性（p>0.05）。在 CNT 组中，在 T0 和 T8 时，mRSS 或 DT-US 与循环成纤维细胞的百分比之间均无相关性。该研究表明，在局限性皮肤系统性硬化症中，循环成纤维细胞的百分比与 DT 之间存在显著关系，这一点通过 mRSS 和 US 都得到了证实。这一观察结果很可能表明，循环成纤维细胞对皮肤纤维化进展有重要贡献，这可以被视为进一步的生物标志物。
