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Introduction SSc is an autoimmune disease characterized by fibrous changes in the connective tissue of the skin and internal organs.The etiology and pathogenesis of SSc are currently unclear.There is evidence that monocyte chemoattractant protein-1(MCP-1) has been identified in the blood and in lesions in patients with SSC.This chemokine is a chemoattractant for monocytes/macrophages,as well as an inducer of collagen biosynthesis.Recent studies have shown that increased levels of pro-inflammatory chemokines are associated with the onset and/or development of a fibrotic condition,suggesting that chemokines and their receptors may be important mediators of inflammation and fibrosis in SSc.In particular,it has been suggested that MCP-1 plays an important role in the development and progression of SSc.Objectives To study the associations of the MCP-1 level with the main clinical manifestations and activity of SSc during active therapy.Material and Methods 66 patients with SSc and interstitial lung disease(SSc-ILD)were enrolled into the study(disease duration 7.2±5.6 years,diffused/limited SSc 1.7/1,average age 50.3 ± 12.6 years,females 77%).All patients received low or moderate dose glucocorticoids and immunosuppressants,45(68%) received rituximab(RTM) at cumulative dose 2.4±1.5 grams.The level of MCP-1 was determined by the ELISA method.Subsequently correlation analysis was made to clarify the association of the MCP-1 level with the main clinical manifestations,activity of SSc(EScSG, points), laboratory parameters(ESR,CRP,ANA-HEP-2,a-Scl-70,B cell count),glucocorticoid and immunosuppressant-therapy and cumulative RTM-dose. The control group included people without autoimmune diseases,who were comparable in age and gender(n=38).To determine the diagnostic value of MCP-1 in patients with SSc,a ROC-analysis was performed.Results The area under the ROC curve(AUC) is 0.753,95% CI:0.652;0.854,p=0.00001.At the cut-off point of 78.85,the MCP-1 marker makes it possible to differentiate patients with SSc from healthy controls with a sensitivity of 86% and a specificity of 57%.The level of MCP-1 was significantly correlated with the development of,cardiopathy (r=0.37),diastolic dysfunction of the left ventricle(r=0.26),decreased glomerular filtration rate(r=0.31),arthritis(r=0.29),modified skin score (r=0.31),SSc activity(r=0.29),levels of CRP(r=0.38),ESR(r=0.36). An inverse correlation was found between the level of MCP-1 and the total dose of RTM(r= -0.37),but not with the dose of glucocorticoids and the use of immunosuppressants.There was no correlation between the level of MCP-1 and the indicators of functional pulmonary tests and MSCT data.Conclusions The data obtained indicate the role of MCP-1 in maintaining the inflammatory activity of SSc,which probably contributes to the progression of cardiopathy,endothelial dysfunction,and cutaneous fibrosis.A decrease in MCP-1 levels during RTM-therapy may be a potential predictor of the effectiveness of this drug,but this issue requires further study.