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Correlation between circulating fibrocytes and dermal thickness in limited cutaneous systemic sclerosis patients: a pilot study

  • Observational Research
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Abstract

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.

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Acknowledgements

The authors would like to thank Barbara Wade, contract Professor at the University of Torino, for her linguistic advice. Professor Vanessa Smith is a Senior Clinical Investigator of the Research Foundation—Flanders (Belgium) (FWO) [1802915 N]. Barbara Ruaro was supported by an EULAR scientific training bursary.

Funding

No specific funding was received from any bodies in the public, commercial or nonprofit sectors to carry out the research reported in this manuscript.

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Author notes

  1. Barbara Ruaro and Stefano Soldano contributed equally to this study.

Authors and Affiliations

  1. 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

    Barbara Ruaro, Stefano Soldano, Sabrina Paolino, Paola Montagna, Carmen Pizzorni, Andrea Casabella, Samuele Tardito, Alberto Sulli & Maurizio Cutolo

  2. Department of Rheumatology, Ghent University Hospital, Ghent, Belgium

    Vanessa Smith

  3. Department of Internal Medicine, Ghent University, Ghent, Belgium

    Vanessa Smith

  4. Unit for Molecular Immunology and Inflammation, VIB Inflammation Research Center (IRC), Ghent, Belgium

    Vanessa Smith

  5. Division of Clinical Immunology, Department of Internal Medicine, University of Genova, IRCCS San Martino Polyclinic Hospital, Genoa, Italy

    Paola Contini

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  1. Barbara Ruaro
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Contributions

All authors have: (1) made substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data; (2) been involved in drafting the manuscript or revising it critically for important intellectual content; (3) given final approval of the version to be published; and (4) agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Barbara Ruaro.

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The authors declare no competing interests with this work.

Ethical approval

Study was approved by Ethics Committee of the IRCCS San Martino Polyclinic Hospital of Genoa (Protocol Number 273-REG-2015).

Research involving human participants

This article contains a study with human participants.

Informed consent

The patients were enrolled after having obtained their written informed consent for the use of imaging and the demographic data as educational material and for publications. This study was carried out in accordance with the ethical standards stipulated in the 1964 Declaration of Helsinki and its later amendments and was evaluated by the local IRB.

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Ruaro, B., Soldano, S., Smith, V. et al. Correlation between circulating fibrocytes and dermal thickness in limited cutaneous systemic sclerosis patients: a pilot study. Rheumatol Int 39, 1369–1376 (2019). https://doi.org/10.1007/s00296-019-04315-7

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  • DOI: https://doi.org/10.1007/s00296-019-04315-7

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