A broad look into the future of systemic sclerosis

Systemic sclerosis (SSc) is a systemic autoimmune disease with the key features of inflammation, vasculopathy and fibrosis. This article focussed on emerging fields based on the authors’ current work and expertise. The authors provide a hierarchical structure into the studies of the pathogenesis of...

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Main Authors: Gabriela Riemekasten, Jörg H.W. Distler
Format: Article
Language:English
Published: SAGE Publishing 2022-08-01
Series:Therapeutic Advances in Musculoskeletal Disease
Online Access:https://doi.org/10.1177/1759720X221109404
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author Gabriela Riemekasten
Jörg H.W. Distler
author_facet Gabriela Riemekasten
Jörg H.W. Distler
author_sort Gabriela Riemekasten
collection DOAJ
description Systemic sclerosis (SSc) is a systemic autoimmune disease with the key features of inflammation, vasculopathy and fibrosis. This article focussed on emerging fields based on the authors’ current work and expertise. The authors provide a hierarchical structure into the studies of the pathogenesis of SSc starting with the contribution of environmental factors. Regulatory autoantibodies (abs) are discussed, which are parts of the human physiology and are specifically dysregulated in SSc. Abs against the angiotensin II receptor subtype 1 (AT1R) and the endothelin receptor type A (ETAR) are discussed in more detail. Extracellular vesicles are another novel player to possess disease processes. Fibroblasts are a key effector cell in SSc. Therefore, the current review will provide an overview about their plasticity in the phenotype and function. Promising nuclear receptors as key regulators of transcriptional programmes will be introduced as well as epigenetic modifications, which are pivotal to maintain the profibrotic fibroblast phenotype independent of external stimuli. Fibroblasts from SSc patients exhibit a specific signalling and reactivate developmental pathways and stem cell maintenance such as by employing hedgehog and WNT, which promote fibroblast-to-myofibroblast transition and extracellular matrix generation. Pharmacological interventions, although for other indications, are already in clinical use to address pathologic signalling.
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spelling doaj.art-40578cbd130e4bf891f9b02212db92f42022-12-22T04:00:38ZengSAGE PublishingTherapeutic Advances in Musculoskeletal Disease1759-72182022-08-011410.1177/1759720X221109404A broad look into the future of systemic sclerosisGabriela RiemekastenJörg H.W. DistlerSystemic sclerosis (SSc) is a systemic autoimmune disease with the key features of inflammation, vasculopathy and fibrosis. This article focussed on emerging fields based on the authors’ current work and expertise. The authors provide a hierarchical structure into the studies of the pathogenesis of SSc starting with the contribution of environmental factors. Regulatory autoantibodies (abs) are discussed, which are parts of the human physiology and are specifically dysregulated in SSc. Abs against the angiotensin II receptor subtype 1 (AT1R) and the endothelin receptor type A (ETAR) are discussed in more detail. Extracellular vesicles are another novel player to possess disease processes. Fibroblasts are a key effector cell in SSc. Therefore, the current review will provide an overview about their plasticity in the phenotype and function. Promising nuclear receptors as key regulators of transcriptional programmes will be introduced as well as epigenetic modifications, which are pivotal to maintain the profibrotic fibroblast phenotype independent of external stimuli. Fibroblasts from SSc patients exhibit a specific signalling and reactivate developmental pathways and stem cell maintenance such as by employing hedgehog and WNT, which promote fibroblast-to-myofibroblast transition and extracellular matrix generation. Pharmacological interventions, although for other indications, are already in clinical use to address pathologic signalling.https://doi.org/10.1177/1759720X221109404
spellingShingle Gabriela Riemekasten
Jörg H.W. Distler
A broad look into the future of systemic sclerosis
Therapeutic Advances in Musculoskeletal Disease
title A broad look into the future of systemic sclerosis
title_full A broad look into the future of systemic sclerosis
title_fullStr A broad look into the future of systemic sclerosis
title_full_unstemmed A broad look into the future of systemic sclerosis
title_short A broad look into the future of systemic sclerosis
title_sort broad look into the future of systemic sclerosis
url https://doi.org/10.1177/1759720X221109404
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