Researchers study high levels of the ADAR1 protein in macrophages by Margarida Maia, PhD

The protein ADAR1 occurs in great amounts in macrophages, a type of immune cell that appears in the early stages of systemic sclerosis (SSc), making the cells more active and stirring up a “turmoil” of inflammation, a mouse study found.

Researchers also observed that mice in which the disease was induced by injection of a chemical — bleomycin — developed fewer symptoms in their skin and lungs when engineered to have ADAR1 deficiency in macrophages. Their macrophages also made fewer certain inflammatory molecules.

The findings suggest that “targeting ADAR1 could be a potential novel therapeutic strategy for treating sclerosis,” the researchers wrote.
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The study, “ADAR1 promotes systemic sclerosis via modulating classic macrophage activation,” was published in the journal Frontiers in Immunology.

Case study highlights option of a second stem cell transplant for relapsed SS
by Patricia Inácio, PhD 

A 42-year-old man with scleroderma responded well to a second stem cell transplant after experiencing a disease relapse with lung involvement following his initial transplant, according to a recent report.
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Improvements in skin thickening and lung function were quickly seen, and the patient was still in remission two years after the procedure.

The study, “Case report: A successful second autologous hematopoietic stem cell transplantation in refractory systemic sclerosis, with positive effect on skin involvement, pulmonary function and microcirculation,” was published in the journal Frontiers in Immunology.

Blood levels of the periostin protein were associated with the degree of skin and cardiac involvement, but not lung or blood vessel involvement, in people with systemic sclerosis (SSc), a study found.

Levels of the protein also were higher in patients with diffuse forms of SSc, those living with the disease for a shorter time, and in male patients.

Findings overall suggest that periostin may be a useful biomarker for predicting disease severity, particularly cardiac complications, in SSc.

“To our knowledge, this is the first study to show that periostin is elevated in SSc cardiac tissue,” the researchers wrote, noting that “future work will need to prospectively investigate periostin levels in SSc patients.”
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The study, “Periostin overexpression in scleroderma cardiac tissue and its utility as a marker for disease complications,” was published in the journal Arthritis Research and Therapy.

People with systemic scleroderma (SSc) who test positive for cyclic citrullinated peptide (CCP) antibodies are more likely than those who test negative to develop interstitial lung disease (ILD) — when the lungs become scarred — and have worse lung function.

​That’s according to data from a South Korean study that included people with systemic lupus erythematosus (SLE) or myositis, disorders with symptoms that sometimes overlap with scleroderma.
The study, “A retrospective analysis of the relationship between anti-cyclic citrullinated peptide antibody and interstitial lung disease in systemic sclerosis,” was published in Scientific Reports.

A CCP antibody test looks for anti-CCP antibodies in the blood. They are a type of autoantibody that wrongfully turns against healthy tissues in the joints.

Blood levels of microRNA-27a found abnormally low in women with SSc - ​by Lindsey Shapiro, PhD

The levels of a small RNA molecule called microRNA-27a, or miR-27a, are significantly lower in the blood of women with systemic sclerosis (SSc) compared with healthy women, a study shows.Thus, “MiR-27a could serve as a reliable diagnostic marker for SSc,” researchers wrote, adding that the molecule “could be considered as a treatment option both for SSc and its related disorders and complications, which indeed necessitates further investigations.”
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The study, “MiR-27a as a diagnostic biomarker and potential therapeutic target in systemic sclerosis,” was published in Scientific Reports. 

Analysis of immune cell gene activity may predict patient's response to treatment - by Marisa Wexler, MS 

Analyzing the global genetic activity of immune cells called monocytes can identify distinct groups among people with systemic scleroderma, a new study indicates.
This type of analysis “may represent a viable mechanism for identifying patients and potentially their response to therapeutics,” its researchers wrote.
The study, “Three Distinct Transcriptional Profiles of Monocytes Associate with Disease Activity in Scleroderma Patients,” was published in Arthritis & Rheumatology.

Patients with persistent symptoms used more healthcare resources, researchers said - by Lindsey Shapiro, PhD

Tobacco use by systemic sclerosis (SSc) patients is linked to worsening gastrointestinal (GI) symptoms, but the immunosuppressive and anti-scarring medications used to treat the autoimmune disease aren’t, according to a recent analysis of data from a multicenter, U.S.-based patient registry.
The findings are striking in light of previous studies that suggested certain medications might drive GI problems in SSc patients, whereas tobacco hasn’t yet been linked to this type of symptom, noted Sarah Luebker, a doctor of osteopathic medicine, the study’s first author ,and a rheumatology fellow at Vanderbilt University Medical Center.

Most reporting on-the-job silica exposure are men, a study finds - by Margarida Maia, PhD

Exposure to silica, a mineral used to make building materials, at work is associated with younger age at diagnosis, more severe disease, and reduced survival in people with systemic sclerosis (SSc), according to a study of more than 1,000 patients in Canada and Mexico.
Also, those reporting on-the-job silica exposure were nearly eight times more likely to be men than women. Exposed male patients were more likely to be Caucasian, smokers, and to have more severe lung disease, while exposed female patients were younger at SSc diagnosis relative to those unexposed.
“Screening for silica exposure among higher risk individuals may be beneficial,” the researchers wrote, adding that “these patients may require closer monitoring for systemic disease.”
The study, “Exposure to silica and systemic sclerosis: A retrospective cohort study based on the Canadian Scleroderma Research Group,” was published in the journal Frontiers in Medicine.

Preparation and self-advocacy have made a difference for this columnist -by Amy Gietzen | October 12, 2022

Anyone living with scleroderma knows it is a difficult disease to manage. As patients, we are constantly flustered by a disease that seems to have no boundaries. Symptoms and treatment strategies vary from person to person, and scleroderma has no cure.
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Because of this, every scleroderma patient has the unfortunate task of becoming their own self-advocate, which entails learning through lived experiences. Patients must learn how to keep up with treatments, manage symptoms, and cultivate resources, which include people I refer to as “reliables,” or those I trust, along with medical specialists and others in my support network.

When yoga poses get challenging, a columnist keeps looking for improvement - by Lisa Weber | October 7, 2022

My feet were planted firmly on my turquoise yoga mat, and I felt strong as I held the Warrior 1 pose. My front foot was lunging forward as my arms were stretched up high above my head. Soft, spalike instrumentals swirled around me as the instructor’s voice guided me to place my hands on the ground and bring myself to a forward bend. I glanced at the TV to get a visual of these instructions, calling for hands and feet on the floor to make a bridge with my body.
The past gymnast inside me thinks, “This will be easy!”
In my head, I’m still agile and flexible, as I was before scleroderma started its war on my body. Without much thought, I sprang right into that pose. Only I didn’t look like the graceful, bendy yoga instructor. My hands didn’t open fully to support my weight, and my legs wouldn’t stretch straight enough to form the V-shape I was hoping to achieve.