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Inicio Medicina Clínica (English Edition) Utility of cytokines CXCL4, CXCL8 and GDF15 as biomarkers in systemic sclerosis
Journal Information
Vol. 159. Issue 8.
Pages 359-365 (October 2022)
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Vol. 159. Issue 8.
Pages 359-365 (October 2022)
Original article
Utility of cytokines CXCL4, CXCL8 and GDF15 as biomarkers in systemic sclerosis
Utilidad de las citocinas CXCL4, CXCL8 y GDF15 como biomarcadores en la esclerosis sistémica
José E. Oller-Rodrígueza,b,
Corresponding author
joseeloy1986@gmail.com

Corresponding author.
, Elvira Vicens Bernabeua, Roxana Gonzalez-Mazaríoa, Elena Grau Garcíaa, Francisco M. Ortiz Sanjuana, José A. Román Ivorraa,b
a Servicio de Reumatología, Hospital UyP La Fe, Valencia, Spain
b Escuela de Doctorado. Universidad Católica de Valencia San Vicente Mártir, Valencia, Spain
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Abstract
Background and objectives

Systemic sclerosis (SSc) is an autoinmune disease that can affect several organs and its mortality is fundamentally related to its pulmonary involvement. There are some cytokines with high serum levels of patients with SSc. Our goal is to determine the role of CXCL4, CXCL8 and GDF15 in the physiopathology of SSc and whether they can be considered organic damage biomarkers.

Patients and methods

Observational case–control study of SSc patients (ACR/EULAR 2013 criteria). Demographic, clinical, analytical, activity, severity, health perception, and disability variables were collected. Moreover, Videocapillaroscopy, Echocardiography and Respiratory Function Test were made. Serum levels of CXCL4, CXCL8 and GDF15 were measured both in SSc patients and in healthy controls.

Results

A total of 42 patients were included (95.4% women), with an average age of 59.2 years and a median of 4 years from diagnosis. We also included 42 healthy controls. We found significantly higher levels of GDF15 in SSc patients than in controls (p<0.001), but no higher CXCL4 or CXCL8 levels. GDF15 was associated with Diffuse SSc, pulmonary arterial hypertension, interstitial lung disease, less forced vital capacity, high titles of antiScl70, disease activity, and dilated loops in capillaroscopy. CXCL4 levels were associated to a higher Rodnan punctuation, while CXCL8 was associated to C4 fraction consumption and tortuosities in capillaroscopy.

Conclusions

GDF15 high levels were associated with diffuse SSc, lung impairment, disease activity and changes in capillaroscopy. Moreover, CXCL4 was only associated with skin impairment, while CXCL8 was not related to organic damage.

Keywords:
Systemic sclerosis
CXCL4
CXCL8
GDF15
Capillaroscopy
Resumen
Antecedentes y objetivos

La esclerosis sistémica (ES) es una enfermedad autoinmunitaria que afecta a diferentes órganos y cuya mortalidad se relaciona fundamentalmente con su afectación pulmonar. Los pacientes con ES presentan niveles séricos elevados de algunas citocinas. Nuestro objetivo es determinar el papel de CXCL4, CXCL8 y GDF15 en la fisiopatología de la ES, y si pueden considerarse biomarcadores de daño orgánico.

Pacientes y métodos

Estudio observacional de casos-controles, con pacientes afectados de ES (criterios ACR/EULAR 2013) y controles sanos. Se determinaron los niveles séricos de CXCL4, CXCL8 y GDF15 en ambos grupos, y se registraron variables demográficas, clínicas, analíticas, de actividad, gravedad, percepción de salud y discapacidad de pacientes con ES, a quienes, además, se les realizó videocapilaroscopia, ecocardiograma y espirometría.

Resultados

Se incluyeron 42 pacientes (95,4% mujeres), con una edad media de 59,2 años y una mediana de 4 años desde el diagnóstico, con 42 controles sanos. Se hallaron niveles significativamente mayores de GDF15 en pacientes con ES que en controles (p<0,001), pero no de CXCL4 ni CXCL8. GDF15 se asoció a ES difusa, hipertensión pulmonar, enfermedad pulmonar intersticial, menor capacidad vital forzada, títulos altos de anti-Scl70, actividad de ES y dilataciones capilares. Asimismo, los niveles de CXCL4 se asociaron a mayor afectación cutánea (Rodnan), mientras que CXCL8 se asoció a consumo de la fracción C4 del complemento y tortuosidades en la capilaroscopia.

Conclusiones

Los niveles elevados de GDF15 se asociaron a ES difusa, afectación pulmonar, actividad de la ES y alteraciones en la capilaroscopia. Por otra parte, CXCL4 se asoció a afectación cutánea, no relacionándose CXCL8 con daño orgánico.

Palabras clave:
Esclerosis sistémica
CXCL4
CXCL8
GDF15
Capilaroscopia

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