Title : Correlation of serum IL-6, TGF-b and STAT3 in dermis with the extent of skin fibrosis (modified rodnan skin score) in patients of Systemic sclerosis
Abstract:
Systemic Sclerosis is an autoimmune disease characterized by progressive fibrosis of the skin and internal organs. Skin fibrosis is the hallmark clinical feature of this disease. Inflammatory mediators such as Interleukin-6 (IL-6) and Transforming Growth Factor-β (TGF-β) are known to mediate fibroblast activation in Systemic Sclerosis which results in fibrosis of the skin. Recently, it has been demonstrated that STAT-3 is involved in the downstream signalling of both IL-6 and TGF-β, thus playing a key role in the pathogenesis of Systemic Sclerosis. A Comparative Cross-Sectional Study was conducted among patients with Systemic Sclerosis attending the Dermatology OPD of Lok Nayak Hospital associated to Maulana Azad Medical College and Department of Pathology, GB Pant Hospital, New Delhi. Twenty clinically diagnosed adult (age >18 years) (male or female) patients of systemic sclerosis, fulfilling the EULAR criteria for SSC were included in the study. A thorough clinical examination, including Modified Rodnan Skin Scoring was done to study the extent, severity and type of Systemic Sclerosis. Skin biopsy from the fore arm was sent for histopathological examination and Immunohistochemistry for STAT-3 in the dermis. STAT-3 immunohistochemistry (IHC) revealed a high positivity for STAT-3 in the dermis of all the patients. There was a significant negative correlation between STAT-3 IHC with pulmonary arterial hypertension (p = 0.019), and a positive correlation with the pattern of antinuclear antibody staining (p = 0.031) with the highest in patients with speckled pattern, presence of anticentromere antibody (p = 0.019) as well as with findings of reticular opacities on Chest X-ray (p = 0.037). There may be a potential therapeutic role in targeting STAT-3 as it plays an important role in the disease pathogenesis of skin fibrosis in Systemic Sclerosis. Immunohistochemistry for STAT-3 IHC may aid as a predictor for disease prognosis.
