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Pathogenesis of systemic sclerosis associated interstitial lung disease
Systemic sclerosis is an autoimmune disease leading to vasculopathy and fibrosis of skin and internal organs. Despite likely shared pathogenic mechanisms, the patterns of skin and lung fibrosis differ. Pathogenesis of interstitial lung disease, a major cause of death in systemic sclerosis, reflects...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922569/ https://www.ncbi.nlm.nih.gov/pubmed/35382227 http://dx.doi.org/10.1177/2397198320903867 |
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author | Nihtyanova, Svetlana I Denton, Christopher P |
author_facet | Nihtyanova, Svetlana I Denton, Christopher P |
author_sort | Nihtyanova, Svetlana I |
collection | PubMed |
description | Systemic sclerosis is an autoimmune disease leading to vasculopathy and fibrosis of skin and internal organs. Despite likely shared pathogenic mechanisms, the patterns of skin and lung fibrosis differ. Pathogenesis of interstitial lung disease, a major cause of death in systemic sclerosis, reflects the intrinsic disease pathobiology and is associated with distinct clinical phenotypes and laboratory characteristics. The commonest histological pattern of systemic sclerosis–interstitial lung disease is non-specific interstitial pneumonia. Systemic sclerosis–interstitial lung disease pathogenesis involves multiple components, including susceptibility and triggering factors, which could be genetic or environmental. The process is amplified likely through ongoing inflammation and the link between inflammatory activity and fibrosis with IL6 emerging as a key mediator. The disease is driven by epithelial injury, reflected by markers in the serum, such as surfactant proteins and KL-6. In addition, mediators that are produced by epithelial cells and that regulate inflammatory cell trafficking may be important, especially CCL2. Other factors, such as CXCL4 and CCL18, point towards immune-mediated damage or injury response. Monocytes and alternatively activated macrophages appear to be important. Transforming growth factor beta appears central to pathogenesis and regulates epithelial repair and fibroblast activation. Understanding pathogenesis may help to unravel the stages of systemic sclerosis–interstitial lung disease, risks of progression and determinants of outcome. With this article, we set out to review the multiple factors, including genetic, environmental, cellular and molecular, that may be involved in the pathogenesis of systemic sclerosis–interstitial lung disease and the mechanisms leading to sustained fibrosis. We propose a model for the pathogenesis of systemic sclerosis–interstitial lung disease, based on the available literature. |
format | Online Article Text |
id | pubmed-8922569 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-89225692022-04-04 Pathogenesis of systemic sclerosis associated interstitial lung disease Nihtyanova, Svetlana I Denton, Christopher P J Scleroderma Relat Disord SSc-ILD Supplement Systemic sclerosis is an autoimmune disease leading to vasculopathy and fibrosis of skin and internal organs. Despite likely shared pathogenic mechanisms, the patterns of skin and lung fibrosis differ. Pathogenesis of interstitial lung disease, a major cause of death in systemic sclerosis, reflects the intrinsic disease pathobiology and is associated with distinct clinical phenotypes and laboratory characteristics. The commonest histological pattern of systemic sclerosis–interstitial lung disease is non-specific interstitial pneumonia. Systemic sclerosis–interstitial lung disease pathogenesis involves multiple components, including susceptibility and triggering factors, which could be genetic or environmental. The process is amplified likely through ongoing inflammation and the link between inflammatory activity and fibrosis with IL6 emerging as a key mediator. The disease is driven by epithelial injury, reflected by markers in the serum, such as surfactant proteins and KL-6. In addition, mediators that are produced by epithelial cells and that regulate inflammatory cell trafficking may be important, especially CCL2. Other factors, such as CXCL4 and CCL18, point towards immune-mediated damage or injury response. Monocytes and alternatively activated macrophages appear to be important. Transforming growth factor beta appears central to pathogenesis and regulates epithelial repair and fibroblast activation. Understanding pathogenesis may help to unravel the stages of systemic sclerosis–interstitial lung disease, risks of progression and determinants of outcome. With this article, we set out to review the multiple factors, including genetic, environmental, cellular and molecular, that may be involved in the pathogenesis of systemic sclerosis–interstitial lung disease and the mechanisms leading to sustained fibrosis. We propose a model for the pathogenesis of systemic sclerosis–interstitial lung disease, based on the available literature. SAGE Publications 2020-03-05 2020-03 /pmc/articles/PMC8922569/ /pubmed/35382227 http://dx.doi.org/10.1177/2397198320903867 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | SSc-ILD Supplement Nihtyanova, Svetlana I Denton, Christopher P Pathogenesis of systemic sclerosis associated interstitial lung disease |
title | Pathogenesis of systemic sclerosis associated interstitial lung
disease |
title_full | Pathogenesis of systemic sclerosis associated interstitial lung
disease |
title_fullStr | Pathogenesis of systemic sclerosis associated interstitial lung
disease |
title_full_unstemmed | Pathogenesis of systemic sclerosis associated interstitial lung
disease |
title_short | Pathogenesis of systemic sclerosis associated interstitial lung
disease |
title_sort | pathogenesis of systemic sclerosis associated interstitial lung
disease |
topic | SSc-ILD Supplement |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922569/ https://www.ncbi.nlm.nih.gov/pubmed/35382227 http://dx.doi.org/10.1177/2397198320903867 |
work_keys_str_mv | AT nihtyanovasvetlanai pathogenesisofsystemicsclerosisassociatedinterstitiallungdisease AT dentonchristopherp pathogenesisofsystemicsclerosisassociatedinterstitiallungdisease |