AUTHOR=De Luca Giacomo , Campochiaro Corrado , Burastero Samuele E. , Matucci-Cerinic Marco , Doglioni Claudio , Dagna Lorenzo 

TITLE=Periostin expression in uninvolved skin as a potential biomarker for rapid cutaneous progression in systemic sclerosis patients: a preliminary explorative study

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1214523

DOI=10.3389/fmed.2023.1214523

ISSN=2296-858X

ABSTRACT=Objectives: to evaluate periostin serum levels and skin expression in patients with systemic sclerosis (SSc).Methods: we enrolled 35 patients with diffuse(d-SSc) or limited(l-SSc) SSc, 15 patients with VEDOSS and 30 sex-matched healthy controls. Periostin serum levels were determined by ELISA.Periostin skin expression was determined by immunohistochemistry(IHC) on paired involved and uninvolved 5-mm skin biopsy samples in a subgroup of 10 d-SSc and 10 l-SSc patients. A 12-months follow-up was considered.Results: we included 50 patients(mean age 53.1±16.1 years;females 94%;mean disease duration 38.2±45.1 months; anti-centromere 50%;anti-Scl70 40%), 35 of whom with a definite SSc(68.8% l-SSc;31.4% d-SSc; mean mRSS 9.0±7.2) and 15 with VEDOSS; 30 controls were included. Periostin serum levels were higher in SSc patients compared to controls (32.7±8.0ng/ml vs 27.7±7.3ng/ml,p<0.001), while they were comparable among different groups of patients (29.7±6.9ng/ml in VEDOSS; 33.4±7.8ng/ml in lc-SSc; 34.0±8.5 in dc-SSc; p=ns). SSc patients with digital ulcers had higher periostin serum levels (36.2±7.9ng/ml vs 30.6±7.3ng/ml;p<0.02). Skin samples from involved skin of l-SSc and d-SSc showed a significant dermal expression of periostin; an identical periostin expression was evident in the uninvolved skin from patients with d-SSc. In 7 out of 10 l-SSc patients periostin expression was absent on uninvolved skin. In the remaining 3 l-SSc patients, a mild periostin expression on IHC was detectable on uninvolved skin, and all of these 3 l-SSc patients presented a dramatic skin progression.Conclusions: periostin skin expression may be a useful biomarker to herald the presence of a disease at higher risk of rapid cutaneous involvement.