Role of Gas6 and TAM Receptors in the Identification of Cardiopulmonary Involvement in Systemic Sclerosis and Scleroderma Spectrum Disorders. (12th May 2020)

• Record Type: Journal Article
• Authors: Bellan, Mattia; Dimagli, Arnaldo; Piccinino, Cristina; Giubertoni, Ailia; Ianniello, Aurora; Grimoldi, Federico; Sguazzotti, Maurizio; Nerviani, Alessandra; Barini, Michela; Carriero, Alessandro; Smirne, Carlo; Burlone, Michela Emma; Rigamonti, Cristina; Minisini, Rosalba; Salmi, Livia; Barbaglia, Matteo Nazzareno; Castello, Luigi Mario; Sola, Daniele; Marino, Paolo; Avanzi, Gian Carlo; Pirisi, Mario; Sainaghi, Pier Paolo
• Other Names: Rizzo Roberta Academic Editor.
• Is Part Of: Disease markers. Volume 2020(2020)
• Publication Date: 2020-05-12
• Subjects: Diagnosis -- Periodicals; Biochemical markers -- Periodicals; Pathology -- Periodicals; 616
• DOI: 10.1155/2020/2696173
• Languages: English
• ISSNs: 0278-0240

Abstract

Abstract : Background . Few biomarkers are available for early identification of pulmonary arterial hypertension (PAH) and interstitial lung disease (ILD) in systemic sclerosis (SS) and scleroderma spectrum disorders (SSD). Aims . To evaluate Gas6, sAxl, and sMer as biomarkers for cardiopulmonary complications of SS and SSD. Methods . In a cross-sectional observational study, we recruited 125 consecutive patients, affected by SS and SSD and referred to a tertiary-level pulmonary hypertension outpatient clinic. All patients underwent a comprehensive evaluation for identification of PAH and ILD. Gas6, sMer, and sAxl concentrations were measured with ELISA protocols, and concentrations were compared according to PAH or ILD. Results . Nineteen subjects had pulmonary hypertension (PH) (14 PAH), and 39 had ILD (6 severe). Plasma sMer was increased in PAH (18.6 ng/ml IQR [11.7-20.3]) with respect to the absence (12.4 [8.0-15.8]) or other form of pulmonary hypertension (9.6 [7.4-12.5]; K–W variance p < 0.04 ). Conversely, Gas6 and sAxl levels were slightly increased in mild ILD (25.8 ng/ml [19.5-32.1] and 24.6 [20.1-32.5]) and reduced in severe ILD (16.6 [15.0-22.1] and 15.5 [14.9-22.4]) in comparison to no evidence of ILD (23.4 [18.8-28.1] and 21.6 [18.1-28.4]; K–W, p ≤ 0.05 ). Plasma sMer ≥ 19 ng / ml has 50% sensitivity and 92% specificity in PAH identification (area under the ROC curve (AUC) 0.697, p < 0.03 ). Values of Gas 6 ≤ 24.5 ng / ml and of sAxl ≤ 15.5 ng / ml have 100% and 67% sensitivity and 47% and 86% specificity, respectively, in identifying severe ILD (Gas6 AUC 0.787, p < 0.001 ; sAxl AUC 0.705, p < 0.05 ). Conclusions . The assay of Gas6 sAxl and sMer may be useful to help in the identification of PAH and ILD in SS and SSD patients. The Gas6/TAM system seems to be relevant in cardiopulmonary complications of SS and SSD and merits further investigations.