The Role of Biomarkers in the the Pathogenesis, Clinical Manifestations, and Therapeutic Outcome of Systemic Sclerosis

Review The Role of Biomarkers in the the Pathogenesis, Clinical Manifestations, and Therapeutic Outcome of Systemic Sclerosis Anna Bazsó 1,*, Péter Szodoray 2, Yehuda Shoenfeld 3,4 and Emese Virág Kiss Med Dsci 1,5 1 Department of Clinical Immunology, Adult and Paediatric Rheumatology, Department of Rheumatology and Immunology, Semmelweis University, 1023 Budapest, Hungary 2 Department of Immunology, Oslo University Hospital, Rikshospitalet and University of Oslo, 0372 Oslo, Norway 3 Recanati Medical School, Reichman University, 4610101, Herzelia, Israel 4 Zabludowicz Center for Autoimmune Diseases (Founder), Sheba Medical Center, 5265601 Tel-Hashomer, Israel 5 Division of Locomotor System and Rheumatology Prevention, Department of Internal Medicine and Haematology, Semmelweis University, 1088 Budapest, Hungary * Correspondence: [email protected] Received: 12 January 2025; Revised: 20 March 2025; Accepted: 28 March 2025; Published: 3 April 2025 Abstract: Systemic sclerosis (SSc) is a complex autoimmune disorder characterized by progressive fibrosis and obliterative vasculopathy affecting the skin and various internal organs, including the kidneys, lungs, cardiovascular system, and gastrointestinal tract. The disease manifests in two major clinical subtypes: limited cutaneous systemic sclerosis (lcSSc) and diffuse cutaneous systemic sclerosis (dcSSc), distinguished primarily by the extent of skin involvement and the pattern of internal organ involvement. Biomarkers, serving as quantifiable indicators of biological processes in SSc, hold significant potential for refining disease classification, predicting progression, assessing therapeutic responses, and evaluating clinical outcomes. Unlike other autoimmune diseases, SSc lacks highly specific biomarkers. Given its heterogeneity and multifactorial pathogenesis, the development of a composite biomarker panel may represent the most effective approach for future diagnostic and longitudinal monitoring strategies in SSc.