Biomarkers in systemic sclerosis: A comprehensive review

Abstract Systemic sclerosis (SSc) is a rare, chronic autoimmune disorder characterized by skin and internal organ fibrosis and associated with multiple immune system dysregulations. Despite significant advancements in medical research, the entire etiology of SSc remains incompletely understood, although it is believed to result from a complex interplay of genetic, environmental, and immunological factors. Over the years, numerous biomarkers associated with SSc have been extensively investigated. Notably, anti-Scl-70 and anti-centromere antibodies serve as common SSc-specific autoantibodies, aiding in the identification of distinct SSc subtypes and prediction of specific clinical manifestations. In addition, certain serum biomarkers–including Krebs von den Lungen-6, surfactant protein-D, and CCL18–have been recognized as indicative of SSc-related interstitial lung disease. These biomarkers offer valuable insights into the severity of lung damage and the prognosis of pulmonary arterial hypertension. Beyond the specific autoantibodies mentioned above, several potential biomarkers have emerged that hold promise for enhanced accuracy in diagnosing SSc, classifying disease subtypes, and evaluating organ involvement and treatment response. The exploration and validation of these biomarkers are expected to significantly contribute to the advancement of precision medicine in managing SSc patients.