92 scleroderma and (negatively) with disease duration (Dziadzio et al. 2005). Moreover in liver fibrosis, the mean concentra- tion of total CCN2 is highest in the fibrosis group (5.2-fold) and in the chronic viral hepatitis group (4.3-fold) but lower in those patients with fully developed cirrhosis (Gressner et al. 2006). Similarly, CCN2 concentration appears to predict myocardial fibrosis in chronic heart failure patients (Koitabashi et al. 2008). Conclusion CCN2 was identified over 15 years ago; however, the actual physiological relevance of CCN2 is only just beginning to emerge. However, it remains clear that studies on CCN2 expression have established that CCN2 is an effective marker of fibroproliferative disease. Thus ELISAs examining CCN2 levels in patients are warranted as diagnostic tools for fibrosis as well as in investigating the efficacy of drugs in clinical trials. 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