AB0775 Characteristics of patients with scleroderma (SSC) treated with various drugs in the clinical assessment and tgf Β and il13 concentration in comparison to the healthy group
Authors: K. Romanowska-Próchnicka, A. Wajda, A. Paradowska-Gorycka, M. Walczyk, M. Marecka, J. Trochimiuk, D. Szukiewicz, M. Olesińska
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Scleroderma (SSc) is a rare multisystem chronic disease the treatment of which is still challenging. Until now, there is no effective therapy that can modify the overall disease course. However, the main aim of Ssc treatment is directed toward managing organs involvement and providing symptomatic relief. Effective drug therapy should inhibit three components of the disease: tissue fibrosis, vascular abnormalities and autoimmunity. Moreover, potential drug needs to be considered in the context of specific four subsets of the disease: fibroproliferative, inflammatory, limited, and normal-like. It was shown that various subsets could have different profile of specific cytokines: TGFβ – associated with fibroproliferative and inflammatory type of disease and IL13 – mediator of fibrotic and vascular pathology. <h3>Objectives</h3> The aim of the study was to assess the level of TGFβ and IL-13 in SSc pts with various treatment regimen comparing to healthy control. <h3>Methods</h3> 55 patients (71% were women) with SSc diagnosed according to EULAR/ACR 2013 criteria were divided into 5 treatment groups: 1st group – 8 pts treated with methotrexate (MTX), 2–13 pts with mycophenolate mofetil (MMF), 3–5 pts with cyclophosphamide (CYC), 4th group- 7 pts with azatioprine (AZA), 5th group- 22 pts without immunosupressive treatment. All patients have been treated based on a scheme required for organs involvement in accordance with the update of EULAR recommendations from 2016. Mean age of patients was 54.56±13.97. The blood and serum samples have been collected for basic examination. TGFβ and IL13 concentration in serum was quantitated by ELISA. Differences in cytokine concentration were determined using non-parametric Kruskal-Wallis test. The level of statistical significance was set at p&lt;0.05. The modified Rodnan Skin Score (mRSS) examination were taken by one assessor at the beginning of the study and six months later. There were measured DLCO, HRCT, echocardiography and capillaroscopy. <h3>Results</h3> In 82% pts positive antinuclear antibodies have been revealed: in 16% positive results for CENPB were obtained and in 44% for Scl70. Capillaroscopy shown in 23% of pts early pattern, in 38% – active pattern, and in 27% – late pattern. 32% of SSc pts had confirmed pulmonary fibrosis, while 90% – Raynaud's syndrome. The median of mRSS in CENPB (+) pts was 5,<sup>4 -24</sup> in Scl70 (+) pts – 12.<sup>2–30</sup> Statistically significant differences were found between IL13 and TGFβ levels in patients treated with immunosuppressants and healthy subjects. There was no correlation between IL13 or TGFβ with lung fibrosis progression or skin involvement. <h3>Conclusions</h3> In conclusion, our findings indicate that IL 13 and TGFβ are characteristic cytokines in scleroderma, but these parameters did not correlate with severely progressive course of SSc. <h3>Disclosure of Interest</h3> None declared