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AB0668 Calcinosis cutis and its association of serum levels of osteonectin, osteonectin, nitric oxide and tgf-b in systemic sclerosis
  1. RA Carranza Muleiro1 2,
  2. MDP Cruz-Domínguez2,
  3. LM Apolinar3,
  4. AA Reséndiz-Albor2,
  5. AL Vázquez-Martínez3,
  6. G García-Collinot2,
  7. LJ Jara-Quezada4,
  8. IM Arciniega1
  1. 1Secciόn de Estudios de Posgrado e Investigaciόn, Escuela Superior de Medicina Instituto Politécnico Nacional
  2. 2Divisiόn de Investigaciόn en Salud, Instituto Mexicano del Seguro Social Hospital de Especialidades Centro Medico la Raza
  3. 3Hospital de Especialidades Centro Medico Siglo XXI Laboratorio de Enfermedades Endocrinolόgicas, Instituto Méxicano del Segúro Social
  4. 4Jefatura de Investigaciόn en Salud, Instituto Mexicano del Seguro Social Hospital de Especialidades Centro Medico la Raza, México city, Mexico

Abstract

Background Systemic sclerosis (SSc) is characterized by fibrosis, autoimmunity and vasculopathy. ES is classified subtypes: diffuse (dSSc) and limited (ISSc). More than 35% develop calcinosis. Calcium, phosphorus, parathormone, vitamin D, TGF-β, nitric oxide and osteonectin and osteopontin involved in bone mineralization.

Objectives The aim was to compare osteonectin (ON), osteopontin (OP), TGF-β, nitric oxide (NO), Paratohormone (PTH), Vitamin D and minerals concentrations in ES with and without calcinosis.

Methods Cross-sectional study in ES patients (ACR criteria). We quantified OP, ON, TGF-β, ON, Calcium, Phosphorus, PTH and vitamin D in serum by ELISA. We performed descriptive statistics, Student t, Pearson correlation (significance p<0.05) in SPSSv21 program.

Results We included 71 patients, age 52.94 (± 11.47); 28 (40%) with calcinosis (18 dSSc/10 lSSc), and 43 (60%) without calcinosis (13 dSSc/30 lSSc). Biochemical parameters between two groups. In the whole population the higher PCR had moderate positive correlation (r =0.41, p=0.042), and serum calcium level had a moderate negative correlation (r = -0.47, p=0.021); ON increased in direct relation to OP (r =0.3, p=0.014) and the serum levels of VitD had lower indirect relation with the evolution time of SSc (r = -0.28, P=0.025) and the ON increase in direct relation to serum creatinine (r =0.039, p=0.006).

Conclusions Patients with a longer time evolution of SSc have less serum levels of VitD and those with higher inflammation (PCR) have a higher TGF-β than a potent inducer of fibrosis. PCR and TGF-B have a moderate direct correlation, PCR and Calcium have moderate indirect correlation, ON and OP have a low direct correlation, VitD and evolution of diseases (years) had a low indirect correlation and NO and creatinine had a very low direct correlation.

References

  1. Fueki H, Hino R, Yoshioka M, Nakamura M, Tokura Y.Calcinosis cutis associated with primary Sjogren's syndrome: strong expression of osteonectin and matrix Gla protein.Rheumatology (Oxford) 2011; 50(12):2318–20.

  2. Kim SY, Choi HY, Myung KB, Choi YW.The expression of molecular mediators in the idiopathic cutaneous calcification and ossification. J Cutan Pathol 2008; 35(9):826–31.

  3. Ahmed S, O'Neill KD, Hood AF, Evan AP, Moe SM. Calciphylaxis is associated with hyperphosphatemia and increased osteopontin expression by vascular smooth muscle cells. Am J Kidney Dis 2001;37(6):1267–76.

  4. Kawakami T, Soma Y, Mizoguchi M, Saito R. Immunohistochemical expression of transforming growth factor beta3 in calcinosis in a patient with systemic sclerosis and CREST syndrome. Br J Dermatol. 2000;143(5):1098–100.

References

Disclosure of Interest None declared

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