Open AccessAssociation of soluble urokinase plasminogen activator receptor levels with fibrotic and vascular manifestations in systemic sclerosis
Author(s) -
Sheraz Butt,
Jørgen Jeppesen,
Line V. Iversen,
Mogens Fenger,
Jesper EugenOlsen,
Charlotte Andersson,
Søren Jacobsen
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0247256
Subject(s) - supar , medicine , dlco , gastroenterology , idiopathic pulmonary fibrosis , pulmonary fibrosis , plasminogen activator , cardiology , pulmonary hypertension , fibrosis , urokinase , urokinase receptor , pathology , lung , diffusing capacity , lung function
Objective We assessed the association of suPAR (soluble urokinase plasminogen activator receptor) plasma levels with fibrotic and vascular manifestations in patients with systemic sclerosis (SSc). Methods suPAR plasma levels were measured in 121 consecutive patients with SSc and correlated to pulmonary and vascular features of SSc, including interstitial lung disease as characterized by percentage of predicted CO diffusing capacity (DLco) and forced vital capacity (FVC), pulmonary fibrosis by computed tomography, and pulmonary arterial hypertension, telangiectasias, and digital ulcers. Results Overall, 121 SSc patients (84% females; mean age, 57 ± 12 [range: 22–79] years) were enrolled; 35% had diffuse cutaneous SSc. suPAR plasma levels ranged from 1.3–10.2 [median: 2.9 (p25–p75: 2.3–3.9)] ng/mL. Log(suPAR) levels correlated with DLco (r = -0.41, p <0.0001) and FVC (r = -0.26, p = 0.004), also when adjusted for age, sex, and pulmonary hypertension. A suPAR cut-off level of >2.5 ng/mL showed a sensitivity of 91% for identifying patients with either DLco <50% or FVC < 60% of the predicted values. Similarly, 19 (90%) had a suPAR >2.5 ng/mL among those diagnosed with pulmonary fibrosis vs. 59 (60%) among those who did not ( p = 0.008). suPAR values were not associated with vascular manifestations. Conclusion suPAR levels strongly correlated with pulmonary involvement in SSc. Future studies should test if suPAR estimation can be used for surveillance of severe pulmonary involvement in SSc.