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. 2021 Feb 22;16(2):e0247256.
doi: 10.1371/journal.pone.0247256. eCollection 2021.

Association of soluble urokinase plasminogen activator receptor levels with fibrotic and vascular manifestations in systemic sclerosis

Sheraz Butt  1 , Jørgen L Jeppesen  1 , Line Vinderslev Iversen  2   3 , Mogens Fenger  4 , Jesper Eugen-Olsen  5 , Charlotte Andersson  6 , Søren Jacobsen  7
Affiliations

Association of soluble urokinase plasminogen activator receptor levels with fibrotic and vascular manifestations in systemic sclerosis

Sheraz Butt et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Concentration range of suPAR.
Histogram showing the distribution of suPAR concentrations (ng/mL) in the study population.
Fig 2
Fig 2. Correlation between log(suPAR) values and percentage of predicted diffusion capacity estimates.
Correlation coefficient r = -0.41 p<0.0001.
Fig 3
Fig 3. Correlation between log(suPAR) values and percentage of predicted total capacity estimates.
Correlation coefficient r = -0.27 p<0.004.
See this image and copyright information in PMC

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