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Systemic sclerosis and localized scleroderma—current concepts and novel targets for therapy

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Abstract

Systemic sclerosis (SSc) is a chronic autoimmune disease with a high morbidity and mortality. Skin and organ fibrosis are key manifestations of SSc, for which no generally accepted therapy is available. Thus, there is a high unmet need for novel anti-fibrotic therapeutic strategies in SSc. At the same time, important progress has been made in the identification and characterization of potential molecular targets in fibrotic diseases over the recent years. In this review, we have selected four targeted therapies, which are tested in clinical trials in SSc, for in depths discussion of their preclinical characterization. Soluble guanylate cyclase (sGC) stimulators such as riociguat might target both vascular remodeling and tissue fibrosis. Blockade of interleukin-6 might be particularly promising for early inflammatory stages of SSc. Inhibition of serotonin receptor 2b signaling links platelet activation to tissue fibrosis. Targeting simultaneously multiple key molecules with the multityrosine kinase-inhibitor nintedanib might be a promising approach in complex fibrotic diseases such as SSc, in which many partially independent pathways are activated. Herein, we also give a state of the art overview of the current classification, clinical presentation, diagnostic approach, and treatment options of localized scleroderma. Finally, we discuss whether the novel targeted therapies currently tested in SSc could be used for localized scleroderma.

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Authors and Affiliations

  1. Division of Rheumatology, University Hospital Zurich, Gloriastr. 25, 8091, Zurich, Switzerland

    Oliver Distler

  2. Division of Dermatology, University Hospital Zurich, Zurich, Switzerland

    Antonio Cozzio

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  1. Oliver Distler

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  2. Antonio Cozzio

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Correspondence toOliver Distler.

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This article is a contribution to the Special Issue on Advances in Immunodermatology - Guest Editors: Lars French and Alexander Navarini

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Distler, O., Cozzio, A. Systemic sclerosis and localized scleroderma—current concepts and novel targets for therapy.Semin Immunopathol38, 87–95 (2016). https://doi.org/10.1007/s00281-015-0551-z

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