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Expression of advanced glycation end products and their receptor in skin from patients with systemic sclerosis with and without calcinosis
Davies CA et al. – Findings suggest a possible contribution of advanced glycation (AGE) Nε-carboxymethyl lysine-(CML) deposition on the extracellular matrix (ECM) in the dermis of the lcSScCal subgroup to the pathogenesis of formation of calcinotic deposits.

Methods
  • Study was conducted to:
    • To establish which tissue components express AGEs and their receptor (RAGE) in skin from pts with SSc, and
    • How their expression relates to the disease subtypes and various clinical parameters
  • Skin punch biopsies were taken from the forearms of:
    • 61 SSc pts with lcSSc
    • 32 with calcinosis (lcSScCal) and
    • 29 w/o lcSSc
    • 36 with the dcSSc subtype and 22 healthy control subjects
  • IHC localization of AGE-CML and RAGE was assessed semi-quantitatively on the microvascular endothelium, dermal fibroblasts and the cutaneous ECM

Results
  • AGE-CML expression on the papillary dermis ECM of lcSScCal was greater vs control
  • The reticular dermis of lcSScCal showed increased AGE- CML expression vs controls, dcSSc, and lcSSc
  • Increased immunostaining for RAGE was seen on the reticular dermis ECM of the lcSScCal group vs controls
  • lcSScCal subgroup showed correlations for AGE-CML, and to a lesser extent for RAGE, with increased RP duration
  • No evidence that the expression of AGE-CML or RAGE related to Ab status, clinical or histological skin score or patient age
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