High level of chemokine CCL18 is associated with pulmonary function deterioration, lung fibrosis progression and reduced survival in Systemic Sclerosis

Objectives

Markers for early identification of progressive interstitial lung disease (ILD) in systemic sclerosis (SSc) are in demand. Chemokine CCL18 which has been linked to pulmonary inflammation is an interesting candidate, but data have not been consistent. Here, we aimed to assess CCL18 levels in a large, prospective and unselected SSc cohort with longitudinal, paired data sets on pulmonary function and lung fibrosis.

Methods

Sera from the Oslo University Hospital SSc cohort (n=298) and healthy controls (n=100) were analysed for CCL18 by enzyme immunoassay. High CCL18 (>53 ng/ml) was defined using mean value +2SD in healthy controls sera as cut-off.

Results

High serum CCL18 was identified in 35% (105/298). Annual decline in Forced Vital Capacity (FVC) differed significantly between high and low CCL18 subsets (13.3% and 4.7, p=0.016), as did the annual progression rate of lung fibrosis (0.9% (SD2.9) and 0.2% (SD1.9)). Highest rates of annual FVC decline >10% (21%) and annual fibrosis progression (1.2%) were seen in patients with high CCL18 and early disease (10% (Odds Ratio (OR) 1.1, 95%CI 1.01-1.11) and FVC Conclusions

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