Elevated levels of C-reactive protein (CRP) in systemic sclerosis (SSc) have been linked to early inflammatory stages of the disease. This study has been designed to investigate CRP levels longitudinally in a cohort of SSc patients and to correlate these findings with comorbidities and disease characteristics. In this retrospective study, patients with SSc treated at the outpatient clinic of the Department of Rheumatology and Clinical Immunology, University Medical Center Freiburg, were analyzed. Only patients with at least three consecutive visits and at least 1 year follow-up were included in this study. CRP serum levels were measured at every visit and categorized as positive if CRP concentrations were ≥ 5 mg/l. Subjects with elevated CRP levels at more than 80% of visits were defined as inflammatory SSc. The longitudinal CRP profiles were correlated with disease characteristics and comorbidities. A total of 1815 consecutive visits of 131 SSc patients were analyzed. Over the observed time span (7.6 (1.0–19.5) years), 18.3% (n = 24) of patients had continuously elevated CRP levels (inflammatory SSc), whereas in 29% (n = 38), CRP levels were always in the normal range. There was no association between disease duration and CRP levels at first visit. Inflammatory SSc was associated with male gender (p = 0.022), anti-Scl-70 antibodies (p = 0.009), diffuse cutaneous SSc (p = 0.036), pulmonary fibrosis (p < 0.001), rheumatoid arthritis (p = 0.007), and cardiac arrhythmia (p = 0.048). Moreover, patients with inflammatory SSc revealed higher modified Rodnan skin scores (p < 0.001); lower forced vital capacity (FVC) (p < 0.001), total lung capacity (p = 0.001), and diffusing capacity (p = 0.008); and faster decline of FVC per year (p = 0.007). Even treatment with cyclophosphamide (CYC) did not decrease CRP levels (p = 0.754). Inflammatory SSc is characterized by a more severe phenotype, high morbidity, and a large proportion of male patients. Even treatment with CYC does not alter CRP levels in this subpopulation with a high unmet medical need.

中文翻译：

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炎性停留炎性：系统性硬化症的一个亚群，特征是高发病率和对环磷酰胺的炎性抵抗力。

系统性硬化症（SSc）中C反应蛋白（CRP）的水平升高与疾病的早期炎症阶段有关。本研究旨在纵向研究一组SSc患者的CRP水平，并将这些发现与合并症和疾病特征相关联。在这项回顾性研究中，对在弗莱堡大学医学中心风湿病和临床免疫学门诊治疗的SSc患者进行了分析。本研究仅包括至少连续3次就诊且至少随访1年的患者。如果CRP浓度≥5 mg / l，则每次访视均测量CRP血清水平，并归为阳性。CRP水平升高且访视率超过80％的受试者被定义为炎症性SSc。纵向CRP图谱与疾病特征和合并症相关。共分析了131名SSc患者的1815次连续就诊。在观察到的时间段（7.6（1.0-19.5）年）中，有18.3％（n = 24）的患者CRP水平持续升高（炎性SSc），而在29％（n = 38）的患者中，CRP水平始终处于普通范围。初次就诊时病程和CRP水平之间没有关联。炎症性SSc与男性（p = 0.022），抗Scl-70抗体（p = 0.009），弥漫性皮肤SSc（p = 0.036），肺纤维化（p <0.001），类风湿性关节炎（p = 0.007），和心律不齐（p = 0.048）。此外，患有炎性SSc的患者显示出更高的改良Rodnan皮肤评分（p <0.001）；较低的强制肺活量（FVC）（p <0.001），总肺活量（p = 0.001）和扩散能力（p = 0.008）；每年FVC的下降速度更快（p = 0.007）。即使使用环磷酰胺（CYC）进行治疗也不会降低CRP水平（p = 0.754）。炎性SSc的特征是表型更为严重，发病率较高，并且男性患者比例较高。即使在未满足医疗需求的情况下，即使使用CYC进行治疗也不会改变该亚群中的CRP水平。