Na(+) deposition in the fibrotic skin of systemic sclerosis patients detected by (23)Na-magnetic resonance imaging

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Item Type:	Article
Title:	Na(+) deposition in the fibrotic skin of systemic sclerosis patients detected by (23)Na-magnetic resonance imaging
Creators Name:	Kopp, C., Beyer, C., Linz, P., Dahlmann, A., Hammon, M., Jantsch, J., Neubert, P., Rosenhauer, D., Müller, D.N., Cavallaro, A., Eckardt, K.U., Schett, G., Luft, F.C., Uder, M., Distler, J.H.W. and Titze, J.
Abstract:	Objective. Skin fibrosis is the predominant feature of SSc and arises from excessive extracellular matrix deposition. Glycosaminoglycans are macromolecules of the extracellular matrix, which facilitate Na(+) accumulation in the skin. We used (23)Na-MRI to quantify Na(+) in skin. We hypothesized that skin Na(+) might accumulate in SSc and might be a biomarker for skin fibrosis. Methods. In this observational case-control study, skin Na(+) was determined by (23)Na-MRI using a Na(+) volume coil in 12 patients with diffuse cutaneous SSc and in 21 control subjects. We assessed skin fibrosis by the modified Rodnan skin score prior to (23)Na-MRI and on follow-up 12 months later. Results. (23)Na-MRI demonstrated increased Na(+) in the fibrotic skin of SSc patients compared with skin from controls [mean (sd): 27.2 (5.6) vs 21.4 (5.3) mmol/l, P < 0.01]. Na(+) content was higher in fibrotic than in non-fibrotic SSc skin [26.2 (4.8) vs 19.2 (3.4) mmol/l, P < 0.01]. Furthermore, skin Na(+) amount was correlated with changes in follow-up modified Rodnan skin score (R(2) = 0.68). Conclusions. (23)Na-MRI detected increased Na(+) in the fibrotic SSc skin; high Na(+) content was associated with progressive skin disease. Our findings provide the first evidence that (23)Na-MRI might be a promising tool to assess skin Na(+) and thereby predict progression of skin fibrosis in SSc.
Keywords:	Systemic Sclerosis, Fibrosis, Skin Na(+), (23)Na-MRI, Extracellular Matrix
Source:	Rheumatology
ISSN:	1462-0324
Publisher:	Oxford University Press
Volume:	56
Number:	4
Page Range:	556-560
Date:	1 April 2017
Additional Information:	Erratum in: Rheumatology 56(4):674.
Official Publication:	https://doi.org/10.1093/rheumatology/kew371
PubMed:	View item in PubMed

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