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

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. and Beyer, C. and Linz, P. and Dahlmann, A. and Hammon, M. and Jantsch, J. and Neubert, P. and Rosenhauer, D. and Müller, D.N. and Cavallaro, A. and Eckardt, K.U. and Schett, G. and Luft, F.C. and Uder, M. and 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
Publisher:Oxford University Press
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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