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Papers of The 4th Japan Scar Workshop |
7. Future Therapeutic Strategies for Systemic Sclerosis
Masataka Kuwana
Division of Rheumatology, Department of Internal Medicine, Keio
University School of Medicine, Tokyo, Japan
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Systemic sclerosis (or scleroderma; SSc) is a connective tissue disease
characterized by excessive fibrosis of the dermis and various internal
organs, microvascular abnormalities, and immune dysregulation such as
antinuclear antibody production. SSc is still an intractable disease
with a 10-year survival rate < 80%, since there is currently no
therapeutic agent shown to be effective for SSc by clinical trials. For
instance, recent clinical trials on relaxin and fully humanized anti-TGF1
antibody that theoretically inhibits fibroblast activation ended up with
negative results. Our efforts to find novel therapeutic targets focus on
immune responses and angiogenesis/vasculogenesis, which are involved in
the pathogenic processes of SSc. Current potential targets include
intracellular tyrosine kinases; immune cells, such as monocytes, and T
and B cells; and circulating progenitors, including mesenchymal stem
cells and endothelial progenitor cells. Information obtained from these
studies on SSc patients would be useful in developing novel therapeutic
agents for organ-specific fibrotic diseases, such as interstitial lung
disease, liver cirrhosis, atherosclerosis, and keloids. |
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