Systemic sclerosis is a generalized disorder of connective tissue clinically characterized by thickening and fibrosis of the skin and by distinctive forms of involvement of internal organs. One of the hallmarks of systemic sclerosis is the presence of serum autoantibodies against a variety of nuclear and cytoplasmic antigens. The primary purpose of this study was to identify the autoantibodies profile in the scleroderma sera and the secondary goal was to determine the correlation and discrepancy of autoantibody profile. Autoantibody profile was determined in 118 samples stored in the Advanced Diagnostic Laboratory at the University of Calgary. 78 sera were provided from Canadian and 40 sera were provided from Ukraine. We used the following techniques to identify autoantibodies profile in scleroderma patients: 1. Antinuclear antibody (ANA) by indirect immunofluorescence on human epithelial cell substrate 2. Detection and identification of specific autoantibodies by Innolia strip assay 3. Detection and identification of specific auto antibodies against extractable nuclear antigens. 111 out of 118 patients showed positive ANA results by indirect immunofluorescence and 7 patients had negative ANA results. Anti-ENA analyses by Inolia were positive in 84 patients, while by western blotting 81 patients showed positive results. In this study, we compared the results of anti-ENA antibody by Innolia with SLR technique. A significant correlation was found between anti-SCl-70 antibodies (P=0.000) and anti- RNP antibodies (P=0.001) and JO-1 antibodies (P=0.014). Thus, we may propose that SLR and Innolia techniques could be used for the detection of autoantibody in systemic sclerosis.

Background: Depression is a major disabling factor around the world. Most of the mental disorders immediately affect the inner moodandcognitive aspect of individuals. Therefore, hiding the depression can delay the early diagnosis and, consequently, a proper treatment in the patients. Objectives: We designed the study to determine the association between rheumatoid diseases and depression. Methods: This is a descriptive-analytic study which was performed on 354 patients referred to Rheumatology Clinic of Ahvaz, a province in south west of Iran in 2016. Then demographic information, depression, quality of life and social support were completed based on standardized questionnaires filled by the patients. Results: The prevalence of depression in rheumatoid arthritis (RA), systemic lupus erythematous (SLE) and systemic sclerosis (SSc) patients was 61. 63%, 73. 52% and 60%, respectively. There is a meaningful relationship between depression, age and duration of disease in SSc patients. There is a significant relationship between depression and gender in SLE and RA patients. There is a significant relationship between depression and the degree of education of SLE patients. There is a meaningful relationship between depression and quality of life, social support and corticosteroid consumption. Conclusions: The prevalence of depression is very high in all three diseases, which is equal in terms of quality of life, social support and corticosteroid usage in all three diseases. Psychiatric disorders such as depression are common in rheumatic patients.

Background: Systemic sclerosis is an autoimmune connective tissue disorder which is characterised by cutaneous and internal organ fibrosis. Raynaud’s phenomenon is the earliest feature and may precede the onset of the disease by months to years. The heart, lungs, gastrointestinal tract, kidneys and other organs may be involved. Our aim was to evaluate skin thickness and echogenicity in systemic sclerosis patients by ultrasound and compare it with the healthy age and sex matched controls.Method: Our study included 15 successively admitted patients (14 females and 1 male) with systemic sclerosis and 15 healthy age and sex matched controls. All the patients met the ACR criteria of diagnosis. The age range of the patients was 25-55 years. The disease duration ranged from 1-8 years. A complete history and physical examination was done for each patient. Skin thickness and echogenicity were measured by a 20MHz ultrasound probe at 6 different anatomical sites which was compared with that of the controls.Result: Skin thickness was more in systemic sclerosis patients (significant p value) as compared to controls, and echogenicity was inversely proportional to the skin thickness.Conclusion: Skin ultrasonography is a noninvasive method which can reflect the severity of skin involvement and periodic assessment of skin thickness and echogenicity can help to monitor the progression of the disease.

Systemic Sclerosis (SSc) is a connective tissue disease that affects various organs including the skin, lungs, kidneys, and heart. The etiology is poorly understood; however, a causative agent may initiate the disease in a patient with a genetic predisposition for SSc. There are three features responsible for the clinical and pathologic manifestations of the disease: vascular lesions of small arteries, excessive deposition of collagen in skin and internal organs, and alterations of humoral and cellular immunity. Type I collagen, the major component of extracellular matrix in skin and other tissues, is a heterotrimer of two a1 and one a2 collagen polypeptides. The synthesis of both of the chain types is highly regulated by several cis-acting regulatory elements and trans-acting protein factors, which are involved in basal gene expression. Also, several cytokines have been identified that positively and negatively influence dermal fibroblast proliferation and collagen synthesis, including: TGF-b, CTGF and IFN-Y. TGF-b and CTGF are profibrotic cytokines, whereas IFN-Y is antifibrotic cytokine. Imbalance between matrix metalloproteinases and tissue inhibitor of metalloproteinases might also contribute to the excess accumulation of collagen in the dermis. Because of high mortality and morbidity in SSc which directly related to the extent of the fibrotic, a precise understanding of the molecular mechanism of fibrosis will help to find effective therapeutic agents for this incurable disease in the future. This review focuses on collagen genes and proteins and then factors involved in synthesis and degradation of collagen in connection with systemic sclerosis will be explained briefly.