Summary

Systemic sclerosis (SSc) is an idiopathic systemic autoimmune disease. It is characterized by a triad of hallmarks: immune dysfunction, fibrosis and vasculopathy. Immune dysfunction in SSc is characterized by the activation and recruitment of immune cells and the production of autoantibodies and cytokines. How immune abnormalities link the fibrosis and vasculopathy in SSc is poorly understood. A plethora of immune cell types are implicated in the immunopathogenesis of SSc, including T cells, B cells, dendritic cells, mast cells and macrophages. How these different cell types interact to contribute to SSc is complicated, and can involve cell-to-cell interactions and communication via cytokines, including transforming growth factor (TGF)-β, interleukin (IL)-6 and IL-4. We will attempt to review significant and recent research demonstrating the importance of immune cell regulation in the immunopathogenesis of SSc with a particular focus on fibrosis.

We investigate the immunological basis of systemic sclerosis in this review article. Evidence points to a key role of both the innate and the adaptive immune system in driving the pathology. Drugs targeting these pathways could be novel therapeutics in systemic sclerosis.
Graphical Abstract

We investigate the immunological basis of systemic sclerosis in this review article. Evidence points to a key role of both the innate and the adaptive immune system in driving the pathology. Drugs targeting these pathways could be novel therapeutics in systemic sclerosis.

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