Evaluation of elafin as a marker of skin fibrosis – a preliminary study.

Abstract

Abstract Elafin can act as a possible serum marker modulated in multiple pathological conditions, including fibrosis and vascular remodelling. The aim af our pilot study was to check the possible role of elafin in patients with skin fibrosis, including systemic sclerosis (SSc), chronic variants of graft versus host disease (cGvHD) and different variants of morphea regarding its relationship with the severity of skin involvement and clinical parameters. The study included 125 Caucasian patients and 30 healthy controls. In all groups serum elafin was measured using commercially available enzymelinked immunosorbent assay kits (Elisa). cGVHD patients presented significantly higher mean plasma levels of elafin in comparison to other groups of patients and there was no statistically significant difference in mean serum levels of elafin between morphea and SSc patients. Also there was no difference in mean serum levels of elafin in morphea patients between its clinical variants and severity of the disease, although the non-active stage morphea presented higher values of elafin concentrations. There was no correlation between elafin concentration and Rodnan skin score, lungs involvement and GFR in SSc. We noticed the elevated levels of elafin in the group of patients with cGvHD, which may suggest a relationship of this marker with a chronic disease process, including fibrosis. We did not find the association of elafin and SSc as well as morphea (including severity of the disease process and phase). However, taking into account the inconsistent role of elafin in fibrosis, the complex regulation of the elafin gene in human keratinocytes, as well as the multifaceted involvement in skin inflammation, further studies are needed.