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Systemic sclerosis: a prototypic multisystem fibrotic disorder
John Varga, David Abraham
John Varga, David Abraham
Published March 1, 2007
Citation Information: J Clin Invest. 2007;117(3):557-567. https://doi.org/10.1172/JCI31139.
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Review Series

Systemic sclerosis: a prototypic multisystem fibrotic disorder

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Abstract

A unique feature of systemic sclerosis (SSc) that distinguishes it from other fibrotic disorders is that autoimmunity and vasculopathy characteristically precede fibrosis. Moreover, fibrosis in SSc is not restricted to a single organ, but rather affects many organs and accounts for much of the morbidity and mortality associated with this disease. Although immunomodulatory drugs have been used extensively in the treatment of SSc, no therapy to date has been able to reverse or slow the progression of tissue fibrosis or substantially modify the natural progression of the disease. In this Review, we highlight recent studies that shed light on the cellular and molecular mechanisms underlying the fibrotic process in SSc and that identify cellular processes and intra- and extracellular proteins as potential novel targets for therapy in this prototypic multisystemic fibrotic disease.

Authors

John Varga, David Abraham

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Figure 3

Profibrotic signaling by TGF-β through SMAD-dependent pathways.

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Profibrotic signaling by TGF-β through SMAD-dependent pathways.
The ECM ...
The ECM serves as a reservoir for latent TGF-β, which is maintained in an inactive form by latent TGF-β binding proteins (LTBPs). Upon activation, TGF-β binds to its cell surface receptors and triggers SMAD-mediated intracellular signal transduction. Activated SMAD proteins accumulate in the nucleus and bind to conserved SBE regulatory elements in target genes, recruit coactivators and chromatin-modifying enzymes such as p300/CBP to the DNA, and induce mRNA synthesis and cellular responses. Inhibitory SMAD7 blocks ligand-induced SMAD protein phosphorylation and shuts down SMAD-mediated signaling.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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