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Abstract
Polarisation-sensitive optical coherence tomography (PS-OCT) offers a novel, non-invasive method of assessing skin fibrosis in the multisystem disease systemic sclerosis (SSc) by measuring collagen retardance. This study aimed to assess retardance as a biomarker in SSc. Thirty-one patients with SSc and 27 healthy controls (HC) underwent PS-OCT imaging. ‘Skin score’ was assessed by clinical palpation (0–3 scale). A subset of ten patients and ten age/sex-matched HC had a biopsy and longitudinal imaging. Histological assessment included quantification of epidermal thickness, collagen content (to assess fibrosis) and matrix metalloproteinase (MMP) activity (in situ zymography). PS-OCT images were assessed for epidermal thickness (structure) and fibrosis (retardance). Positive correlation was observed between epidermal thickness as measured by histology and structural PS-OCT (r = 0.79; p < 0.001). Retardance was: HC mean 0.21 (SD 0.21) radian/pixel; SSc skin score 0, 0.30 (0.19); skin score 1, 0.11 (0.16); skin score 2, 0.06 (0.12); skin score 3, 0.36 (0.35). Longitudinal retardance decreased at one-week across groups, increasing at one-month for HC/skin score 0–1; HC biopsy site retardance suggests scarring is akin to fibrosis. Relationships identified between retardance with both biopsy and skin score data indicate that retardance warrants further investigation as a suitable biomarker for SSc-related fibrosis.
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1 Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust, Musculoskeletal Research Group, Salford, UK (GRID:grid.451052.7) (ISNI:0000 0004 0581 2008); Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK (GRID:grid.462482.e) (ISNI:0000 0004 0417 0074)
2 Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK (GRID:grid.462482.e) (ISNI:0000 0004 0417 0074); University of Manchester, Centre for Dermatology Research, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407); Michigan State University College of Human Medicine, Lansing, USA (GRID:grid.5379.8)
3 University of Manchester, Photon Science Institute, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)
4 University of Manchester, School of Physics and Astronomy, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)
5 University of Manchester, Centre for Imaging Sciences, Division of Informatics, Imaging and Data Sciences, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)
6 Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK (GRID:grid.462482.e) (ISNI:0000 0004 0417 0074); University of Manchester, Centre for Dermatology Research, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)
7 University of Manchester, School of Physics and Astronomy, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407); University of Manchester, Photon Science Institute, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)
8 Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust, Musculoskeletal Research Group, Salford, UK (GRID:grid.451052.7) (ISNI:0000 0004 0581 2008); Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK (GRID:grid.462482.e) (ISNI:0000 0004 0417 0074); University of Manchester, NIHR Manchester Biomedical Research Centre, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)
9 Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK (GRID:grid.462482.e) (ISNI:0000 0004 0417 0074); University of Manchester, Centre for Dermatology Research, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407); University of Manchester, NIHR Manchester Biomedical Research Centre, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)
10 Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust, Musculoskeletal Research Group, Salford, UK (GRID:grid.451052.7) (ISNI:0000 0004 0581 2008); Salford Care Organisation, part of the Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK (GRID:grid.462482.e) (ISNI:0000 0004 0417 0074); University of Manchester, Photon Science Institute, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407); University of Manchester, NIHR Manchester Biomedical Research Centre, Manchester, UK (GRID:grid.5379.8) (ISNI:0000000121662407)