Endostatin as a biomarker of systemic sclerosis: insights from a systematic review and meta-analysis
IntroductionThe critical role played by vascular dysfunction and ineffective angiogenesis in the pathophysiology of systemic sclerosis (SSc) suggests that circulating biomarkers reflecting these alterations may be useful in the clinical evaluation of this patient group. We sought to address this iss...
Saved in:
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-12-01
|
| Series: | Frontiers in Immunology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1450176/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850252077452754944 |
|---|---|
| author | Arduino A. Mangoni Arduino A. Mangoni Angelo Zinellu |
| author_facet | Arduino A. Mangoni Arduino A. Mangoni Angelo Zinellu |
| author_sort | Arduino A. Mangoni |
| collection | DOAJ |
| description | IntroductionThe critical role played by vascular dysfunction and ineffective angiogenesis in the pathophysiology of systemic sclerosis (SSc) suggests that circulating biomarkers reflecting these alterations may be useful in the clinical evaluation of this patient group. We sought to address this issue by conducting a systematic review and meta-analysis of studies investigating a such candidate biomarker, endostatin, an endogenous glycoprotein exerting anti-angiogenic effects, in SSc patients and healthy controls.MethodsA literature search was conducted in the electronic databases Web of Science, PubMed, and Scopus from inception to 27 May 2024. Risk of bias and certainty of evidence were assessed using the JBI checklist for analytical studies and GRADE, respectively.ResultsIn 19 eligible studies, circulating endostatin concentrations were significantly higher in SSc patients than controls (standard mean difference, SMD=0.90, 95% CI 0.56 to 1.23, p<0.001; low certainty of evidence). Endostatin concentrations were also significantly higher in SSc patients with digital ulcers than those without (SMD=0.43, 95% CI 0.24 to 0.62, p<0.001; very low certainty of evidence) and in patients with pulmonary arterial hypertension than those without (SMD=1.21, 95% CI 0.67 to 1.76, p<0.001; very low certainty of evidence). By contrast, no significant differences were observed between SSc patients with limited vs. diffuse disease and those with different video capillaroscopy patterns. There was limited evidence regarding endostatin concentrations in SSc patients with interstitial lung disease, telangiectasias, and gastrointestinal manifestations. There were no significant associations in meta-regression and subgroup analysis of studies investigating endostatin in SSc patients and controls between the effect size and various patient and study characteristics.DiscussionTherefore, the results of this systematic review and meta-analysis suggest that measuring endostatin can be useful in assessing the presence of SSc and specific complications, i.e., digital ulcers and pulmonary arterial hypertension, in these patients.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024558174. |
| format | Article |
| id | doaj-art-a331af9510b44d1bb34b71da94980f80 |
| institution | OA Journals |
| issn | 1664-3224 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj-art-a331af9510b44d1bb34b71da94980f802025-08-20T01:57:44ZengFrontiers Media S.A.Frontiers in Immunology1664-32242024-12-011510.3389/fimmu.2024.14501761450176Endostatin as a biomarker of systemic sclerosis: insights from a systematic review and meta-analysisArduino A. Mangoni0Arduino A. Mangoni1Angelo Zinellu2Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedford Park, SA, AustraliaDepartment of Clinical Pharmacology, Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA, AustraliaDepartment of Biomedical Sciences, University of Sassari, Sassari, ItalyIntroductionThe critical role played by vascular dysfunction and ineffective angiogenesis in the pathophysiology of systemic sclerosis (SSc) suggests that circulating biomarkers reflecting these alterations may be useful in the clinical evaluation of this patient group. We sought to address this issue by conducting a systematic review and meta-analysis of studies investigating a such candidate biomarker, endostatin, an endogenous glycoprotein exerting anti-angiogenic effects, in SSc patients and healthy controls.MethodsA literature search was conducted in the electronic databases Web of Science, PubMed, and Scopus from inception to 27 May 2024. Risk of bias and certainty of evidence were assessed using the JBI checklist for analytical studies and GRADE, respectively.ResultsIn 19 eligible studies, circulating endostatin concentrations were significantly higher in SSc patients than controls (standard mean difference, SMD=0.90, 95% CI 0.56 to 1.23, p<0.001; low certainty of evidence). Endostatin concentrations were also significantly higher in SSc patients with digital ulcers than those without (SMD=0.43, 95% CI 0.24 to 0.62, p<0.001; very low certainty of evidence) and in patients with pulmonary arterial hypertension than those without (SMD=1.21, 95% CI 0.67 to 1.76, p<0.001; very low certainty of evidence). By contrast, no significant differences were observed between SSc patients with limited vs. diffuse disease and those with different video capillaroscopy patterns. There was limited evidence regarding endostatin concentrations in SSc patients with interstitial lung disease, telangiectasias, and gastrointestinal manifestations. There were no significant associations in meta-regression and subgroup analysis of studies investigating endostatin in SSc patients and controls between the effect size and various patient and study characteristics.DiscussionTherefore, the results of this systematic review and meta-analysis suggest that measuring endostatin can be useful in assessing the presence of SSc and specific complications, i.e., digital ulcers and pulmonary arterial hypertension, in these patients.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024558174.https://www.frontiersin.org/articles/10.3389/fimmu.2024.1450176/fullendostatinsystemic sclerosisbiomarkersvascular dysfunctionineffective angiogenesisfibrosis |
| spellingShingle | Arduino A. Mangoni Arduino A. Mangoni Angelo Zinellu Endostatin as a biomarker of systemic sclerosis: insights from a systematic review and meta-analysis Frontiers in Immunology endostatin systemic sclerosis biomarkers vascular dysfunction ineffective angiogenesis fibrosis |
| title | Endostatin as a biomarker of systemic sclerosis: insights from a systematic review and meta-analysis |
| title_full | Endostatin as a biomarker of systemic sclerosis: insights from a systematic review and meta-analysis |
| title_fullStr | Endostatin as a biomarker of systemic sclerosis: insights from a systematic review and meta-analysis |
| title_full_unstemmed | Endostatin as a biomarker of systemic sclerosis: insights from a systematic review and meta-analysis |
| title_short | Endostatin as a biomarker of systemic sclerosis: insights from a systematic review and meta-analysis |
| title_sort | endostatin as a biomarker of systemic sclerosis insights from a systematic review and meta analysis |
| topic | endostatin systemic sclerosis biomarkers vascular dysfunction ineffective angiogenesis fibrosis |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2024.1450176/full |
| work_keys_str_mv | AT arduinoamangoni endostatinasabiomarkerofsystemicsclerosisinsightsfromasystematicreviewandmetaanalysis AT arduinoamangoni endostatinasabiomarkerofsystemicsclerosisinsightsfromasystematicreviewandmetaanalysis AT angelozinellu endostatinasabiomarkerofsystemicsclerosisinsightsfromasystematicreviewandmetaanalysis |