{
  "abstract": "Background Interstitial lung disease (ILD) is a major determinant of morbidity and mortality in systemic sclerosis (SSc). Automated quantitative CT (qCT) enables reproducible assessment of ILD extent and parenchymal texture composition. Whether circulating biomarkers reflect distinct qCT-defined features of SSc-ILD remains insufficiently characterised.Objectives To determine whether circulating biomarkers are associated with ILD presence, qCT-derived disease burden and radiological pattern composition in patients with SSc.Methods In this cross-sectional study, consecutive patients with SSc underwent same-day serum sampling and high-resolution CT. ILD presence was assessed visually, while qCT quantified ground-glass opacities (GGO), fibrotic abnormalities and total ILD extent (%). Serum levels of Krebs von den Lungen-6 (KL-6), C-C motif chemokine ligand 18 (CCL-18), surfactant protein D (SP-D), interleukin (IL)-33, IL-11, IL-25 and matrix metalloproteinase 12 (MMP-12) were measured using commercial ELISA assays.Results Eighty-two patients were included; 59 (72%) had ILD on CT. KL-6, CCL-18 and SP-D levels were significantly higher in patients with ILD, with KL-6 remaining independently associated with ILD presence in multivariable analysis. KL-6 showed the strongest associations with qCT measures of disease burden, including total ILD extent, GGO and fibrotic abnormalities. CCL-18 was associated with total ILD extent and GGO. SP-D was linked to ILD presence but not to qCT-derived measures of disease burden. IL-25 showed a preliminary association with the GGO-to-fibrosis ratio and was higher in patients with a GGO-predominant qCT pattern. IL-33, IL-11 and MMP-12 did not show significant associations with ILD presence or qCT-derived lung involvement.Conclusions Circulating biomarkers showed distinct associations with SSc-ILD presence and qCT-defined disease burden. IL-25 may also reflect radiological pattern composition, warranting validation in independent cohorts.",
  "abstract_shown": true,
  "affiliations": [
    "Dipartimento di Scienze Mediche e Cardiovascolari, Rheumatology Unit, Sapienza University of Rome, Rome, Italy",
    "IRCCS Ospedale Galeazzi - Sant`Ambrogio, Milan, Italy",
    "Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, Rome, Italy",
    "Istituto Superiore di Sanità, National Center for Global Health, Rome, Italy",
    "Dipartimento di Scienze Mediche e Cardiovascolari, Respiratory Medicine Unit, Sapienza University of Rome, Rome, Italy"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 17,
  "authors": [
    {
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        0
      ],
      "name": "Fabrizio Conti"
    },
    {
      "affs": [
        0
      ],
      "name": "Valeria Riccieri"
    },
    {
      "affs": [
        1
      ],
      "name": "Greta Pellegrino"
    },
    {
      "affs": [
        2
      ],
      "name": "Valeria Panebianco"
    },
    {
      "affs": [
        0
      ],
      "name": "Simona Truglia"
    },
    {
      "affs": [
        0
      ],
      "name": "Marius Cadar"
    },
    {
      "affs": [
        2
      ],
      "name": "Nicholas Landini"
    },
    {
      "affs": [
        0
      ],
      "name": "Martina Salerno"
    },
    {
      "affs": [
        0
      ],
      "name": "Ilaria Bisconti"
    },
    {
      "affs": [
        0
      ],
      "name": "Elena Platania"
    },
    {
      "affs": [
        0
      ],
      "name": "Jacopo Landro"
    },
    {
      "affs": [
        0
      ],
      "name": "Francesca Romana Di Ciommo"
    },
    {
      "affs": [
        3
      ],
      "name": "Giuseppe Ocone"
    },
    {
      "affs": [
        3
      ],
      "name": "Loredana Frasca"
    },
    {
      "affs": [
        0
      ],
      "name": "Davide Mohammad Reza Beigi"
    },
    {
      "affs": [
        0
      ],
      "name": "Giada La Spina"
    },
    {
      "affs": [
        4
      ],
      "name": "Gregorino Paone"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4fndwf2q0y0h3.bib",
  "cited_by": 0,
  "doi": "10.1136/rmdopen-2026-006938",
  "fulltext_url": "https://rmdopen.bmj.com/content/12/4/e006938.full",
  "id": "4fndwf2q0y0h3",
  "issns": [
    "2056-5933"
  ],
  "landing_url": "https://doi.org/10.1136/rmdopen-2026-006938",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "R"
    ],
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      "openalex",
      "2745|Systemic Sclerosis and Related Diseases"
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  "pdf_url": "https://rmdopen.bmj.com/content/12/4/e006938.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-08",
  "publisher": "BMJ Publishing Group",
  "ris": "https://research.draconitic.com/paper/4fndwf2q0y0h3.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T14:21:26Z",
      "native_id": "37f8ceddf7e847e2b4ba09cf0c238ff1",
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  "subjects": [
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  "title": "Circulating biomarkers reflect distinct quantitative CT-defined features of systemic sclerosis-associated interstitial lung disease",
  "title_text": "Circulating biomarkers reflect distinct quantitative CT-defined features of systemic sclerosis-associated interstitial lung disease",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T14:21:26Z",
  "url": "https://research.draconitic.com/paper/4fndwf2q0y0h3",
  "venue": "RMD Open",
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