Inhibition of tumour progression locus 2 (TPL2) halts the progression of liver fibrosis in a stringent long term choline deficient high-fat diet (CdHFD) rat model

Background and aims: Systemic sclerosis (SSc) is characterized by skin fibrosis and involvement of esophagus, lungs, heart and kidneys.Liver involvement in SSc is considered rare, but reports addressing this issue are scarce.Here, we evaluated the prevalence of liver fibrosis and hepatic autoimmunity in a cohort of SSc patients.Method: A retrospective observational study was performed on 97 patients diagnosed with SSc or mixed connective tissue disease with sclerodermic manifestations who underwent transient elastography evaluating liver stiffness (LS) and controlled attenuation parameter (CAP) due to clinical indication; a biochemistry assessment and major antibodies associated to liver autoimmunity were recorded whether performed together to clinical and demographic data.Results: Among the 97 patients included, 16 (16.5%)had LS ≥7.5 kPa, 5 of whom had LS ≥12.5 kPa.Predictors of LS ≥7.5 were alcohol consumption, waist circumference, elevated alkaline phosphatase (ALP) levels, anti-La and anti-mitochondrial antibody (AMA) positivity.CAP values compatible with steatosis (≥280 dB/m) were observed in 6 (6.2%) patients.Waist circumference, body mass index and diabetes mellitus were significant predictors of steatosis.Out of 97 patients, 19 (19.5%) were positive for AMA, 4 (4.2%) for anti-Sp100, 1 (1%) for anti-gp210 and 7 (7.3%) were diagnosed with primary biliary cholangitis.Conclusion: Among SSc patients, the prevalence of biomarkers of hepatic fibrosis and AMA is relatively high, suggesting the opportunity of performing a transient elastography and a screening for hepatic autoimmunity at diagnosis and/or along the course of the disease.