Open Access Open Badges Research article

Levels of adiponectin, a marker for PPAR-gamma activity, correlate with skin fibrosis in systemic sclerosis: potential utility as biomarker?

Katja Lakota1*, Jun Wei2, Mary Carns2, Monique Hinchcliff2, Jungwha Lee3, Michael L Whitfield4, Snezna Sodin-Semrl1 and John Varga2

Author affiliations

1 Department of Rheumatology, University Medical Centre Ljubljana, Vodnikova 62, Ljubljana 1000, Slovenia

2 Department of Medicine, Feinberg School of Medicine, Northwestern University, East Huron Street 240, Chicago, 60611-2909 IL, USA

3 Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, North Lake Shore Drive 680, Chicago, 60611-2909 IL, USA

4 Department of Genetics, Dartmouth Medical School, Remsen 7400, Hanover, 03755 NH, USA

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Citation and License

Arthritis Research & Therapy 2012, 14:R102  doi:10.1186/ar3827

Published: 1 May 2012



Progressive fibrosis in systemic sclerosis (SSc) is linked to aberrant transforming growth factor beta (TGF-beta) signaling. Peroxisome proliferator-activated receptor gamma (PPAR-gamma) blocks fibrogenic TGF-beta responses in vitro and in vivo. Reduced expression and function of PPAR-gamma in patients with SSc may contribute to progression of fibrosis. Here we evaluated the levels of adiponectin, a sensitive and specific index of PPAR-gamma activity, as a potential fibrogenic biomarker in SSc.


Adiponectin levels were determined in the sera of 129 patients with SSc and 86 healthy controls, and serial determinations were performed in 27 patients. Levels of adiponectin mRNA in skin biopsies from SSc patients were assessed in an expression profiling microarray dataset. Regulation of adiponectin gene expression in explanted human subcutaneous preadipocytes and fibroblasts was examined by real-time quantitative PCR.


Patients with diffuse cutaneous SSc had reduced serum adiponectin levels. A significant inverse correlation between adiponectin levels and the modified Rodnan skin score was observed. In longitudinal studies changes in serum adiponectin levels were inversely correlated with changes in skin fibrosis. Skin biopsies from a subset of SSc patients showed reduced adiponectin mRNA expression which was inversely correlated with the skin score. An agonist ligand of PPAR-gamma potently induced adiponectin expression in explanted mesenchymal cells in vitro.


Levels of adiponectin, reflecting PPAR-gamma activity, are correlated with skin fibrosis and might have potential utility as a biomarker in SSc.