A Potential Link Between Oxidative Stress and Endothelial-to-Mesenchymal Transition in Systemic Sclerosis

Duong Thi Bich Thuan, Hatem Zayed, Ali H Eid, Haissam Abou-Saleh, Gheyath K Nasrallah, Arduino A Mangoni, Gianfranco Pintus

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57 Citations (Scopus)
14 Downloads (Pure)


Systemic sclerosis (SSc), an autoimmune disease that is associated with a number of genetic and environmental risk factors, is characterized by progressive fibrosis and microvasculature damage in the skin, lungs, heart, digestive system, kidneys, muscles, joints, and nervous system. These abnormalities are associated with altered secretion of growth factor and profibrotic cytokines, such as transforming growth factor-beta (TGF-β), interleukin-4 (IL-4), platelet-derived growth factor (PDGF), and connective-tissue growth factor (CTGF). Among the cellular responses to this proinflammatory environment, the endothelial cells phenotypic conversion into activated myofibroblasts, a process known as endothelial to mesenchymal transition (EndMT), has been postulated. Reactive oxygen species (ROS) might play a key role in SSs-associated fibrosis and vascular damage by mediating and/or activating TGF-β-induced EndMT, a phenomenon that has been observed in other disease models. In this review, we identified and critically appraised published studies investigating associations ROS and EndMT and the presence of EndMT in SSc, highlighting a potential link between oxidative stress and EndMT in this condition.

Original languageEnglish
Article number1985
Number of pages14
JournalFrontiers in Immunology
Publication statusPublished - 19 Sep 2018

Bibliographical note

© 2018 Thuan, Zayed, Eid, Abou-Saleh, Nasrallah, Mangoni and Pintus. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.


  • Endothelial-to-Mesenchymal Transition
  • Oxidative stress
  • Reactive oxygen species
  • Scleroderma
  • Systemic sclerosis


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