New breakthrough in difficult-to-treat condition

A recent study presented at the European League Against Rheumatism Annual Congress revealed oestrogens – female hormones – might help fight scleroderma (SSc), an autoimmune disease. The researchers say the findings may explain the increased incidence of SSc in women after menopause and the greater severity of SSc in men. But most importantly, they open up the possibility of developing potential hormone therapies for the difficult-to-treat condition.

Scleroderma is a genetic autoimmune rheumatic disease that affects the skin and other organs around the body, explains Dr. Tony Hampton, a family medicine physician with Advocate Medical Group. The disease causes thickening and tightening of the skin as well as inflammation and scarring of many body parts.

“Unfortunately, scleroderma is a challenge to diagnose since it has symptoms that are found in other conditions. Your doctor must examine you and possibly order labs and exams to look for bone abnormalities to help diagnose scleroderma,” says Dr. Hampton.

Symptoms of scleroderma include fibrosis or skin thickening, Raynaud’s phenomenon, where skin color changes occurs in your fingers after cold exposure, enlarged red blood vessels in the hands, calcium deposits in your skin, high blood pressure, heartburn, joint pain and shortness of breath.

As part of the study, the researchers used two different techniques to evaluate the effect of oestrogen inhibition in mice with skin fibrosis. The first population of mice had gene inactivation to disrupt the key receptor that responds to oestrogens. On the second group, the researchers used tamoxifen, which is a hormone therapy that blocks the action of oestrogen. They found that for both techniques oestrogen inhibition consistently and significantly aggravated the process of skin fibrosis.

“Because of the clear sex bias in SSc, we decided to assess if blocking the action of oestrogens, the female hormones that decreases during menopause, plays a role in the development or vulnerability to this disease,” explained Dr. Jerome Avouac of the Paris Descartes University Medical School in Paris, France.

Currently, there is no drug that has proven to stop or reverse the key symptom of scleroderma, which is skin thickening. Treatment options currently only focus on managing the symptoms.

“Having confirmed that oestrogens indeed play a role in protecting against skin fibrosis in experimental models representative of SSc, the next step will be to begin investigating the potential role of hormone therapies as a treatment of SSc skin disease,” Dr. Avouac concluded.

“This research is important because it suggests that scleroderma may become treatable with hormonal approaches,” says Dr. Hampton.