Recent innovations in the screening and diagnosis of systemic sclerosis-associated interstitial lung disease

Ashima Makol, Vivek Nagaraja, Chiemezie Amadi, Janelle Vu Pugashetti, Elaine Caoili, Dinesh Khanna

Research output: Contribution to journalReview articlepeer-review


Introduction: Interstitial lung disease (ILD) is the leading cause of mortality in patients with systemic sclerosis (SSc). Risk of developing progressive ILD is highest among patients with diffuse cutaneous disease, positive anti-topoisomerase I antibody, and elevated acute phase reactants. With the FDA approval of two medications and a pipeline of novel therapeutics in trials, early recognition and intervention is critical. High-resolution computed tomography of the chest is the current gold standard test for diagnosis of ILD. Yet, it is not offered as a screening tool to all patients due to which ILD can be missed in up to a third of patients. There is a need to develop and validate more innovative screening modalities. Areas covered: In this review, we provide an overview of screening and diagnosis of SSc-ILD, highlighting the recent innovations particularly the role of soluble serologic, radiomic (quantitative lung imaging, lung ultrasound), and breathomic (exhaled breath analysis) biomarkers in the early detection of SSc-ILD. Expert opinion: There is remarkable progress in the development of new radiomics and serum biomarkers in diagnosing SSc-ILD. There is an urgent need for conceptualizing and testing composite ILD screening strategies that incorporate these biomarkers.

Original languageEnglish (US)
Pages (from-to)613-626
Number of pages14
JournalExpert review of clinical immunology
Issue number6
StatePublished - 2023


  • HRCT
  • Systemic sclerosis
  • biomarkers
  • diagnosis
  • interstitial lung disease
  • lung ultrasound
  • oscillometry
  • screening

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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