Houston: Patients with a certain type of
scleroderma may get cancer and scleroderma simultaneously,
Johns Hopkins researchers have found, suggesting that in
some diseases, autoimmunity and cancer may be linked.
Scleroderma is a complex autoimmune disease, with visible
symptoms, affecting the skin, or invisible, affecting internal
organs. For some people living with scleroderma, it affects
The study may answer what causes scleroderma, an
incurable autoimmune disease that causes scar tissue to
develop in the skin and in major organ systems, and to pinning
down why some with scleroderma appear to be at increased risk
The insights add to the growing body of evidence linking
some autoimmune disorders with cancer.
Indian American doctor, Ami A Shah, an assistant
professor of medicine in the division of rheumatology at the
Johns Hopkins University School of Medicine and the study`s
lead author said, "Our research adds more to the discussion
about whether cancer and autoimmune diseases are related and
whether cancer may be a trigger for scleroderma."
The small study, which appears online in the journal
Arthritis and Rheumatism, looked at blood and tumor samples
from 23 patients with both scleroderma and cancer who were
treated at the Johns Hopkins Scleroderma Centre.
Ten per cent of the patients treated at the scleroderma
centre have cancer as well as the autoimmune disease.
The researchers looked for specific immune markers in
each patient, determining which type of antibodies the
Those with antibodies called anti-RNA polymerase I/III
had the most closely related onset of cancer and scleroderma,
they found. Those patients got both diseases within two years
of one another.
The reasons for the apparent link between scleroderma and
cancer are not understood, Shah says. And it is unknown
whether cancer could be causing scleroderma or if scleroderma
could be causing cancer.
Most often, Shah says, the patients developed cancer
first and then scleroderma soon after. She says one theory, as
yet unproven, is that as the body generates an immune response
to fight a tumor, the immune response could trigger the
development of scleroderma.
It is also possible, she says, that the immune response
could successfully defeat a developing tumor but still result
Another possibility could be that organ damage from
scleroderma could predispose patients to cancer. Or it could
be that the use of immune-suppressing drugs to treat
scleroderma could lead to cancer.