{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T06:02:08Z","timestamp":1792735328590,"version":"4.5.0"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006260","name":"Rheumatology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006260","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001845","name":"Scleroderma Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001845","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis & Rheumatology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Objective<\/jats:title>\n Peripheral blood leukocyte telomere length (PBL\u2010TL) shortening is associated with systemic sclerosis\u2013related interstitial lung disease (SSc\u2010ILD). However, its association with other organ involvement, disease severity, and survival remains unclear. This study aimed to define the relationship of TL with SSc\u2010specific disease manifestations and outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n PBL\u2010TL was measured by quantitative polymerase chain reaction in 244 patients with SSc and 314 healthy controls. Multivariate modeling was used to assess the association of PBL\u2010TL with disease severity and event\u2010free survival. Longitudinal changes in PBL\u2010TL were measured in a subset of patients. TL was quantified in SSc skin and lung tissues by telomere fluorescence in situ hybridization.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n PBL\u2010TL was significantly shorter in patients with SSc than healthy controls. Shortened PBL\u2010TL was associated with presence and severity of ILD and pulmonary hypertension (PH), with the shortest PBL\u2010TL found in subjects with concurrent ILD and PH (\n P<\/jats:italic>\n = 0.04). PBL\u2010TL was not associated with skin disease or peripheral vascular disease. Shorter PBL\u2010TL was associated with hospitalizations (\n P<\/jats:italic>\n < 0.01) and worse event\u2010free survival (\n P<\/jats:italic>\n = 0.03). Patients with early SSc had a faster rate of PBL\u2010TL shortening compared with patients with longer disease duration (\n P<\/jats:italic>\n = 0.04). TL was shorter in SSc\u2010ILD lung epithelial cells (\n P<\/jats:italic>\n = 0.01), whereas no difference was found in epithelial cells of SSc skin (\n P<\/jats:italic>\n = 0.82).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Short PBL\u2010TL is associated with pulmonary disease severity and predicts worse SSc clinical outcomes. This study provides rationale to further investigate the role of telomere dysfunction in SSc pathogenesis and validate TL as a prognostic biomarker in SSc.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/art.43400","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T09:19:22Z","timestamp":1758187162000},"page":"428-437","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Telomere Length of Peripheral Blood Leukocytes Predicts Disease Severity and Worse Survival in Systemic Sclerosis"],"prefix":"10.1002","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2693-3648","authenticated-orcid":false,"given":"Monica M.","family":"Yang","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Medicine University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuo","family":"Liu","sequence":"additional","affiliation":[{"name":"Jinqiu Hospital of Liaoning Province Shenyang People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Michael","family":"Wax","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seoyeon","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4211-2628","authenticated-orcid":false,"given":"Sarah","family":"French","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J.","family":"Wolters","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, Department of Medicine University of California San Francisco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4840-3063","authenticated-orcid":false,"given":"Francesco","family":"Boin","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine Cedar\u2010Sinai Medical Center Los Angeles California"},{"name":"Kao Autoimmunity Institute, Cedars\u2010Sinai Medical Center Los Angeles California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01692-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41580-024-00800-5"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2021.7804"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)12384-7"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-023-37193-6"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0804280105"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200804-550OC"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-215918"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis\u20102013\u2010204424"},{"issue":"3","key":"e_1_2_6_11_1","first-page":"S42","article-title":"Assessment of disease severity and prognosis","volume":"21","author":"Medsger TA","year":"2003","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00879-2022"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/30.10.e47"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-209897"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01044-2019"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-12-3082"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-62703-317-6_13"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn338"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0609367104"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0531-5565(01)00218-2"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)66630-5"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0092-8674(01)00504-9"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2017.05.015"},{"issue":"4","key":"e_1_2_6_24_1","first-page":"1489","article-title":"Telomere dynamics in myelodysplastic syndrome determined by telomere measurement of marrow metaphases","volume":"9","author":"Sashida G","year":"2003","journal-title":"Clin Cancer Res"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mnh.0000165890.60254.4e"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1006\/bbrc.1995.1774"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.02.034"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1504780112"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.86704"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-03-418038"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.287.5456.1253"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201602-095AW"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00268-2020"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.111.241299"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1326922"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12979-022-00263-2"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2022.09.652"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00163814"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keae573"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajplung.00141.2023"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms5172"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01078"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2020-218918"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.100956"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa127"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01641-2018"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00441-2023"}],"container-title":["Arthritis & Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.43400","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/art.43400","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/art.43400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:27:56Z","timestamp":1773008876000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/art.43400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,2]]},"references-count":46,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/art.43400"],"URL":"https:\/\/doi.org\/10.1002\/art.43400","archive":["Portico"],"relation":{},"ISSN":["2326-5191","2326-5205"],"issn-type":[{"value":"2326-5191","type":"print"},{"value":"2326-5205","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,2]]},"assertion":[{"value":"2025-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}