Paracrine interactions between cells involved in scleroderma

Activated cells of the immune system, endothelial cells, and fibroblasts are all capable of releasing cytokines and growth factors which might exert a paracrine or autocrine influence on other cells. This could in turn modulate celluar properties and induce production of the same or other factors. Thus, there is the potential for local cytokine loops to initiate and perpetuate the immunologic, vascular, and fibrotic components of scleroderma.