Several reports described evidence that circulating monocytes and macrophages in patients with SSc-associated lung fibrosis displayed elevated levels of markers of the tissue remodeling/profibrotic (M2) phenotype including CD163, CCL18 and IL10 [204] and a recent investigation described increased expression of multiple alternative macrophage activation markers that correlated with progression of SSc associated pulmonary fibrosis [205]. This evidence concerns the gene CCL18 and pulmonary fibrosis.