A validation study (Cohort 4, 62 SSc patients and age- and sex-matched 10 healthy controls) confirmed significantly elevated serum levels tenascin-C in SSc (Fig. 1e), with the highest levels in patients with SSc-interstitial lung disease (ILD) (ILD versus no ILD P=0.017), confirming results from a previous study (Supplementary Table 2) (ref. 11). Here, TNC is linked to interstitial lung disease.