The expression of CTGF is increased in SSc fibroblasts.21, 22 Since IGFBP‐4 reduces baseline and TGF‐ß–induced ECM production and CTGF is a mediator of the profibrotic effects of TGF‐ß,23, 24 we examined the effect of IGFBP‐4 on CTGF. This evidence concerns the gene IGFBP4 and systemic sclerosis.