In another study, SSc patients with renal, myocardial and pulmonary involvement presented elevated serum E-selectin, VCAM-1, VEGF, and ET-1 when compared to both healthy controls and patients without systemic manifestations, indicating that circulating levels of these molecules may reflect the ongoing EC activation state and correlate to the extent of internal organ complications [41]. Here, VCAM1 is linked to systemic sclerosis.