High levels of both sPD-1 and sPD-L2 levels were associated with a diffuse scleroderma subtype, the development of finger ulcers, pulmonary fibrosis, a higher MRSS, positive Scl-70 antibodies, a decreased vital capacity, and a decreased diffusion capacity for CO2 The cytokine IL-10, which overall has immunoregulatory effects and is considered an anti-inflammatory cytokine, was positively correlated with levels of PD-L2 expressing B cells taken from patients with pSSc [15]. The gene discussed is HOXD13; the disease is diffuse scleroderma.