In another study, 82 proteins were found to be differentially expressed in sera from SSc-PAH patients compared to SSc patients without lung vascular involvement, including an IFN-γ signature and two other proteins of interest, Midkine (implicated in the pathogenesis of arterial hypertension, renal disease, and lung fibrosis) and Follistatin-like 3 (FSTL3, regulated by TGF-β) in association with SSc-PAH (40). Here, MDK is linked to pulmonary fibrosis.