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Research in Systemic Sclerosis

Whilst there is currently no cure for Systemic Sclerosis (SSc), SSc is a treatable disease. This has relied on advances in research that has made a difference to the lives of patients with SSc. However, we still have a long way to go in understanding the disease. 

We need to identify the cause and triggers of SSc, how to detect SSc in its early stages, to identify the different types of SSc and consequently how the disease behaves (e.g. some patients have a very mild and stable spectrum, others have more severe and rapidly worsening spectrum), and how we can better target treatment to bring precision medicine to patients. This means optimising the benefits of treatment whilst minimising the side-effects of medication for the individual person. Research is therefore necessary to continue to discover new treatments and improve the care of patients with SSc.

We hope to make a difference in the lives of patients through research. The clinician researchers and scientists at SGH lead a nation-wide SSc research network and have built a database to allow analysis of clinical data, as well as blood and other tissue samples from patients who have chosen to participate. The team lead and collaborate with renowned local and international academic institutions, and industry to accelerate discoveries and uncover new cures for SSc. 

About Research Focus Area

  • Understanding the cause and triggers of SSc
  • Early diagnosis of SSc for better outcomes
  • Stratification of different subgroups of SSc to better predict their diseases course and target treatment
  • Clinical and translational research in the lung, heart and gut complications of SSc as these are the leading causes of death in the Asian population of SSc
  • Discovery of new treatments for SSc

Top 10 publications in Systemic Sclerosis


  1. L Xiang, Kua SM, Low AHL Work Productivity and Economic Burden of Systemic Sclerosis in a Multi-Ethnic Asian Population. Arthritis Care & Research 2022; 74 (5): 818-827 https://doi.org/10.1002/acr.24521

  2. Noviani M, Chellamuthu VR, Albani S*, Low AHL*. Towards molecular stratification and precision medicine in systemic sclerosis. Frontiers in Medicine. Epub 30 June 2022 https://doi.org/10.3389/fmed.2022.911977

  3. TC Tan, L Chandrasekaran, YY Leung, R Purbojati, S Pettersson, AHL Low. Gut Microbiome profiling in Systemic Sclerosis; A metagenomic approach. Clin Exp Rheum 2022; accepted 16/12/22

  4. TT Tan, M Noviani, YY Leung, AHL Low. Microbiome and systemic sclerosis: a review of current evidence Best Practice & Research Clinical Rheumatology 2021;  Best Practice & Research Clinical Rheumatology 2021;35 (3):101687 https://doi.org/10.1016/j.berh.2021.101687

  5. Ng SA, Low AHL. Systemic sclerosis in Asians: Are there racial differences? J Scleroderma Relat Disord. 2022 Jun;7(2):98-109. https://doi.org/10.1177/23971983221074749.

  6. Cassandra Hong, Xiang Ling, Syed Ehsan Saffari, Andrea HL Low. Nailfold capillaroscopy for the early diagnosis of the scleroderma spectrum of diseases in patients without Raynaud's phenomenon. Journal of Scleroderma and Related Disorders. 2022 Jun;7(2):144-150. https://doi.org/10.1177/23971983221088460.

  7. Eleonora Adami, Sivakumar Viswanathan, Anissa A Widjaja, Benjamin Ng, Sonia Chothani, Nevin Zhihao, Jessie Tan, Pei Min Lio, Benjamin L. George, Umut Altunoglu, Kakaly Ghosh, Bhairav S. Paleja, Sebastian Schafer, Bruno Reversade, Salvatore Albani, Andrea Low Hsiu Ling, Steven O'Reilly, Stuart A. Cook. IL11 is elevated in systemic sclerosis and IL11-dependent ERK signaling underlies TGFβ-mediated activation of dermal fibroblasts. Rheumatology (Oxford) 2021; 60 (12): 5820-5826 https://doi.org/10.1093/rheumatology/keab168

  8. Noviani Maria; Saffari Seyed Ehsan; Tan Ju Le; Yip James Wei Luen; Teng Gim Gee; Law Weng Giap; Chan Grace Yin Lai; Santosa Amelia; Lim Anita Yee Nah; Hong Cassandra; Ng Sue-Ann; Tay Edgar Lik Wui; Ruan Wen; Yap Jonathan; Low Andrea Hsiu Ling. Mortality and hospitalization outcomes of interstitial lung disease and pulmonary hypertension in the Singapore systemic sclerosis cohort. Seminars in arthritis and rheumatism 2020; 50(3):473-479 https://doi.org/10.1016/j.semarthrit.2019.11.005

  9. B Paleja, A. Low, Pavanish Kumar, Suzan Saidin, Ahmad Lajam, Camillus Chua, Liyun Lai, Salvatore Albani. Systemic sclerosis perturbs the architecture of the immunome. Frontiers in Immunology 2020; 11:1602 https://doi.org/10.3389/fimmu.2020.01602

  10.  Low Andrea Hsiu Ling; Teng Gim Gee; Pettersson Sven; de Sessions Paola Florez; Ho Eliza Xin Pei; Fan Qiao; Chu Collins Wenhan; Law Annie Hui Nee; Santosa Amelia; Lim Anita Yee Nah; Wang Yu Tien; Haaland Benjamin; Thumboo Julian. A double-blind randomized placebo-controlled trial of probiotics in systemic sclerosis associated gastrointestinal disease. Seminars in arthritis and rheumatism 2019; 49(3):411-419 https://doi.org/10.1016/j.semarthrit.2019.05.006

  11. Marchesseau Stephanie; Ng Sue-Ann; Wang Yu Tien; Xie Wanying; Ng David Chee-Eng; Totman John James;Low Andrea Hsiu Ling. F-FDG PET-MRI with T1 MOLLI mapping to detect systemic sclerosis bowel inflammation and fibrosis. European journal of radiology 2018; 105:289-295 https://doi.org/10.1016/j.ejrad.2018.06.022

  12. Susanna M. Proudman, Molla Huq, Wendy Stevens, Michelle E. Wilson, Joanne Sahhar, Murray Baron, Marie Hudson, Janet Pope, Yannick Allanore, Oliver Distler, Otylia Kowal-Bielecka, Marco Matucci-Cerinic, Low AHL, Gim Gee Teng, Weng Giap Law, Amelia Santosa, Mandana Nikpour, ASIG, CSRG, EUSTAR, Singapore Scleroderma Workgroup (SCORE). What have multicentre registries across the world taught us about the disease features of systemic sclerosis?J Scleroderma Relat Disord 2017; 2(3):169-182 https://doi.org/10.5301/jsrd.5000256

  13. Santosa A, Tan CS, Teng GG, Fong W, Lim A, Law WG, Chan G, Ng SC, Low AHL. Lung and Gastrointestinal Complications are Leading Causes of Death in SCORE, a Multi-Ethnic Singapore Systemic Sclerosis Cohort. Scand J Rheumatol 2016; 45:499-506 https://doi.org/10.3109/03009742.2016.1153141

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