
The study explores metabolic changes preceding pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) patients, using mass spectrometry-based metabolomics. Increased kynurenine and its ratio to tryptophan (kyn/trp) were identified in SSc-PAH development. Elevated kyn/trp, detected two years before diagnosis, predicted PAH, while its slope indicated disease progression.
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