"We were surprised by the high number of womens skin samples showing the Y chromosome," he says.
But an important question remains: what would activate the chronic GVHD reaction?
"It seems clear that a second event, such as an environmental exposure, is needed. It could be a virus, or radiation, chemicals, toxins--we just dont know. But the fetal cell-GVHD association would explain why it [scleroderma] is more common in women and why at that age after many women have had children. Weve known about cells from the baby going to the mother, and vice versa, but we didnt know cells could survive in the circulation for decades," he says.
The next step, Dr. Jimenez says, is to try to determine whether the fetal cells might actually cause the GVHD, and in turn, systemic sclerosis. "Were trying to isolate the cells that carry the male chromosome and see what kinds of cells they are," he says.
"We would like to show that those cells are stimulating the pathogenesis of scleroderma. If these foreign cells are involved in the pathogenesis of disease, you can create a vaccine or try some other way to eliminate them from the body.
"The study describes the presence of fetal cell levels in scleroderma, and suggests the possibility that systemic sclerosis can be produced this way. This needs to be explored further."
Some 300,000 Americans have scleroderma, which is actually categorized as two main diseases: localized scleroderma and systemic sclerosis. The former affects only the skin. Systemic sclerosis can affect the internal organs, skin and the bodys small blood vessels. Scleroderma can be devastating; some aggressive forms of the disease can result in death after only a few months.