Reprogramming of the lipid metabolism axis in systemic sclerosis: mechanism analysis and therapeutic potential.

Systemic sclerosis (SSc), a highly fatal autoimmune disease, is characterized by pathological hallmarks including microvascular damage, immune dysregulation, and progressive fibrosis affecting the skin and multiple organs. Clinically, SSc-related interstitial lung disease and cardiovascular complications represent the primary causes of mortality. Emerging research has highlighted the role of lipid metabolism dysregulation in SSc pathogenesis, with clinically observed abnormal lipid profiles potentially linked to disease progression. Advances in lipidomics have elucidated pathological alterations in specific lipid species and their signaling pathways, offering novel insights into metabolic reprogramming in SSc and identifying potential therapeutic targets. This review synthesizes current evidence on lipid abnormalities in SSc patients, focusing on the interplay between dyslipidemia and three core pathological processes: vascular injury, immune dysfunction, and fibrotic remodeling. Additionally, we briefly analyze the effects of existing drug interventions on the lipid profile of SSc patients, providing a foundation for developing lipid metabolism-targeted therapies to refine clinical management.