Cellular and molecular mechanisms of systemic sclerosis: Translation to targeted therapies and clinical practice.

Systemic sclerosis (SSc) is characterized by profound clinical heterogeneity due to dysregulated communication between vascular, immune, and stromal compartments. This review synthesizes genetic and epigenetic determinants of SSc with observations from transcriptomic, proteomic, and metabolomic studies. We highlight emerging cellular- and molecular-level insights into vasculopathy, immune dysregulation, and fibroblast activation in SSc. Finally, we discuss how these mechanistic discoveries inform the development of targeted, precision-medicine based therapeutic approaches in SSc.