In this article, we review the evidence for peripheral blood biomarkers in idiopathic
pulmonary fibrosis (IPF), a life-threatening fibrotic lung disease of unknown etiology.
We focus on selected biomarkers present in peripheral blood, as they are easy to obtain,
can be measured longitudinally, and have the greatest likelihood of achieving clinical
utility. This article concentrates on biomarkers with mechanistic plausibility that
may be directly involved in the development of IPF, including KL-6, surfactant proteins
A and D, matrix metalloproteases (MMP) 1 and 7, CCL18, VEGF, YKL-40, osteopontin,
circulating fibrocytes, and T cells. After reviewing the evidence base for each, we
designate the biomarkers that may have utility as: (1) diagnostic biomarkers to distinguish
IPF from other interstitial lung diseases, (2) prognostic biomarkers that are correlated
with disease progression or mortality, or (3) biomarkers that can be used as tools
for serial monitoring of disease severity. Although there are no validated biomarkers
that are currently available, the need for surrogates of diagnosis, prognosis, and
monitoring of disease course with emerging therapies is great.
Abbreviations:
AaDO2 (alveolar-arterial difference of oxygen), BALF (bronchoalveolar lavage fluid), BNP (brain natriuretic peptide), CCL (CC chemokine ligand), CI (confidence interval), CT (computed tomography), DLCO (diffusing capacity for carbon monoxide), FVC (forced vital capacity), HR (hazard ratio), IL (interleukin), IPF (Idiopathic Pulmonary Fibrosis), KL-6 (Krebs von den lungen-6 antigen), MMP (matrix metalloprotease), PARC (pulmonary and activation-regulated chemokine), SP (surfactant protein), TLC (total lung capacity), Tregs (T regulatory cells), UIP (usual interstitial pneumonia), VEGF (vascular endothelial growth factor)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 10, 2012
Accepted:
January 12,
2012
Received in revised form:
January 11,
2012
Received:
December 1,
2011
Footnotes
Conflict of interest: Dr.Vij has no conflicts of interest to disclose. Dr. Noth has received institutional grants from Centacor, Immuneworks, Actelion, and the National Institutes of Health for conduct of clinical trials in IPF. Both authors acknowledge the Journal's policy on disclosure of potential conflicts of interest.
Identification
Copyright
© 2012 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
