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Peripheral blood biomarkers in idiopathic pulmonary fibrosis

  • Rekha Vij
    Affiliations
    Section of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago, Chicago, Ill
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  • Imre Noth
    Correspondence
    Reprint requests: Imre Noth, MD, Section of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago, 5841 S. Maryland Ave, MC 6076 Chicago, IL 60637.
    Affiliations
    Section of Pulmonary and Critical Care Medicine, Department of Medicine, University of Chicago, Chicago, Ill
    Search for articles by this author
Published:February 10, 2012DOI:https://doi.org/10.1016/j.trsl.2012.01.012
      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)
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