Diagnostic and prognostic biomarkers for chronic fibrosing interstitial lung diseases with a progressive phenotype
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Accepted version
Author(s)
Type
Journal Article
Abstract
Biomarkers have the potential to become central to the clinical evaluation and monitoring of patients with chronic fibrosing interstitial lung diseases with a progressive phenotype. Here we summarize the current understanding of putative serum, bronchoalveolar lavage fluid and genetic biomarkers in this setting, according to their hypothesized pathobiologic mechanisms: evidence of epithelial cell dysfunction (eg, Krebs von den Lungen-6 antigen), fibroblast proliferation and extracellular matrix production/turnover (eg, matrix metalloproteinase-1), or immune dysregulation (eg, CC chemokine ligand 18). While most of the available data comes from idiopathic pulmonary fibrosis, the prototypic progressive fibrosing interstitial lung disease, there are data available in the broader patient population of chronic fibrosing interstitial lung diseases. While a number of these biomarkers show promise, none have been validated. In this review article, we assess both the status of proposed biomarkers for chronic fibrosing lung diseases with a progressive phenotype in predicting disease risk or predisposition, diagnosis, prognosis and treatment response, and provide a direct comparison between idiopathic pulmonary fibrosis and other chronic fibrotic interstitial lung diseases. We also reflect on the current clinical usefulness and future direction of research for biomarkers in the setting of chronic fibrosing interstitial lung diseases with a progressive phenotype.
Date Issued
2020-08-01
Date Acceptance
2020-03-19
Citation
Chest, 2020, 158 (2), pp.646-659
ISSN
0012-3692
Publisher
Elsevier
Start Page
646
End Page
659
Journal / Book Title
Chest
Volume
158
Issue
2
Copyright Statement
© 2020 Published by Elsevier Inc under license from the American College of Chest Physicians. Available open access under a CC-BY-NC-ND Attribution Licence (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Sponsor
National Institute for Health Research
British Lung Foundation
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32268131
PII: S0012-3692(20)30569-9
Grant Number
CS-2013-13-017
C17-3
Subjects
biomarkers
interstitial lung disease
pulmonary fibrosis
Publication Status
Published
Coverage Spatial
United States
Date Publish Online
2020-04-05