Serial Measurements of Circulating KL-6, SP-D, MMP-7, CA19-9, CA-125, CCL18, and Periostin in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Therapy: An Exploratory Study
Idiopathic pulmonary fibrosis (IPF) is a progressive and inevitably fatal disease with a heterogeneous clinical course. This study aimed to evaluate the usefulness of circulating biomarkers in routine IPF clinical practice. We conducted an exploratory study in a cohort of 28 IPF subjects qualified f...
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MDPI AG
2021-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/17/3864 |
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| author | Sebastian Majewski Karolina Szewczyk Aleksandra Żal Adam J. Białas Joanna Miłkowska-Dymanowska Wojciech J. Piotrowski |
| author_facet | Sebastian Majewski Karolina Szewczyk Aleksandra Żal Adam J. Białas Joanna Miłkowska-Dymanowska Wojciech J. Piotrowski |
| author_sort | Sebastian Majewski |
| collection | DOAJ |
| description | Idiopathic pulmonary fibrosis (IPF) is a progressive and inevitably fatal disease with a heterogeneous clinical course. This study aimed to evaluate the usefulness of circulating biomarkers in routine IPF clinical practice. We conducted an exploratory study in a cohort of 28 IPF subjects qualified for anti-fibrotic therapy with up to 24 months serial measurements of seven IPF biomarkers, including those that are well-established, Krebs von den Lungen-6 (KL-6), surfactant protein D (SP-D), matrix metalloproteinase 7 (MMP-7), and more recently introduced ones, cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA-125), chemokine (C-C motif) ligand 18 (CCL18), and periostin. Among studied biomarkers, SP-D had the highest diagnostic accuracy to differentiate IPF subjects from controls, followed by MMP-7 and KL-6. At each study timepoint, KL-6 levels correlated inversely with forced vital capacity % predicted (FVC% pred.), and transfer factor of the lung for carbon monoxide % predicted (T<sub>L,CO</sub>% pred.), while SP-D levels correlated inversely with FVC% pred. and T<sub>L,CO</sub>% pred. at 24 months of anti-fibrotic therapy. Baseline KL-6 and CA19-9 concentrations were significantly elevated in patients with progressive disease in comparison to patients with stable disease. In addition, in the progressors subgroup CA19-9 concentrations significantly increased over the second year of study follow-up. In patients with progressive disease, we observed a significant inverse correlation between a change in SP-D levels and a change in FVC% pred. in the first year of treatment, whereas in the second year a significant inverse correlation between a change in KL-6 levels and a change in FVC% pred. was noted. Our study findings support the view that both well-established IPF biomarkers, including KL-6, SP-D, and MMP-7, and more recently introduced ones, like CA19-9, have the potential to support clinical practice in IPF. |
| first_indexed | 2024-03-10T08:09:25Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T08:09:25Z |
| publishDate | 2021-08-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-08890f2841bd457d83c5842e369f78182023-11-22T10:48:33ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-011017386410.3390/jcm10173864Serial Measurements of Circulating KL-6, SP-D, MMP-7, CA19-9, CA-125, CCL18, and Periostin in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Therapy: An Exploratory StudySebastian Majewski0Karolina Szewczyk1Aleksandra Żal2Adam J. Białas3Joanna Miłkowska-Dymanowska4Wojciech J. Piotrowski5Department of Pneumology, Medical University of Lodz, 90-153 Lodz, PolandDepartment of Pathobiology of Respiratory Diseases, Medical University of Lodz, 90-153 Lodz, PolandDepartment of General and Oncological Pulmonology, Medical University of Lodz, 90-549 Lodz, PolandDepartment of Pathobiology of Respiratory Diseases, Medical University of Lodz, 90-153 Lodz, PolandDepartment of Pneumology, Medical University of Lodz, 90-153 Lodz, PolandDepartment of Pneumology, Medical University of Lodz, 90-153 Lodz, PolandIdiopathic pulmonary fibrosis (IPF) is a progressive and inevitably fatal disease with a heterogeneous clinical course. This study aimed to evaluate the usefulness of circulating biomarkers in routine IPF clinical practice. We conducted an exploratory study in a cohort of 28 IPF subjects qualified for anti-fibrotic therapy with up to 24 months serial measurements of seven IPF biomarkers, including those that are well-established, Krebs von den Lungen-6 (KL-6), surfactant protein D (SP-D), matrix metalloproteinase 7 (MMP-7), and more recently introduced ones, cancer antigen 19-9 (CA19-9), cancer antigen 125 (CA-125), chemokine (C-C motif) ligand 18 (CCL18), and periostin. Among studied biomarkers, SP-D had the highest diagnostic accuracy to differentiate IPF subjects from controls, followed by MMP-7 and KL-6. At each study timepoint, KL-6 levels correlated inversely with forced vital capacity % predicted (FVC% pred.), and transfer factor of the lung for carbon monoxide % predicted (T<sub>L,CO</sub>% pred.), while SP-D levels correlated inversely with FVC% pred. and T<sub>L,CO</sub>% pred. at 24 months of anti-fibrotic therapy. Baseline KL-6 and CA19-9 concentrations were significantly elevated in patients with progressive disease in comparison to patients with stable disease. In addition, in the progressors subgroup CA19-9 concentrations significantly increased over the second year of study follow-up. In patients with progressive disease, we observed a significant inverse correlation between a change in SP-D levels and a change in FVC% pred. in the first year of treatment, whereas in the second year a significant inverse correlation between a change in KL-6 levels and a change in FVC% pred. was noted. Our study findings support the view that both well-established IPF biomarkers, including KL-6, SP-D, and MMP-7, and more recently introduced ones, like CA19-9, have the potential to support clinical practice in IPF.https://www.mdpi.com/2077-0383/10/17/3864idiopathic pulmonary fibrosisIPFbiomarkerKL-6SP-DMMP-7 |
| spellingShingle | Sebastian Majewski Karolina Szewczyk Aleksandra Żal Adam J. Białas Joanna Miłkowska-Dymanowska Wojciech J. Piotrowski Serial Measurements of Circulating KL-6, SP-D, MMP-7, CA19-9, CA-125, CCL18, and Periostin in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Therapy: An Exploratory Study Journal of Clinical Medicine idiopathic pulmonary fibrosis IPF biomarker KL-6 SP-D MMP-7 |
| title | Serial Measurements of Circulating KL-6, SP-D, MMP-7, CA19-9, CA-125, CCL18, and Periostin in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Therapy: An Exploratory Study |
| title_full | Serial Measurements of Circulating KL-6, SP-D, MMP-7, CA19-9, CA-125, CCL18, and Periostin in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Therapy: An Exploratory Study |
| title_fullStr | Serial Measurements of Circulating KL-6, SP-D, MMP-7, CA19-9, CA-125, CCL18, and Periostin in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Therapy: An Exploratory Study |
| title_full_unstemmed | Serial Measurements of Circulating KL-6, SP-D, MMP-7, CA19-9, CA-125, CCL18, and Periostin in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Therapy: An Exploratory Study |
| title_short | Serial Measurements of Circulating KL-6, SP-D, MMP-7, CA19-9, CA-125, CCL18, and Periostin in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Therapy: An Exploratory Study |
| title_sort | serial measurements of circulating kl 6 sp d mmp 7 ca19 9 ca 125 ccl18 and periostin in patients with idiopathic pulmonary fibrosis receiving antifibrotic therapy an exploratory study |
| topic | idiopathic pulmonary fibrosis IPF biomarker KL-6 SP-D MMP-7 |
| url | https://www.mdpi.com/2077-0383/10/17/3864 |
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