Domvri Kalliopi, Organtzis Ioannis, Apostolopoulos Apostolos, Fouka Evangelia, Kontakiotis Theodoros, Papakosta Despoina
Lung Immunology and Bronchoalveolar Lavage Unit, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece.
Out-Patient Clinic for ILDs, Pulmonary Department, Medical School, Aristotle University of Thessaloniki, George Papanikolaou Hospital, 57010 Thessaloniki, Greece.
J Pers Med. 2023 Aug 26;13(9):1307. doi: 10.3390/jpm13091307.
The aim of this present study was to determine serum biomarker levels and their correlation with respiratory function and the clinical course of patients with idiopathic pulmonary fibrosis (IPF).
This study included 72 IPF patients, according to the ATS/ERS criteria, in whom antifibrotic treatment was initiated. Blood samples were taken, and serum biomarkers, such as KL-6, SP-D, CCL18, CXCL13, VEGF-A, IL-8, IGFBP-1, IGFBP-2, IGFBP-7 and ICAM-1 were measured using ELISA methodology. Pulmonary function tests (FVC, TLC, DLCO-% pred) were determined at baseline and after 12 and 24 months and analyzed in correlation with the biomarkers.
The majority of patients (mean age 72 ± 6 years) were men (83%). The FVC and DLCO values at the 12-month follow-up were found to be statistically decreased in deceased patients ( < 0.05). The SP-D ( < 0.001) and the IGFBP-1 ( = 0.021) levels were found to be increased at the 1-year follow-up in deceased patients, and similarly, the SP-D ( = 0.005) and ICAM-1 ( = 0.043) levels at the 2-year follow-up. A chi-square test revealed that 70% of the category IV GAP index was found with cut-off elevated levels of a biomarker combination (KL-6, SP-D, VEGF-A) from the ROC curve analysis ( < 0.05).
This study provides evidence, for the first time in a Greek population, of the possibility of using a combination of KL-6, SP-D, and VEGF-A serum levels along with the GAP index.
本研究的目的是确定特发性肺纤维化（IPF）患者的血清生物标志物水平及其与呼吸功能和临床病程的相关性。
本研究纳入了72例符合美国胸科学会/欧洲呼吸学会（ATS/ERS）标准且开始抗纤维化治疗的IPF患者。采集血样，采用酶联免疫吸附测定（ELISA）方法检测血清生物标志物，如KL-6、表面活性蛋白D（SP-D）、趋化因子配体18（CCL18）、趋化因子配体13（CXCL13）、血管内皮生长因子A（VEGF-A）、白细胞介素8（IL-8）、胰岛素样生长因子结合蛋白1（IGFBP-1）、胰岛素样生长因子结合蛋白2（IGFBP-2）、胰岛素样生长因子结合蛋白7（IGFBP-7）和细胞间黏附分子1（ICAM-1）。在基线以及12个月和24个月后进行肺功能测试（用力肺活量（FVC）、肺总量（TLC）、一氧化碳弥散量占预计值百分比（DLCO-%pred）），并分析其与生物标志物的相关性。
大多数患者（平均年龄72±6岁）为男性（83%）。在12个月随访时，死亡患者的FVC和DLCO值在统计学上有所下降（P<0.05）。在1年随访时，死亡患者的SP-D水平（P<0.001）和IGFBP-1水平（P = 0.021）升高，同样，在2年随访时，SP-D水平（P = 0.005）和ICAM-1水平（P = 0.043）升高。卡方检验显示，根据受试者工作特征曲线（ROC）分析，70%的IV类综合评估预后（GAP）指数与生物标志物组合（KL-6、SP-D、VEGF-A）的临界值升高水平相关（P<0.05）。
本研究首次在希腊人群中提供了证据，证明可以联合使用KL-6、SP-D和VEGF-A的血清水平以及GAP指数。
