Sherozia Elene, Page Clive, Kakhniashvili Tamuna, Tabagari Nino, Gotua Maia
Internal Medicine, David Tvildiani Medical University, Tbilisi, GEO.
Internal Medicine, The Center for Diabetes, Endocrine and Cardio-Pulmonary Diseases Diacor, Tbilisi, GEO.
Cureus. 2025 Jul 24;17(7):e88645. doi: 10.7759/cureus.88645. eCollection 2025 Jul.
Background The clinical course of patients with idiopathic pulmonary fibrosis (IPF) and other progressive interstitial lung diseases (F-ILDs) varies from mild to severe worsening, which makes the development of new diagnostic and prognostic methods even more urgent. A number of studies have shown that plasma connective tissue growth factor (CTGF) is elevated during IPF, and that the levels of this substance are correlated with the changes in forced vital capacity (FVC). The aim of our study was to investigate CTGF levels in patients with F-ILDs group, including its subgroups IPF and other F-ILDs, as well as post-COVID-19 cases, and to assess their association with lung function changes over a 12-month period. Methods A prospective cohort study was conducted with patients observed over 30 months. The involvement period was 18 months, followed by a 12-month observation period. A total of 86 subjects were enrolled in the study. FVC (measured by spirometry), diffusing lung capacity for carbon monoxide (DLCO), and CTGF levels in blood serum (measured by enzyme-linked immunosorbent assay (ELISA)) were assessed at the beginning and end of the study. Results Regression analysis of the correlations between mean serum CTGF levels, FVC, and DLCO changes in the F-ILDs group demonstrated a significant negative correlation between the changes in mean serum CTGF levels, FVC, and DLCO. Similarly, in the IPF, idiopathic nonspecific interstitial pneumonia (iNSIP) and chronic sarcoidosis (IV stage) subgroups, there was a significant negative correlation between changes in mean serum CTGF levels, FVC, and DLCO. However, in the post-COVID-19 group, regression analysis did not reveal any correlations between changes in mean serum CTGF concentrations, FVC, and DLCO. Conclusion Our data suggest a correlation between decreased pulmonary function and increased CTGF levels in patients with IPF and other PPF conditions. Therefore, CTGF emerges as a potential surrogate marker for fibrosis progression in these patients. In contrast, post-COVID-19 fibrosis appears to be a non-progressive fibrotic disease; however, further monitoring is necessary.
特发性肺纤维化（IPF）和其他进行性间质性肺疾病（F-ILDs）患者的临床病程从轻度到严重恶化不等，这使得开发新的诊断和预后方法变得更加紧迫。多项研究表明，IPF期间血浆结缔组织生长因子（CTGF）升高，且该物质水平与用力肺活量（FVC）的变化相关。我们研究的目的是调查F-ILDs组患者（包括其亚组IPF和其他F-ILDs）以及新冠病毒感染后病例的CTGF水平，并评估其与12个月期间肺功能变化的关联。方法：对患者进行了为期30个月的前瞻性队列研究。受累期为18个月，随后是12个月的观察期。共有86名受试者纳入研究。在研究开始和结束时评估FVC（通过肺量计测量）、一氧化碳弥散量（DLCO）以及血清中CTGF水平（通过酶联免疫吸附测定（ELISA）测量）。结果：F-ILDs组中血清CTGF平均水平、FVC和DLCO变化之间的相关性回归分析显示，血清CTGF平均水平变化、FVC和DLCO之间存在显著负相关。同样，在IPF、特发性非特异性间质性肺炎（iNSIP）和慢性结节病（IV期）亚组中，血清CTGF平均水平变化、FVC和DLCO之间存在显著负相关。然而，在新冠病毒感染后组中，回归分析未发现血清CTGF平均浓度变化、FVC和DLCO之间存在任何相关性。结论：我们的数据表明，IPF和其他PPF疾病患者肺功能下降与CTGF水平升高之间存在相关性。因此，CTGF成为这些患者纤维化进展的潜在替代标志物。相比之下，新冠病毒感染后纤维化似乎是一种非进行性纤维化疾病；然而，需要进一步监测。
