Can biomarkers predict survival in idiopathic pulmonary fibrosis?

INTRODUCTION:The aim of this study is to investigate the relationship between KL-6,MMP-7,SP-A,SP-D,VEGF,Periostin and pro-BNP levels and prognosis of IPF and to evaluate these markers according to the gender-age-physiology(GAP) index.

MATERIAL METHOD:Forty-seven patients diagnosed with IPF were included in the study.KL-6,MMP-7,SP-A,SP-D,VEGF and periostin levels were studied in serum samples taken at diagnosis.Patients who died during the follow-up period were recorded.Then,the biomarker levels of these patients at the time of diagnosis were statistically evaluated and interpreted.

RESULTS:The mean age of patients was 68±7 years,39(83%) were male.Twelve of these patients died during study period.When the SP-A,SP-D,KL-6,periostin,VEGF,MMP-7 and pro-BNP levels at the time of diagnosis were evaluated in terms of determining the survival effect of biomarkers,no significant difference was found between the patients who survived and died during the follow-up.When the effect of each single marker on survival is investigated in univariate Cox models in patients with IPF,it is seen that they were not a significant risk factor.In the retrospective stepwise Cox regression model established using biomarkers in patients with IPF,SP-D and KL-6 were determined as biomarkers associated with survival.According to the results of this analysis,a relationship was found between increased SP-D levels and good prognosis. According to the results of this analysis, a relationship was found between increased KL-6 levels and poor prognosis. 

CONCLUSION:Our findings show that SP-D and KL-6 biomarkers may contribute significantly to the determination of survival in patients with IPF.