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Potential biomarkers for diagnosis and disease evaluation of idiopathic pulmonary fibrosis

Chinese Medical Journal 2023年第11期136卷 1278-1290页

作者： Qing Wang Zhaoliang Xie Nansheng Wan Lei Yang Zhixian Jin Fang Jin Zhaoming Huang Min Chen Huiming Wang Jing Feng Department of Respiratory and Critical Care Medicine Tianjin Medical University General HospitalTianjin 300052China Department of Respiratory and Critical Care Medicine of Kunming Municipal First People’s Hospital KunmingYunnan 650000China Respiratory Department of Sanming Yong’an General Hospital SanmingFujian 366000China

Idiopathic pulmonary fibrosis(IPF)is a chronic progressive lung disease characterized by progressive lung fibrogenesis and histological features of usual interstitial pneumonia.IPF has a poor prognosis and presents a spectrum of disease courses ranging from slow evolving disease to rapid deterioration;thus,a differential diagnosis remains challenging.Several biomarkers have been identified to achieve a differential diagnosis;however,comprehensive reviews are lacking.This review summarizes over 100 biomarkers which can be divided into six categories according to their functions:differentially expressed biomarkers in the IPF compared to healthy controls;biomarkers distinguishing IPF from other types of interstitial lung disease;biomarkers differentiating acute exacerbation of IPF from stable disease;biomarkers predicting disease progression;biomarkers related to disease severity;and biomarkers related to treatment.Specimen used for the diagnosis of IPF included serum,bronchoalveolar lavage fluid,lung tissue,and sputum.IPF-specific biomarkers are of great clinical value for the differential diagnosis of IPF.Currently,the physiological measurements used to evaluate the occurrence of acute exacerbation,disease progression,and disease severity have limitations.Combining physiological measurements with biomarkers may increase the accuracy and sensitivity of diagnosis and disease evaluation of IPF.Most biomarkers described in this review are not routinely used in clinical practice.Future large-scale multicenter studies are required to design and validate suitable biomarker panels that have diagnostic utility for IPF.

关键词： alveolar epithelial cell dysfunction Biomarker Diagnosis Fibrogenesis Extracellular matrix remodeling Idiopathic pulmonary fibrosis Immune dysfunction

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