Biomarkers in idiopathic pulmonary fibrosis.
Biomarkers in idiopathic pulmonary fibrosis.
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DOI：
10.1097/mcp.0b013e328356d03c
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发表时间：
2012-09
影响因子：
3.3
通讯作者：
Kaminski N
中科院分区：
文献类型：
--
作者：
Zhang Y;Kaminski N
本文综述了特发性肺纤维化（IPF）分子生物标志物的最新文献。特别关注最近的研究，这些研究确定了与IPF相关的基因和预测IPF结局的外周血生物标志物。多项研究试图确定IPF的诊断和预测生物标志物。直到最近，这些研究的规模有限，缺乏重复性，但当结合在一起时，仍然提供了令人信服的证据，即血液蛋白（KL-6，SP-A，MMP-7，CCL-18等）或细胞（纤维细胞和T细胞亚群）的变化表明疾病的存在和结果。最近，更大规模的研究已经确定了与IPF相关的基因多态性，以及准确预测IPF患者结局的蛋白质标志物和综合临床和分子预测规则。外周血包含疾病存在和结局相关信息，并提示IPF患者中不同的生物学定义的结局轨迹。虽然最近发现的生物标志物仍应在多种临床背景下进行验证，但有足够的证据表明，外周血生物标志物的收集需要纳入药物研究的设计中，并且其中一些标志物在肺移植优先级中进行临床评估。
This review examines the recent literature on molecular biomarkers of idiopathic pulmonary fibrosis (IPF). Specific attention is dedicated to the recent studies that identified the genes associated with IPF and the peripheral blood biomarkers that predict outcome in IPF. Multiple studies attempted to identify diagnostic and predictive biomarkers in IPF. Until recently, these studies were limited in size and lacked replication, but still when taken together provided convincing evidence that changes in blood proteins (KL-6, SP-A, MMP-7, CCL-18, among others) or cells (fibrocytes and T-cell subpopulations) are indicative of the disease presence and outcome. More recently, larger studies have identified gene polymorphisms associated with IPF, as well as protein markers and integrated clinical and molecular prediction rules that accurately predict outcome in patients with IPF. The peripheral blood contains disease presence and outcome relevant information, and suggests distinct biologically defined outcome trajectories in patients with IPF. Although recently identified biomarkers should still be validated in multiple clinical contexts, there is sufficient evidence to suggest that collection of peripheral blood biomarkers needs to be incorporated in the design of drug studies and that some of these markers be clinically evaluated in lung transplant prioritization.