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High turnover of types III and VI collagen in progressive idiopathic pulmonary fibrosis
Author(s) -
Hoyer Nils,
Jessen Henrik,
Prior Thomas S.,
Sand Jannie M. B.,
Leeming Diana J.,
Karsdal Morten A.,
Åttingsberg Emilia K. A.,
Vangsgaard Gustav K. M.,
Bendstrup Elisabeth,
Shaker Saher B.
Publication year - 2021
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.14056
Subject(s) - medicine , hazard ratio , idiopathic pulmonary fibrosis , fibrosis , gastroenterology , biomarker , disease , extracellular matrix , pulmonary function testing , lung , confidence interval , biochemistry , chemistry , biology , microbiology and biotechnology
Background and objective Prediction of idiopathic pulmonary fibrosis (IPF) progression is vital for the choice and timing of treatment and patient follow‐up. This could potentially be achieved by prognostic blood biomarkers of extracellular matrix (ECM) remodelling. Methods Neoepitope biomarkers of types III and VI collagen turnover (C3M, C6M, PRO‐C3 and PRO‐C6) were measured in 185 patients with newly diagnosed IPF. Disease severity at baseline and progression over 6 months was assessed by lung function tests and 6‐min walk tests. All‐cause mortality was assessed over a 3‐year follow‐up period. Results High baseline levels of C3M, C6M, PRO‐C3 and PRO‐C6 were associated with more advanced disease at the time of diagnosis. Baseline levels of C6M and PRO‐C3 were also associated with mortality over 3 years of follow‐up (hazard ratio [HR]: 2.3, 95% CI: 1.3–3.9, p = 0.002 and HR: 1.8, 95% CI: 1.1–3.0, p = 0.03). Patients with several increased biomarkers at baseline, representing a high ECM remodelling phenotype, had more advanced disease at baseline, higher risk of progression or death at 6 months (OR: 1.4, 95% CI: 1.1–1.8, p = 0.002) and higher mortality over 3 years of follow‐up (HR: 2.4, 95% CI: 1.3–4.5, p = 0.007). Conclusion Blood biomarkers of types III and VI collagen turnover, assessed at the time of diagnosis, are associated with several indices of disease severity, short‐term progression and long‐term mortality. These biomarkers can help to identify patients with a high ECM remodelling phenotype at high risk of disease progression and death.