CHEST Guidelines-Diagnostic-and-Prognostic-Biomarkers-for-Chronic-F

Diagnostic-and-Prognostic-Biomarkers-for-Chronic-F

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The article by Yoshikazu Inoue and colleagues delves into the potential role of biomarkers in diagnosing, monitoring, and treating chronic fibrosing interstitial lung diseases (ILDs) with a progressive phenotype, such as idiopathic pulmonary fibrosis (IPF). Biomarkers are crucial as they can significantly enhance clinical evaluations and treatment outcomes. The study provides a comprehensive review of various biomarkers, including serum, bronchoalveolar lavage (BAL) fluid, and genetic markers, proposing their association with different disease mechanisms like epithelial dysfunction, fibroblast proliferation, and immune dysregulation.<br /><br />Key biomarkers discussed include Krebs von den Lungen-6 (KL-6) for epithelial cell dysfunction, and matrix metalloproteinase-1 (MMP-1) for extracellular matrix turnover. The paper highlights the promising nature of some biomarkers, albeit recognizing that none have been fully validated yet. The authors underscore the existing challenges in predicting an individual patient’s disease progression, given the broad variability among patients.<br /><br />Comparison between IPF and other fibrotic ILDs reveals shared clinical, radiological, and pathological features, providing a rationale for grouping these conditions for study purposes. The review emphasizes the potential of biomarkers in predicting disease predisposition, diagnosing, and prognosticating the disease, while offering insights into the current clinical applicability and future research directions.<br /><br />Future directions in research point towards exploiting combinations of biomarkers to refine diagnoses and enhance treatment strategies. This could lead to the optimized stratification of patients, particularly identifying those at high risk for disease progression and tailoring personalized treatment plans, thus advancing the field of personalized medicine in chronic fibrosing ILDs. Overall, the article advocates for rigorous validation and clinical trial incorporation of these biomarkers, underscoring the need for international, coordinated research efforts to realize their full clinical potential.

Keywords

biomarkers

chronic fibrosing interstitial lung diseases

idiopathic pulmonary fibrosis

Krebs von den Lungen-6

matrix metalloproteinase-1

epithelial dysfunction

fibroblast proliferation

immune dysregulation

personalized medicine

disease progression