Clinical use of biomarkers of survival in pulmonary fibrosis

Michiel Thomeer,Stijn Willems,Wim A Wuyts,Maurits G Demedts,Jan C Grutters

doi:10.1186/1465-9921-11-89

Abstract

BackgroundBiologic predictors or biomarkers of survival in pulmonary fibrosis with a worse prognosis, more specifically in idiopathic pulmonary fibrosis would help the clinician in deciding whether or not to treat since treatment carries a potential risk for adverse events. These decisions are made easier if accurate and objective measurements of the patients' clinical status can predict the risk of progression to death.MethodA literature review is given on different biomarkers of survival in interstitial lung disease, mainly in IPF, since this disease has the worst prognosis.ConclusionSerum biomarkers, and markers measured by medical imaging as HRCT, pertechnegas, DTPA en FDG-PET are not ready for clinical use to predict mortality in different forms of ILD. A baseline FVC, a change of FVC of more than 10%, and change in 6MWD are clinically helpful predictors of survival.

Highlights

Interstitial lung diseases (ILD) [1] are a heterogeneous group of lung diseases that comprise more than 200 clinical pathological entities
Improved survival and cure from different forms of ILD are dependent on a better understanding of the pathophysiology of the disease, its diagnostic accuracy in clinical practice, and an analysis of possible biomarkers which can guide the clinician in their treatment [5]
There is an urgent need for biomarkers or markers of disease activity that would help the clinician in deciding whether or not to treat since treatment carries a potential risk for adverse events

Summary

Conclusion

Interstitial lung diseases are a diverse and complex collection of parenchymal lung diseases that vary widely in aetiology, histopathology, clinical radiological presentation, and clinical course [78]. There is an urgent need for biomarkers or markers of disease activity that would help the clinician in deciding whether or not to treat since treatment carries a potential risk for adverse events. These decisions are made easier if accurate and objective measurements of the patients’ clinical status can predict the risk of progression to death. Author details 1Department of Respiratory Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium. Competing interests The authors declare that they have no competing interests

Introduction

51. O’Donnell D

Findings

54. Fleischmann R