Turnover of type I and III collagen predicts progression of idiopathic pulmonary fibrosis

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  • H. Jessen
  • N. Hoyer
  • T. S. Prior
  • P. Frederiksen
  • M. A. Karsdal
  • D. J. Leeming
  • E. Bendstrup
  • J. M.B. Sand
  • Shaker, Saher Burhan

Background: Idiopathic pulmonary fibrosis (IPF) is characterized by the accumulation of fibrillar collagens in the alveolar space resulting in reduced pulmonary function and a high mortality rate. Biomarkers measuring the turnover of type I and III collagen could provide valuable information for prognosis and treatment decisions in IPF. Methods: Serological biomarkers reflecting the formation of type III collagen (PRO-C3) and degradation of type I (C1M) and III collagen (C3M) were evaluated in a real-world cohort of 178 newly diagnosed IPF patients. Blood samples and clinical data were collected at baseline, six, and 12 months. Baseline and longitudinal biomarker levels were related to disease progression of IPF (defined as ≥ 5% decline in forced vital capacity (FVC) and/or ≥ 10% decline in diffusing capacity for carbon monoxide (DLco) and/or all-cause mortality at 12 months). Furthermore, we analysed differences in percentage change of biomarker levels from baseline between patients receiving antifibrotic treatment or not. Results: Increased baseline levels of type I and III collagen turnover biomarkers were associated with a greater risk of disease progression within 12 months compared to patients with a low baseline type I and III collagen turnover. Patients with progressive disease had higher serum levels of C1M (P = 0.038) and PRO-C3 (P = 0.0022) compared to those with stable disease over one year. There were no differences in biomarker levels between patients receiving pirfenidone, nintedanib, or no antifibrotics. Conclusion: Baseline levels of type I and III collagen turnover were associated with disease progression within 12 months in a real-world cohort of IPF patients. Longitudinal biomarker levels of type I and III collagen turnover were related to progressive disease. Moreover, antifibrotic therapy did not affect type I and III collagen turnover biomarkers in these patients. PRO-C3 and C1M may be potential biomarkers for a progressive disease behavior in IPF.

OriginalsprogEngelsk
Artikelnummer205
TidsskriftRespiratory research
Vol/bind22
Udgave nummer1
Sider (fra-til)1.8
ISSN1465-9921
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
The clinical study performed at Gentofte and Aarhus Hospital was sponsored by Roche A/S, Boehringer Ingelheim and Trygfonden. The biomarker analyses were partly funded by the Danish Agency for Science, Technology and Innovation; and the Danish Research Foundation. None of the funding sources had any involvement in the study design, in the collection, analyses and interpretation of data, in the writing of the article or in the decision to submit the article for publication.

Publisher Copyright:
© 2021, The Author(s).

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