Biomarkers Predict Lung Decline in Systemic Sclerosis PDF Print E-mail
Thursday, 20 September 2012 21:39
Predicting risk of pulmonary fibrosis and pulmonary hypertension is an urgent priority in systemic sclerosis. Lung function often declines rapidly in the first years after diagnosis, and interstitial lung disease (ILD), although highly variable in severity and disease coruse, is a major cause of mortality in systemic sclerosis.

Two ILD specialists at London's Brompton Hospital identify two biomarkers in peripheral blood as possibly simpler and better alternatives to the current best standard for prognosis, a staging system based on a combination of CT imaging and forced expiratory volume measurements.

Decreased FEV and decreased diffusing capacity of the lung for carbon monoxide are sensitive for interstitial lung disease, note the authors of the review in the International Journal of Rheumatology, but may indicate pulmonary vascular disease rather than ILD. The most promising tests specific for ILD in systemic sclerosis are KL-6, a glycoprotein in alveolar and bronchiolar epithelial cells whose serum levels rise after cellular injury, and CCL-18, an immune-system regulator in lung cells that is increased in a number of fibrotic lung diseases.

Serum levels of KL-6 are significantly higher in systemic sclerosis patients who have ILD than in those who don't, according to the review. The molecule has been used routinely to predict ILD in systemic sclerosis patients in Japan, but requires validation in prospective studies. In the first large study to test a prognostic biomarker for pulmonary decline in systemic sclerosis while adjusting for severity of lung disease, increased levels of CCL-18 were independently predictive of decreasing lung function and death.

Like many proposed biomarkers, these require validation by separate studies. At least two multicenter trials are currently under way to identify markers of prognosis in idiopathic pulmonary fibrosis. No such study has yet been launched for ILD in systemic sclerosis.

Source: UBM Medica (2012), "Biomarkers Found to Predict Lung Decline in Systemic Sclerosis"; Original article can be viewed at the MusculoskeletalNetwork

 
More articles :

» 7 Tips For Maintaining Healthier Skin In Scleroderma

Scleroderma is a rare, connective tissue disease in which the body’s normal tissue is replaced with thick, dense tissue, due to the overproduction of collagen. Although can affect other parts of the body including the kidneys, hearts, and...

» Scleroderma Foundation Medical Advisory Board Offers Consensus On Gleevec

® (imatinib mesylate, Novartis) is approved in the United States for the treatment of certain forms leukemias and solid tumors. The recent discovery that Gleevec® inhibits important cellular enzymes that control fibrosis led to studies to evaluate...

» Gluten - A Health Issue or Just The Latest Fad?

So what's all the fuss about gluten? Is it a real health issue or just the latest fad?Fran Sussman, a holistic practitioner, discussed this issue in a recent online article. As she noted, Gluten is the protein found in wheat, rye, oats, spelt and...

» Survival in Pulmonary Hypertension Associated With the Scleroderma Spectrum of Diseases

Stephen C. Mathai, Laura K. Hummers, Hunter C. Champion, Fredrick M. Wigley, Ari Zaiman, Paul M. Hassoun, and Reda E. GirgisObjective. Pulmonary hypertension (PH) is an important cause of mortality in systemic sclerosis (SSc), where it can be...

» The Incidence Of Prostate Cancer Higher In Men With Autoimmune Diseases

Men with autoimmune diseases have a higher incidence of (PCa) than those without those diseases, according to study findings presented at the annual meeting.Using the National Inpatient Sample database, researchers obtained data on 189,290 men...

» Georgetown Study: Scleroderma Dramatically Under-diagnosed With Commercial Screening Method

New research from Georgetown University Medical Center (GUMC) suggests that up to 40 percent of patients will not be correctly diagnosed with the disorder using a new automated commercial screening test. The findings of the study will be presented...