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 :

» Studies Show That Natural Probiotic Supplements Can Help Reduce and Treat Autoimmune Disease Symptoms

Most consumers are familiar with the dangers of disease-causing bacteria; but over the last several decades, medical professionals and lay consumers alike have discovered a host of proven and potential benefits to be had from the consumption of...

» Imaging Lung Disease in Systemic Sclerosis

Diane Strollo & Jonathan GoldinPublished online: 16 March 2010Copyright, The Author(s) 2010. This article is published with open access at Springerlink.comAbstract Interstitial lung disease and pulmonary hypertension (PH) are the most common...

» Is The Gluten Free Diet A Fad?

Not long ago, the phrase “ free” was one relegated to health food stores and medical clinics, the sole concern of an unlucky few diagnosed with a gluten-intolerant condition known as and forced to scavenge the grocery isles for the few...

» Greater Global Cooperation and Collaboration in Scleroderma Research Required

Greater global cooperation and collaboration among Scleroderma researchers and clinicians would be all that is required to fuel a drive toward important discoveries and optimize outcomes for patients with this chronic, progressive, and often...

» Lower Extremity Ulcers in Systemic Sclerosis: Features and Response to Therapy

Victoria K. Shanmugam, MBBS, MRCP; Patricia Price, PhD; Christopher E. Attinger, MD; Virginia D. Steen, MD Non-digital lower extremity ulcers are a difficult to treat complication of scleroderma that is often refractory to therapy. They are a...

» Researchers Find Small Group Of ANA & RP Negative Patients

There exists a very small subgroup of patients with (SSc) who lack circulating (ANA) and who do not have Raynaud's phenomenon (RP), research shows. These patients also fail to meet any of the diagnostic criteria for known SSc mimics.The...