Surfactant protein A as a biomarker of outcomes of anti-fibrotic drug therapy in patients with idiopathic pulmonary fibrosis

• Published in: BMC pulmonary medicine 2020-01, Vol.20 (1), p.27-27, Article 27
• Main Authors: Yoshikawa, Takumi, Otsuka, Mitsuo, Chiba, Hirofumi, Ikeda, Kimiyuki, Mori, Yuki, Umeda, Yasuaki, Nishikiori, Hirotaka, Kuronuma, Koji, Takahashi, Hiroki
• Format: Article
• Language: English
• Subjects: Aged; Biomarkers; Biomarkers - blood; Cancer therapies; Carbon monoxide; Diagnosis; Disease Progression; Drug dosages; Drug therapy; Female; Fibroblasts; Fibrosis; Growth factors; Health aspects; Humans; Idiopathic pulmonary fibrosis (IPF); Idiopathic Pulmonary Fibrosis - blood; Idiopathic Pulmonary Fibrosis - drug therapy; Indoles - therapeutic use; Krebs von den Lungen-6 (KL-6); Logistic Models; Lung cancer; Lung diseases; Male; Medical prognosis; Middle Aged; Mucin-1 - blood; Nintedanib; Patient outcomes; Patients; Pirfenidone; Pulmonary fibrosis; Pulmonary Surfactant-Associated Protein A - blood; Pulmonary Surfactant-Associated Protein D - blood; Pulmonology; Pyridones - therapeutic use; Retrospective Studies; Statistical analysis; Surfactant protein A; Surfactant protein-A (SP-A); Surfactant protein-D (SP-D); Surfactants; Treatment Outcome; Vital Capacity
• ISSN: 1471-2466; 1471-2466
• DOI: 10.1186/s12890-020-1060-y

Idiopathic pulmonary fibrosis (IPF) is a progressive and fibrosing lung disease with poor prognosis. Pirfenidone and nintedanib are anti-fibrotic drugs used for patients with IPF. These drugs reduce the rate of decline in forced vital capacity (FVC). Serum surfactant protein (SP)-A, SP-D, and Krebs von den Lungen-6 (KL-6) are monitoring and prognostic biomarkers in patients with IPF; however, their relationship with the therapeutic outcomes of anti-fibrotic drugs has not been investigated. We aim to clarify whether serum SP-A, SP-D, and KL-6 reflect therapeutic outcomes of pirfenidone and nintedanib administration in patients with IPF. We retrospectively investigated patients with IPF who were initiated on pirfenidone or nintedanib administration between January 2014 and June 2018 at our hospital. Changes in clinical parameters and serum SP-A, SP-D, and KL-6 levels were evaluated. Patients with ≥10% decline in FVC or ≥ 15% decline in diffusing capacity of the lung for carbon monoxide (DLco) from baseline to 6 months were classified as progression group, while the other patients were classified as stable group. Forty-nine patients were included (pirfenidone, 23; nintedanib, 26). Stable group comprised 32 patients, while progression group comprised 17 patients. In the stable group, changes in SP-A and KL-6 from baseline to 3 and 6 months significantly decreased compared with the progression group (SP-A: 3 months - 6.0% vs 16.7%, 6 months - 10.2% vs 20.2%, KL-6: 3 months - 9.2% vs 6.7%, 6 months - 15.0% vs 12.1%, p