Serum decorin is a potential prognostic biomarker in patients with acute exacerbation of idiopathic pulmonary fibrosis

• Published in: Journal of thoracic disease 2018-09, Vol.10 (9), p.5346-5358
• Main Authors: Nikaido, Takefumi, Tanino, Yoshinori, Wang, Xintao, Sato, Yuki, Togawa, Ryuichi, Kikuchi, Masami, Misa, Kenichi, Saito, Kazue, Fukuhara, Naoko, Kawamata, Takaya, Rikimaru, Mami, Umeda, Takashi, Morimoto, Julia, Koizumi, Tatsuhiko, Suzuki, Yasuhito, Hirai, Kenichiro, Uematsu, Manabu, Minemura, Hiroyuki, Fukuhara, Atsuro, Sato, Suguru, Saito, Junpei, Yokouchi, Hiroshi, Kanazawa, Kenya, Shibata, Yoko
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2072-1439; 2072-1439; 2077-6624
• DOI: 10.21037/jtd.2018.08.60

Decorin is a small leucine-rich repeat proteoglycan that plays a critical role in collagen fibrillogenesis, and regulates inflammation, wound healing and angiogenesis. In idiopathic pulmonary fibrosis (IPF), decorin is expressed in fibrotic lesions; furthermore, intratracheal gene transfer of decorin has been demonstrated to inhibit bleomycin-induced pulmonary fibrosis. Although these results suggest the critical role of decorin in pulmonary fibrosis, the role of decorin in the acute exacerbation of idiopathic interstitial pneumonia (AE-IIP) has not been clarified in detail. Thus, the goal of this study was to determine the role of decorin in AE-IIP. We retrospectively analyzed AE-IIP patients who had been admitted to our hospital. First, serum decorin levels were compared among patients with AE-IIP, patients with stable idiopathic interstitial pneumonia (SD-IIP), and healthy subjects. Next, the relationship between serum decorin levels and clinical parameters was analyzed in AE-IIP patients. Finally, the association between serum decorin levels and prognosis was evaluated in AE-IIP patients. IIP was divided into IPF and non-IPF, according to the published guidelines. The serum decorin levels of AE-IIP patients were significantly lower than those of both healthy subjects and SD-IIP patients. Serum decorin levels were not related with the clinical parameters and prognosis, when all IIP patients were analyzed. In IPF patients, serum decorin levels had a significant correlation with oxygenation, and IPF patients with low serum decorin levels had a significantly higher survival rate than those with high serum decorin levels. Serum decorin levels are a potential prognostic biomarker in AE-IPF.