Insights in Diagnostic and Prognostic Biomarkers in Interstitial Lung Disease

Abstract

Interstitial lung diseases (ILDs) are a diverse group of rare lung diseases, characterized by inflammation and/or scarring (fibrosis) of the lungs. The current principles of diagnosis and treatment focusses on the recognition of clinical characteristics of ILD and its underlying aetiology. An accurate ILD classification is crucial, as decision making in treatment and predicting course of disease depends on the underlying ILD subtype. It remains challengeable though, to distinguish one subtype from another, as patients may present with similar clinical characteristics. Biological markers (biomarkers) are objective indicators for physiological, pathological or pharmacological processes. In this thesis titled ‘Insights in diagnostic and prognostic biomarkers in interstitial lung disease’, the potential of blood lung biomarkers was evaluated for diagnosis, treatment response and prognosis in patients with various fibrosing ILDs. The results demonstrate novel insights on the roles and applications of non-invasive, easily accessible and generalizable diagnostic and predictive blood biomarkers for fibrotic ILD, including serum cancer antigen 15-3 (CA 15-3), CC-chemokine ligand 18 (CCL18) gene and autoantibody Mi-2β. The use of biomarkers, which may precede pathological responses only later detected by clinical parameters, is attractive and promising for personalized ILD care. Potentially, these biomarkers could be used to improve ILD phenotyping. Thereby, decision-making in diagnosis, treatment and prognosis will improve the determination of the best possible treatment and contribute to disease monitoring and early recognition of progressive disease of each patient with pulmonary fibrosis. Possibly, invasive diagnostic interventions could possibly be avoided in ILD management for the individual patient.