Biomarkers for Interstitial Lung Abnormalities: A Stepping-stone Toward Idiopathic Pulmonary Fibrosis Prevention?

Risk Stratifying Interstitial Lung Abnormalities to Guide Early Diagnosis of Interstitial Lung Diseases

“…Clinicians should be aware that eventually, a majority of patients with fibrotic ILDs will experience disease progression, sometimes several years after the diagnosis; therefore, long-term follow-up is warranted. Compared with those with connective tissue disease-associated ILD, patients with fibrotic hypersensitivity pneumonitis and those with non-IPF idiopathic interstitial pneumonia more frequently experienced disease progression and had a greater risk of death after satisfying PPF criteria, paralleling previous studies (13)(14)(15)(16). Thus, heterogeneity in disease course remains among ILD subtypes even after satisfying PPF criteria.…”

“…Since then, studies have assessed the prevalence of PPF among non-IPF fibrotic ILDs and confirmed the impact of disease progression on subsequent mortality (13)(14)(15)(16). Progression was generally defined using original or modified INBUILD criteria (11,17).…”

“…The question remains, though, whether people with ILAs can be discharged from follow-up if lung function is normal and there are no signs of definite fibrosis on CT. Although several studies have identified blood biomarkers and genetic polymorphisms related to the presence of ILAs, limited data exist on biomarkers predictive of ILA progression (15,16). It would be interesting to link the proposed suspected ILD classification with biomarkers and genetic data in COPDGene.…”