Serum level of periostin can predict long-term outcome of idiopathic pulmonary fibrosis.
BACKGROUND
KL-6 and surfactant proteins A and D are the only established serum biomarkers of idiopathic pulmonary fibrosis (IPF). We have previously shown that serum levels of periostin, a unique matricellular protein, are elevated and correlated with pulmonary function in patients with IPF. We sought to determine whether the serum periostin levels correlate with overall survival (OS) and time-to-event (TTE), as a parameter reflecting long-term outcome, and with the extent of abnormality on chest high-resolution computed tomography (HRCT) scores in patients with IPF.


METHODS
Twenty-nine patients with IPF were analyzed retrospectively. The mean observation period was 1035.2 ± 663.1 days (range, 112-1800 days). High-resolution computed tomography (HRCT) scores were calculated based on the extent of abnormality evidenced by HRCT. We evaluated if there were any correlations between the serum periostin levels and clinical parameters, including HRCT score, using Spearman's rank correlation coefficients and analyzed predictors of OS and TTE using the log-rank tests.


RESULTS
We showed that the serum periostin levels significantly correlated with the increase of honeycombing score on HRCT during a 6-month period. Log-rank tests showed that a higher serum periostin level was a predictor of a shortened OS and TTE. Greater extents of fibrotic lesions on HRCT scan were predictors of shortened OS and TTE.


CONCLUSIONS
In IPF patients, the serum periostin level may be a good predictive biomarker for an increase in the radiological fibrotic area and long-term outcome.
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. Electronic address: motajiri@med.kurume-u.ac.jp.
Morihiro
M
Tajiri
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. Electronic address: okamoto_masaki@med.kurume-u.ac.jp.
Masaki
M
Okamoto
Department of Radiology and Center for Diagnostic Imaging, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. Electronic address: kimichan@med.kurume-u.ac.jp.
Kiminori
K
Fujimoto
Department of Radiology, Kinki Central Hospital of Mutual Aid Association of Public Teachers, 3-1 Kurumazuka, Itami, Hyougo 664-8533, Japan. Electronic address: johkoht@aol.com.
Takeshi
T
Johkoh
Shino-Test Corporation, 1-56 Kanda Jinbocho, Chiyoda-ku, Tokyo 101-8410, Japan. Electronic address: junya.ono@shino-test.co.jp.
Junya
J
Ono
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. Electronic address: tominaga_masaki@med.kurume-u.ac.jp.
Masaki
M
Tominaga
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. Electronic address: azuma@med.kurume-u.ac.jp.
Koichi
K
Azuma
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. Electronic address: kawayama_tomotaka@med.kurume-u.ac.jp.
Tomotaka
T
Kawayama
Department of Laboratory Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga 849-8501, Japan. Electronic address: ohtasho@cc.saga-u.ac.jp.
Shoichiro
S
Ohta
Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, 5-1-1 Nabeshima, Saga 849-8501, Japan. Electronic address: kizuhara@cc.saga-u.ac.jp.
Kenji
K
Izuhara
Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka 830-0011, Japan. Electronic address: hoshino@med.kurume-u.ac.jp.
Tomoaki
T
Hoshino
D000368:Aged; D015415:Biomarkers / Q000097:blood; D015815:Cell Adhesion Molecules / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; D015815:Cell Adhesion Molecules; C512835:POSTN protein, human
Biomarker; High-resolution computed tomography; Idiopathic pulmonary fibrosis; Periostin