A panel of blood proteins can predict which patients with the progressive lung disease idiopathic pulmonary fibrosis (IPF) are likely to live at least five years or to die within two years, say researchers at the University of Pittsburgh School of Medicine and Centocor R&D, Radnor, Pa. The findings, published last week in the American Journal of Respiratory and Critical Care Medicine, could help doctors determine those patients in imminent need of a lung transplant and those who can wait a while longer.
Fifty percent of IPF patients die within three years of diagnosis, but others will do well for long periods of time, explained investigator Naftali Kaminski, M.D., professor of medicine, pathology, human genetics and computational biology, Pitt School of Medicine. In the disease, breathing becomes increasingly impaired as the lungs progressively scar.
“It’s hard to tell based on symptoms alone which patients are in the greatest danger,” Dr. Kaminski said. “This biomarker panel has predictive power that can guide our treatment plan. It may also help us design more effective research trials because we’ll be able to better match experimental therapies with the most appropriate patients.”
The research team collected blood samples from 241 IPF patients. They measured the levels of 92 candidate proteins in 140 patients and found that higher concentrations of five particular proteins that are produced by the breakdown of lung tissue predicted poor survival, transplant-free survival and progression-free survival regardless of age, sex and baseline pulmonary function. They then confirmed the results in a second group of 101 patients.
Based on both groups, the investigators developed the personal clinical and molecular mortality prediction index (PCMI) that incorporates the gender, lung functions and levels of one of the proteins, called MMP7, in the blood. Patients with a low PCMI were more likely to live more than 5 years while the median survival for patients with high PCMI scores was 1.5 years.
The project was funded by the National Institutes of Health, Centocor, and the Dorothy P. and Richard P. Simmons Endowed Chair for Pulmonary Research.
Source: University of Pittsburgh
