生物标志物在特发性肺纤维化中的临床价值

Clinical value of biomarkers in diagnosis and treatment of idiopathic pulmonary fibrosis

特发性肺纤维化(IPF)以成纤维细胞灶进行性积聚和肺泡结构破坏为特点的慢性间质性肺炎。由于发病和进展机制未完全阐明,目前缺乏有效的早期筛查和治愈方法,患者总体预后差,中位生存期仅2~4年。近年,多篇研究证实数十种参与IPF发展过程的分子可作为潜在生物标志物。这些生物标志物可以在IPF的早期诊断(如SP-D、MMP-7、骨桥蛋白)、判断预后(如端粒酶长度、KL-6、mtDNA、HSP-70、LOXL2、CXCL13、miRNA、ICAM-1、CCL18)、指导治疗(如TOLLIP rs3750920基因型、SAMS评分、SP-D)、提供新的治疗靶点(如TERT、TERC、RTEC、PARN)等方面发挥重要作用。

Idiopathic pulmonary fibrosis(IPF)is a chronic interstitial pneumonia characterized by progressive accumulation of fibroblastic foci and destruction of the alveolar structure.Due to an incomplete understanding of the mechanism of the occurrence and progression of IPF,currently no effective means have been available for its early screening or treatment.With a poor overall prognosis,the patients with IPF have a median survival of only 2-4 years.In recent years,several studies have confirmed that dozens of molecules are involved in the development of IPF and can be used as potential biomarkers.These biomarkers play important roles in early diagnosis(such as SP-D,MMP-7,and osteopontin),prognostic evaluation(such as telomerase length,KL-6,mtDNA,HSP-70,LOXL2,CXCL13,miRNA,ICAM-1,and CCL18),and guiding treatment of IPF(such as TOLLIP rs3750920 genotype,SAMS score,and SP-D),and also provide potential therapeutic targets(such as TERT,TERR,RTEC,and PARN).