Research

Biomarkers predict early ILD in systemic sclerosis


A/Prof Tamera Corte

Researchers have identified a composite serum biomarker index to help with the early diagnosis of ILD in patients with systemic sclerosis.

Associate Professor Tamera Corte told the Australasian Rare Lung Disease Conference 2021 that early diagnosis was essential given that interventions such as immunosuppression and antifibrotic therapies were available.

She said an ideal biomarker would be non-invasive and also have some prognostic value.

Professor Corte, from the Royal Prince Alfred Hospital, told the virtual conference that they predicted a composite of serum biomarkers would better represent the heterogeneity of SSc-ILD.

The nationwide study comprised 604 participants with either Ssc-ILD, SSc without ILD, IPF controls and healthy controls.

From 28 initial biomarkers, the investigators found surfactant protein D (SP-D), cancer antigen 15-3 (Ca 15-3) and intercellular adhesion molecule (ICAM-1) were strongly associated with fibrotic lung disease and incorporated into the 0-3 scored biomarker index

“Patients with IPF were more likely to have a higher index than patients with SSc-ILD, who were more likely to have a higher index than patients with SSc but without ILD, who were more likely to have a higher index than healthy controls,” she said.

The study found a biomarker index of 2 or 3 were both associated with fibrotic lung disease (aOR 3.59 and 15.61 respectively).

When limited to SSc patients, the analysis found the index of 2 or 3 discriminated SSc-ILD patients from SSc controls (aOR 3.24 and 12.72).

In terms of the prognostic utility of the biomarker index, Associate Professor Corte said a biomarker index of ≥2 in all patients and an index of 3 in SSc patients was associated with worse transplant-free survival.

She said the simple composite biomarker index robustly identified SSc-ILD independently of clinical variables.

“Taken together, our data supported this composite biomarker index as an objective, minimally-invasive tool that may enhance diagnostic precision and risk-stratification in SSc-ILD patients to complement standard clinical assessment,” she concluded.

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