Article Abstract

Serum decorin is a potential prognostic biomarker in patients with acute exacerbation of idiopathic pulmonary fibrosis

Authors: Takefumi Nikaido, Yoshinori Tanino, Xintao Wang, Yuki Sato, Ryuichi Togawa, Masami Kikuchi, Kenichi Misa, Kazue Saito, Naoko Fukuhara, Takaya Kawamata, Mami Rikimaru, Takashi Umeda, Julia Morimoto, Tatsuhiko Koizumi, Yasuhito Suzuki, Kenichiro Hirai, Manabu Uematsu, Hiroyuki Minemura, Atsuro Fukuhara, Suguru Sato, Junpei Saito, Hiroshi Yokouchi, Kenya Kanazawa, Yoko Shibata

Abstract

Background: Decorin is a small leucine-rich repeat proteoglycan that plays a critical role in collagen fibrillogenesis, and regulates inflammation, wound healing and angiogenesis. In idiopathic pulmonary fibrosis (IPF), decorin is expressed in fibrotic lesions; furthermore, intratracheal gene transfer of decorin has been demonstrated to inhibit bleomycin-induced pulmonary fibrosis. Although these results suggest the critical role of decorin in pulmonary fibrosis, the role of decorin in the acute exacerbation of idiopathic interstitial pneumonia (AE-IIP) has not been clarified in detail. Thus, the goal of this study was to determine the role of decorin in AE-IIP.
Methods: We retrospectively analyzed AE-IIP patients who had been admitted to our hospital. First, serum decorin levels were compared among patients with AE-IIP, patients with stable idiopathic interstitial pneumonia (SD-IIP), and healthy subjects. Next, the relationship between serum decorin levels and clinical parameters was analyzed in AE-IIP patients. Finally, the association between serum decorin levels and prognosis was evaluated in AE-IIP patients. IIP was divided into IPF and non-IPF, according to the published guidelines.
Results: The serum decorin levels of AE-IIP patients were significantly lower than those of both healthy subjects and SD-IIP patients. Serum decorin levels were not related with the clinical parameters and prognosis, when all IIP patients were analyzed. In IPF patients, serum decorin levels had a significant correlation with oxygenation, and IPF patients with low serum decorin levels had a significantly higher survival rate than those with high serum decorin levels.
Conclusions: Serum decorin levels are a potential prognostic biomarker in AE-IPF.