IL-18 binding protein can be a prognostic biomarker for idiopathic pulmonary fibrosis

PLoS One. 2021 Jun 4;16(6):e0252594. doi: 10.1371/journal.pone.0252594. eCollection 2021.

Abstract

Idiopathic pulmonary fibrosis is a chronic, fibrosing interstitial pneumonia that presents with various clinical courses and progression ranging from rapid to slow. To identify novel biomarkers that can support the diagnosis and/or prognostic prediction of idiopathic pulmonary fibrosis, we performed gene expression analysis, and the mRNA of interleukin-18 binding protein was increasingly expressed in patients with idiopathic pulmonary fibrosis compared with healthy controls. Therefore, we hypothesized that the interleukin-18 binding protein can serve as a diagnostic and/or prognostic biomarker for idiopathic pulmonary fibrosis. We investigated the expression of interleukin-18 binding protein in lung tissue, bronchoalveolar lavage fluid, and serum. Additionally, the correlation between interleukin-18 binding protein expression levels and the extent of fibrosis was investigated using mouse models of lung fibrosis induced by subcutaneous bleomycin injections. Serum interleukin-18 binding protein levels were significantly higher in idiopathic pulmonary fibrosis patients (5.06 ng/mL, interquartile range [IQR]: 4.20-6.35) than in healthy volunteers (3.31 ng/mL, IQR: 2.84-3.99) (p < 0.001). Multivariate logistic regression models revealed that the correlation between serum interleukin-18 binding protein levels and idiopathic pulmonary fibrosis was statistically independent after adjustment for age, sex, and smoking status. Multivariate Cox proportional hazard models revealed that serum interleukin-18 binding protein levels were predictive of idiopathic pulmonary fibrosis disease prognosis independent of other covariate factors (hazard ratio: 1.655, 95% confidence interval: 1.224-2.237, p = 0.001). We also demonstrated a significant positive correlation between lung hydroxyproline expression levels and interleukin-18 binding protein levels in bronchoalveolar lavage fluid from bleomycin-treated mice (Spearman r = 0.509, p = 0.004). These results indicate the utility of interleukin-18 binding protein as a novel prognostic biomarker for idiopathic pulmonary fibrosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Animals
  • Biomarkers / blood*
  • Bronchoalveolar Lavage Fluid / chemistry
  • Case-Control Studies
  • Disease Models, Animal
  • Female
  • Humans
  • Hydroxyproline / metabolism
  • Idiopathic Pulmonary Fibrosis / chemically induced
  • Idiopathic Pulmonary Fibrosis / diagnosis*
  • Idiopathic Pulmonary Fibrosis / pathology
  • Intercellular Signaling Peptides and Proteins / blood*
  • Interleukin-18 / blood
  • Logistic Models
  • Lung / metabolism
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models

Substances

  • Biomarkers
  • Intercellular Signaling Peptides and Proteins
  • Interleukin-18
  • interleukin-18 binding protein
  • Hydroxyproline

Grants and funding

YH has received research funding from Japan Society for the Promotion of Science (https://www.jsps.go.jp/, KAKENHI Grant No. 19K17676). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.