Biomarkers for Early Diagnosis of Idiopathic Pulmonary Fibrosis: A Systematic Review

Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease characterized by high mortality and substantial disease burden. Early diagnosis is critical for improving patient survival and prognosis. This review aims to systematically overview the role of biomarkers in the early diagnosis of idiopathic pulmonary fibrosis (IPF), analyze the current research issues, and propose future research directions to provide new insights and methods for the early diagnosis and treatment of this disease.

As of June 2024, we conducted a systematic literature search in databases including PubMed, Web of Science, Embase, and Cochrane Library, and selected relevant studies. We evaluated the included studies, extracted and synthesized data to summarize the current understanding of biomarkers for early diagnosis of IPF.

The pathogenesis of IPF is intricate, and we primarily focused on biomarkers related to alveolar epithelial cell dysfunction [Krebs von den Lungen-6 (KL-6), Surfactant Protein (SP-A/SP-D), Mucin 5B (MUC5B), Telomere Length (TL)], extracellular matrix remodeling and fibrogenesis [S100 Calcium Binding Protein A4 (S100A4), Matrix Metalloproteinases (MMPs), Periostin (POSTN)], as well as immune dysfunction [Serum Amyloid A (SAA), Chitinase-3-like Protein 1 (YKL-40), Chemokines]. These biomarkers hold potential for the early diagnosis of IPF, but limitations remain, such as the lack of dynamic monitoring and the low rate of clinical application.

Although studies on biomarkers for the early diagnosis of IPF have made some progress, numerous challenges remain. Large-scale and multi-center studies are still needed to develop and validate biomarker panels with early diagnostic utility and to promote their application in clinical practice.