Elevated Expression of Growth Differentiation Factor-15 Is Associated With Acute Exacerbation of Idiopathic Pulmonary Fibrosis

作者：Mengshu Cao, Lina Gu, Lili Guo, Mengying Liu, Tianzhen Wang, Ji Zhang, Huizhe Zhang, Yufeng Zhang, Yanchen Shi, Yichao Zhao, Xiaohua Qiu, Xianhua Gui, Miao Ma, Yaqiong Tian, Xiaoqin Liu, Fanqing Meng, Yonglong Xiao, Lingyun Sun · 发表于：Frontiers in Immunology · 年份：2022 · DOI：10.3389/fimmu.2022.891448 · 被引用次数：17 · 研究领域：GDF15 and Related Biomarkers、IL-33, ST2, and ILC Pathways、Studies on Chitinases and Chitosanases

Backgrounds: Growth differentiation factor 15 (GDF-15) is a highly divergent member of the TGF-β superfamily and has been implicated in various biological functions. However, the expression of GDF-15 in patients with acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) is unclear. Method: The study included 47 AE-IPF patients, 61 stable IPF (S-IPF) subjects, and 31 healthy controls (HCs). Serum GDF-15 levels and their expression in the lung were measured. The correlation between serum GDF-15 and other clinical parameters and the risk factors for AE occurrence and the survival of IPF patients were analyzed. Results: Serum GDF-15 levels were significantly elevated in AE-IPF patients (1279.22 ± 540.02 pg/ml) as compared with HCs (891.30 ± 479.90 pg/ml) or S-IPF subjects (107.82 ± 14.21 pg/ml) (both p < 0.001). The protein and mRNA expressions of GDF-15 in the lung of AE-IPF patients were significantly increased as compared with S-IPF cases (p = 0.007 and p = 0.026, respectively). The serum GDF-15 level was correlated with the clinical variables of inflammation, metabolism, and disease severity in IPF subjects (all p < 0.05). The GDF-15 serum concentration was significantly higher in decedents than in survivors (p = 0.005). A serum GDF-15 level above 989.3 pg/ml was a risk factor for AE occurrence (p = 0.04), and the level above 1,075.76 pg/ml was an independent predictor for survival in IPF cases (p = 0.007). Conclusions: The GDF-15 level was significantly elevated in su...