• Jade Jaffar, Sofia Unger, Tamera J Corte, Michael Keller, Paul J Wolters, Luca Richeldi, Stefania Cerri, Cecilia M Prêle, Philip M Hansbro, William Scott Argraves, Rema A Oliver, Brian G Oliver, Judith L Black, and Janette K Burgess.
• The Woolcock Institute of Medical Research, The University of Sydney, Glebe, NSW, Australia; Discipline of Pharmacology, The University of Sydney, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, and Royal Prince Alfred Hospital (Sydney Local Health District), Sydney, NSW, Australia. Electronic address: jade.jaffar@sydney.edu.au.
• Chest. 2014 Oct 1; 146 (4): 105510631055-1063.

BackgroundThe underlying mechanisms of idiopathic pulmonary fibrosis (IPF) are unknown. This progressive disease has high mortality rates, and current models for prediction of mortality have limited value in identifying which patients will progress. We previously showed that the glycoprotein fibulin-1 is involved in enhanced proliferation and wound repair by mesenchymal cells and, thus, may contribute to lung fibrosis in IPF.MethodsSerum, lung tissue, and lung function values were obtained from four independent locations (Sydney, NSW, and Perth, WA, Australia; San Francisco, CA; and Modena, Italy). Patients with IPF were followed for a minimum of 1 year and progression was defined as a significant decline in lung function or death. Primary parenchymal lung fibroblasts of 15 patients with and without IPF were cultured under nonstimulatory conditions. Fibulin-1 levels in serum, and secreted or deposited by fibroblasts, were measured by western blot and in lung tissue by immunohistochemistry.ResultsSerum fibulin-1 levels were increased in patients with IPF compared with subjects without lung disease (P = .006). Furthermore, tissue fibulin-1 levels were increased in patients with IPF (P = .02) and correlated negatively with lung function (r = -0.9, P < .05). Primary parenchymal fibroblasts from patients with IPF produced more fibulin-1 than those from subjects without IPF (P < .05). Finally, serum fibulin-1 levels at first blood draw predicted disease progression in IPF within 1 year (area under the curve , 0.71; 95% CI, 0.57-0.86; P = .012).ConclusionsFibulin-1 is a novel potential biomarker for disease progression in IPF and raises the possibility that it could be used as a target for the development of new treatments.

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