Biomarkers to Assist Lung Disease Prognosis, Precision Medicine

Michigan Medicine researchers have found a protein that could predict the severity of a chronic lung disease that is often fatal in patients with scleroderma. These findings could indicate how aggressively physicians should treat patients with the condition, advancing precision medicine. 

Scleroderma is a long-lasting disease that impacts your skin, connective tissue, and internal organs. It occurs when your immune system causes your body to make too much protein collagen, resulting in scarring in the lungs and kidneys.

According to a recent study in Arthritis Care & Research, the Michigan Medicine researchers found a novel adipokine, also known as CTRP9. CTRP9 is associated with pulmonary function for scleroderma patients with interstitial lung disease. The condition causes scarring in the lungs, which makes it harder for exchanging optimal gas.

“Despite interstitial lung disease being the leading cause of death among scleroderma patients, there are very few markers that predict progression of the disease,” said John Varga, MD, corresponding author of the paper who serves as chief of the Michigan Medicine Division of Rheumatology and associate director of the U-M Scleroderma Program,  in a press release.

“CTRP9 is an entirely novel biomarker that has never been implicated in scleroderma. It will help physicians predict the course of the disease and identify those patients who would not need to be on aggressive treatment for their lung disease.”

To conduct the retrospective study, the researcher examined data from 110 patients with interstitial lung disease and scleroderma, which impacts more than 50,000 people in the United States.

Throughout the study, researchers measured CTRP9 serum levels. Every 12 months over a four-year period, the team would collect clinical and lung function data to study the CTRP9 serum level.

“Patients with higher circulating levels of CTRP9 developed more severe lung disease, and low levels of the protein were associated with preserved function. Researchers also found an association between CTRP9 levels and monocytes, immune cells known to contribute to lung fibrosis,” the press release stated.

Although CTRP9 did not predict the disease’s progression, researchers note there could be a reason why. Since interstitial lung disease often progresses quickly after the diagnosis, and because the baseline disease duration of the subject is nine years, patients could have already reached their disease’s plateaus.

“The results from the new study add to the collection of biomarkers that could help for classification and treatment prediction for people living with scleroderma-associated lung disease,” Varga said. “We look forward to future studies that validate and expand upon this work.”

Researchers can use predictive analytic methods to develop precision medicine and promote chronic disease management by identifying biomarkers that impact chronic diseases. Overall, finding these biomarkers will improve the quality of care for patients.