A key protein in wound healing could be a biomarker to predict sequelae of lung fibrosis after COVID-19

Periostin, a key protein in wound healing, may be a good prognostic biomarker for the appearance of fibrous changes in the lung after surgery, according to a multicenter study led by the Incliva Health Institute of the Valencia Hospital. -19. The results of this prospective and observational study have just been published in the American Journal of Respiratory Cell and Molecular Biology, titled “Biomarkers of fibrosis in Covid-19 patients.” One year after hospital discharge: a prospective cohort study”. Incliva-Hospital Clínico participated in the study, with Alba Mulet, Julia Tarrasó and Jaime Signes- Costa, together with Juan Antonio Carbonell from the Biostatistics Department of Incliva. In addition, the Respiratory Department of the General Hospital of Valencia has been involved; Hospital Virgen de la Arrixaca and Hospital los Arcos del Mar Menor, both in Murcia; Seville Hospital of Santa Maria delle Rocio; Hospital of Infante de Madrid, according to the institute in a statement. Fibrotic pulmonary sequelae after covid-19 have been widely described, and people are concerned about the long-term impact of the SARS-CoV-2 pandemic ” are of great concern”. To date, several biomarkers have been associated with the pathogenesis of fibrosis in interstitial lung diseases, particularly idiopathic pulmonary fibrosis (IPF), a rare form of chronic fibrotic interstitial Disease that causes irreversible loss of lung function. Its prognosis is poor, with an untreated 5-year survival rate of 20% to 40%. In Spain, the number of IPF patients is estimated to be between 8,000 and 12,000, with an incidence of 4.6 -7.4 cases/100,000 inhabitants, female prevalence rate is 13 cases/100,000 residents, male prevalence rate is 20 cases/100,000 residents.The purpose of this study is to analyze the fibrogenesis biomarkers in patients with covid-19 pneumonia presence of a biomarker capable of predicting pulmonary sequelae following disease.The researchers found that periostin measured 2 months after admission “predicted” the presence of radiographic fibrous changes and impaired diffusion 1 year after admission.Mobility Areas of fibrosis Periostin is a key protein in wound healing that mediates tissue remodeling, so when elevated levels of periostin are detected in patients with IPF, it is indicative of areas of active fibrosis in the lung. Individualized follow-up of patients provides new knowledge that periostin may be a good prognostic biomarker of fibrotic changes in the lung after covid-19, which will allow selection of those patients at high risk for progressive fibrosis. The publication was commended in an editorial highlighting the clinical challenges of finding “validated biomarkers to guide personalized medical decision-making for post-COVID-19 pulmonary fibrosis” and the relevance of the obtained results. The study was conducted on patients admitted to the hospital with bilateral covid-19 pneumonia.Patients were divided into two groups according to severity, and blood samples, respiratory function tests and high-resolution CT were performed at two and twelve months after discharge Scans A total of 135 patients were evaluated at 12 months, with a mean age of 61 years. 58.5% were male. There were differences between the groups with respect to age, radiographic involvement, length of hospital stay, and laboratory parameters of inflammation. Differences between 2 and 12 months were also found in all functional tests. At 12 months, 63% of patients had complete resolution on high-resolution computed tomography, but fibrous changes remained in 29.4% of patients. Biomarker analysis showed differences in periostin at two months. No difference was found after one year. New findings suggest that periostin early after hospital discharge can predict the presence of fibrotic changes in the lungs. The researchers believe it would be “interesting” to conduct the new study with a larger population sample and to consider other types of patients, because the population studied here is a relatively sick cohort, all of whom have been hospitalized, so there is no It is unclear whether Periostin would be valuable as a biomarker for patients who develop pulmonary fibrosis but do not require hospitalization. In this study, periostin was used to predict unresolved pulmonary fibrosis 12 months after infection and was detected radiographically at two months. Validating its use to stratify patients at risk of developing fibrosis before the onset of fibrosis is “more valuable” for intervention purposes, the study noted. “In all diseases that eventually develop into pulmonary fibrosis, early diagnosis is important because if left untreated, the prognosis is poor. In addition, currently approved treatments are less effective because they only arrest the progression of the disease Dr. Jaime Signes-Costa, Coordinator of the Incliva Respiratory Diseases Research Group and Head of the Pulmonary Service at Valencia Hospital, explained: “To this end, the Incliva Respiratory Diseases Research Group will launch a new phase II trial this year to study Efficacy and safety of several drugs in IPF.