Biomedicines (Feb 2024)

Baseline Blood Levels of Mucin-1 Are Associated with Crucial On-Treatment Adverse Outcomes in Patients with Idiopathic Pulmonary Fibrosis Receiving Antifibrotic Pirfenidone

  • Tang-Hsiu Huang,
  • Sheng-Huan Wei,
  • Hung-I Kuo,
  • Hsin-Yu Hou,
  • Chin-Wei Kuo,
  • Yau-Lin Tseng,
  • Sheng-Hsiang Lin,
  • Chao-Liang Wu

DOI
https://doi.org/10.3390/biomedicines12020402
Journal volume & issue
Vol. 12, no. 2
p. 402

Abstract

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Mucin-1 is a multi-functional glycoprotein expressed by type II alveolocytes and may be detectable in the circulation following pulmonary fibrosis. The prognostic utility of baseline pre-treatment blood levels of mucin-1 in patients with idiopathic pulmonary fibrosis (IPF) receiving antifibrotics has not yet been fully established. We retrospectively studied a cohort of patients (from two hospitals) with IPF who were receiving pirfenidone for >12 weeks. Baseline blood mucin-1 levels were measured via sandwich enzyme-linked immunosorbent assays. We investigated the performance of mucin-1 levels in longitudinally predicting the risks of acute exacerbation of IPF (AE-IPF) and severe adverse outcomes (SAO), including lung transplantation and death. Seventy patients were included; 20 developed AE-IPF; and 31 had SAO during the follow-up period. Patients with baseline mucin-1 levels ≥2.5 ng/mL had enhanced risks of AE-IPF (adjusted hazard ratio [aHR], 14.07; 95% confidence interval [CI], 4.26–46.49) and SAO within 2 years (aHR, 7.87; 95% CI, 2.86–21.70) and anytime during the follow-up (aHR, 4.68; 95% CI, 2.11–10.39). The risks increased across subgroups with increasing mucin-1 levels. Patients in the “mucin-1 ≥ 2.5” group also exhibited an accelerated decline in DLCO. This study supports baseline blood mucin-1 levels as a biomarker for IPF that predicts adverse outcomes during pirfenidone treatment.

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