A simple blood count to determine the number of a subset of white blood cell — the monocytes — might allow predictions on disease progression of patients with idiopathic pulmonary fibrosis (IPF) and help physicians and patients to plan therapeutic steps. This is the result of a study conducted by TLRC-scientists in an international collaboration, which was recently published in the American Journal of Respiratory and Critical Care Medicine.
IPF is characterised by progressive and irreversible scarring of lung tissue. Patients find it increasingly hard to breathe and experience severe breathlessness. If left untreated, IPF is fatal within about 2-5 years after diagnosis. Since IPF cannot be cured, recent therapies focus on delaying tissue scarring, thus extending life expectancy and quality of life of patients.
The disease course of IPF is highly variable and it is hard to predict how quickly scarring will progress and what life expectancy a patient has. To allow a more precise prognosis, scientists are looking for simple and inexpensive biomarkers — measurable changes in the bodies of patients that can give clues on further disease progression. A previous study showed that a simple blood count could serve as suitable biomarker in IPF and that high monocyte counts (≥0.95 GI/L) are associated with an increased risk of mortality.
A team of TLRC-scientists of the Thoraxklinik Heidelberg and international research groups has recently underpinned the potential of the monocyte count as prognostic biomarker in IPF. The researchers investigated whether the monocyte count correlated with the severity of disease progression. Their retrospective analysis involved data from three studies including 2067 IPF-patients. It showed that also elevated (<0.6 GI/L) monocyte counts were associated with a higher risk for severe disease progression. Within one year after the blood test, patients with a monocyte count of ≥0.6 GI/L were more likely to be treated in hospital and had a higher risk of mortality than patients with low monocyte counts (<0.6 GI/L). In a clinical setting the monocyte count could help to identify patients with a higher risk for severe disease progression and facilitate counselling on therapy options.
The findings of this study form the basis for future prospective clinical trials to investigate the value of monocyte counts as prognostic biomarker in the diagnosis and treatment of IPF and other forms of interstitial lung diseases.
Monocyte Count as a Prognostic Biomarker in Patients with Idiopathic Pulmonary Fibrosis. Kreuter M, Lee JS, Tzouvelekis A, Oldham JM, Molyneaux PL, Weycker D, Atwood M, Kirchgaessler KU, Maher TM. Am J Respir Crit Care Med. 2021 Jan 12. doi: 10.1164/rccm.202003-0669OC. Online ahead of print. PMID: 33434107
Source: TLRC
