A pilot HRCT follow-up study to test the feasibility of predictive efficacy of serum periostin in idiopathic pulmonary fibrosis

<bold>Background:</bold> While serum periostin and Krebs von den Lungen-6 (KL-6) have been acknowledged as independent markers in idiopathic pulmonary fibrosis (IPF) diagnosis, the clinical combinatory potential of these biomarkers combined with high-resolution computed tomography (HRCT) has yet to be fully explored. <bold>Methods:</bold> This retrospective study involved 780 participants, comprising 510 UIP-IPF patients and 270 healthy controls. All subjects underwent clinical and laboratory examinations, particularly the detection of periostin and KL-6 using ELISA with innovative HRCT fibrosis score evaluations at admission and discharge during hospitalization in UIP-IPF patients. <bold>Results:</bold> In our cohort of patients with IPF, the mean length of hospital stay was 195.27±11.18 days, and patients with reduced serum periostin levels had significantly improved survival. Intriguingly, anti-fibrotic treatment highly increased serum periostin levels, which also augmented in HRCT fibrosis score. Additionally, noteworthy pre- and after-treatment variations were also detected in immunological indicators such as CRP, IL-2, IL-4, IL-6, IL-10, and D-Dimer. Lastly, ROC analysis revealed the superior predictive ability of periostin, both individually and when amalgamated with HRCT fibrotic score, as opposed to KL-6. <bold>Conclusions:</bold> Our findings underscore the preeminence of serum periostin over KL-6 in UIP-IPF diagnosis, particularly when conjoined with HRCT fibrosis score.