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Article Dans Une Revue European Respiratory Journal Année : 2022

Cytokines as Prognostic Biomarkers in Pulmonary Arterial Hypertension

Athénaïs Boucly
Ly Tu
  • Fonction : Auteur
Christophe Guignabert
Christopher Rhodes
  • Fonction : Auteur
Pascal de Groote
  • Fonction : Auteur
Grégoire Prévot
  • Fonction : Auteur
Emmanuel Bergot
  • Fonction : Auteur
Antoine Beurnier
Anne Roche
  • Fonction : Auteur
Mitja Jevnikar
  • Fonction : Auteur
Xavier Jaïs
  • Fonction : Auteur
David Montani
Martin Wilkins
Marc Humbert
Olivier Sitbon
Laurent Savale

Résumé

Introduction Risk stratification and assessment of disease progression in patients with pulmonary arterial hypertension (PAH) are challenged by the lack of accurate disease-specific and prognostic biomarkers. To date, B-type natriuretic peptide (BNP) and/or its N-terminal fragment (NT-proBNP) are the only marker for right ventricular dysfunction used in clinical practice, in association with echocardiographic and invasive hemodymamic variables to predict outcome in patients with PAH. Methods This study was designed to identify an easily measurable biomarker panel in the serum of 80 well-phenotyped PAH patients with idiopathic, heritable, or drug-induced PAH at baseline and first follow-up. The prognostic value of identified cytokines of interest was secondly analysed in an external validation cohort of 125 PAH patients. Results Among the 20 biomarkers studied with the multiplex Ella TM platform, we identified a 3-biomarker panel composed of ß-NGF, CXCL9 and TRAIL that were independently associated with prognosis both at the time of PAH diagnosis and at the first follow-up after initiation of PAH therapy. β-NGF and CXCL9 were predictors of death or transplantation, whereas high levels of TRAIL were associated with a better prognosis. Furthermore, prognostic value of the three cytokines was more powerful for predicting survival than usual non-invasive variables (functional class, 6-minute walking distance and BNP/NT-proBNP). The results were validated in a fully independent external validation cohort. Conclusion The monitoring of ß-NGF, CXCL9 and TRAIL levels in serum should be considered in the management and treatment of patients with PAH to objectively guide therapeutic options.
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Dates et versions

hal-03911708 , version 1 (23-12-2022)

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Athénaïs Boucly, Ly Tu, Christophe Guignabert, Christopher Rhodes, Pascal de Groote, et al.. Cytokines as Prognostic Biomarkers in Pulmonary Arterial Hypertension. European Respiratory Journal, inPress, pp.2201232. ⟨10.1183/13993003.01232-2022⟩. ⟨hal-03911708⟩
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