Proteomics in interstitial lung disease: new insights into pathogenesis,
diagnosis and treatment
Abstract
Interstitial lung disease (ILD) is an umbrella term representing a
heterogeneous group of restrictive lung disorders with destructive
abnormalities in the lung interstitium. The overlapping clinical onset
of various ILD subtypes poses significant challenges in diagnosis and
management of the disease. Various omics technologies have explored
disease-specific molecular markers, crucial for understanding the
complex pathophysiology underlying disease progression. Proteomics, a
rapidly advancing high-throughput omics tool, captures dynamic protein
changes within a biological system, depicting its actual functional
state. This enables comprehensive proteome profiling, facilitating the
identification of specific biomarkers and pathways, thereby enhancing
diagnostic precision and paving the way for targeted therapeutic
interventions. This review highlights recent proteomic discoveries in
idiopathic pulmonary fibrosis, autoimmune ILDs, exposure-related ILDs,
and sarcoidosis, including emerging therapeutic avenues. It summarizes
dysregulated pathways and potential biomarkers crucial for differential
diagnosis, prognosis, disease progression, and treatment responses. The
pathogenesis of ILD involves complex interactions of complement
activation, humoral immune responses, and extracellular matrix
organization pathways, and the expression levels of these pathway
mediators vary across ILD stages and subtypes. Further validation of
these pathways and their mediators through multicentric, large-cohort
studies across diverse geographical locations is needed to enhance
disease understanding and develop ”true” clinical biomarkers.