Detection of Interstitial Pneumonia with Autoimmune Features and Idiopathic Pulmonary Fibrosis Are Enhanced by Involvement of Matrix Metalloproteinases Levels and Clinical diagnosis

Background: Higher detection of interstitial pneumonia with autoimmune features (IPAF), idiopathic pulmonary fibrosis (IPF) has significant diagnostic and therapeutic implications. Some MMPs have been reliable diagnostic biomarkers in IPAF and IPF in previous studies, yet relevant reliability remains to be recognized. Material and Methods: 36 ILD patients, including 31 IPAF patients (Mean ± SD, 50.20 ± 5.10 years; 16 (51.6%) females) and 5 IPF patients (Mean ± SD, 61.20 ± 6.73 years; 1 (20.0%) females) were retrospectively enrolled. Serial serum samples were collected from corresponding patients between January 2019 and December 2020. Notably, Serum MMPs levels were measured by U-PLEX Biomarker Group 1(Human) Multiplex Assays (MSD, USA). Results: A combination of MMPs, combinatorial biomarkers and was strongly associated with the above clinical subjects (AUC, 0.597 for Stability vs. Improvement and 0.756 for Stability vs. Exacerbation). Importantly, the AUC of MMP-12 reaches 0.730 (P<0.05, Stability AUC vs. Improvement AUC) while MMP-13 reaches 0.741 (P<0.05, Stability AUC vs. Exacerbation AUC) showed better academic performance than other MMPs in two comparisons. Conclusions: Clinical risk factors and MMPs are strongly associated with either stratification of the degree of disease of progression of IPAF or in two IPAF and IPF independent cohorts. To our knowledge, this is the first to illustrate that MMP-12 and MMP-13 may be expected to become typical promising biomarkers in Improvement - IPAF and Exacerbation - IPAF, respectively.