Cytokines as prognostic biomarkers in pulmonary arterial hypertension

What is it about?

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. In this study, we identified a 3-biomarker panel composed of ß-NGF, CXCL9 and TRAIL that was independently associated with prognosis both at the time of PAH diagnosis and at the first follow-up after PAH therapy initiation. Prognostic value of the three cytokines was more powerful for predicting transplant-free survival than usual non-invasive variables (functional class, 6-minute walking distance and BNP/NT-proBNP level). The results were validated in a fully independent external validation cohort. We believe that these results are likely to be a groundbreaking change in routine clinical practice. The monitoring of ß-NGF, CXCL9 and TRAIL levels in serum should be considered in the management and treatment of patients with PAH during follow-up to objectively identify patients with a high risk of death to adapt treatment (treatment escalation and/or lung transplantation).

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