@article{53e9a12009da4e018a710c2988e45147,
title = "GDF15 is an epithelial-derived biomarker of idiopathic pulmonary fibrosis",
abstract = "Idiopathic pulmonary fibrosis (IPF) is the most common and devastating of the interstitial lung diseases. Epithelial dysfunction is thought to play a prominent role in disease pathology, and we sought to characterize secreted signals that may contribute to disease pathology. Transcriptional profiling of senescent type II alveolar epithelial cells from mice with epithelial-specific telomere dysfunction identified the transforming growth factor-β family member, growth and differentiation factor 15 (Gdf15), as the most significantly upregulated secreted protein. Gdf15 expression is induced in response to telomere dysfunction and bleomycin challenge in mice. Gdf15 mRNA is expressed by lung epithelial cells, and protein can be detected in peripheral blood and bronchoalveolar lavage following bleomycin challenge in mice. In patients with IPF, GDF15 mRNA expression in lung tissue is significantly increased and correlates with pulmonary function. Single-cell RNA sequencing of human lungs identifies epithelial cells as the primary source of GDF15, and circulating concentrations of GDF15 are markedly elevated and correlate with disease severity and survival in multiple independent cohorts. Our findings suggest that GDF15 is an epithelial-derived secreted protein that may be a useful biomarker of epithelial stress and identifies IPF patients with poor outcomes.",
keywords = "Aging, MIC-1, NAG-1, SASP",
author = "Yingze Zhang and Mao Jiang and Mehdi Nouraie and Roth, {Mark G.} and Tracy Tabib and Spencer Winters and Xiaoping Chen and John Sembrat and Yanxia Chu and Nayra Cardenes and Tuder, {Rubin M.} and Herzog, {Erica L.} and Changwan Ryu and Mauricio Rojas and Robert Lafyatis and Gibson, {Kevin F.} and McDyer, {John F.} and Kass, {Daniel J.} and Alder, {Jonathan K.}",
note = "Funding Information: D. J. Kass reports collaborative research funding from Regeneron Pharmaceuticals in pulmonary hypertension, which is unrelated to this article. R. Lafyatis has received consulting fees from PRISM Biolab, Merck, Bristol Myers Squibb, Biocon, Formation, Genentech/Roche, UCB, and Sanofi and grant support from Elpidera and Regeneron, not related to the submitted work. K. F. Gibson reports membership on the advisory board of Bayer Pharmaceuticals, outside the scope of the submitted work. E. L. Herzog has received grant funding from Sanofi, Bristol Myers, and Biogen, and consulting fees from Boehringer Ingelheim, Genentech, and Merck, all unrelated to the submitted work. M. Rojas reports funding from Regeneron and MedImmune, unrelated to this work. None of the other authors has any conflicts of interest, financial or otherwise, to disclose. Funding Information: This project was supported by National Heart, Lung, and Blood Institute Grants HL-113105, HL-135062 (both to J. K. Alder), HL-1226990 (D. J. Kass), HL-123766 (M. Rojas), and HL-109233 and HL-125850 (both to E. L. Herzog), funding from the Samuel and Emma Winters Foundation (J. K. Alder), funding from the Pulmonary Fibrosis Foundation (Y. Zhang), and the Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease. Publisher Copyright: {\textcopyright} 2019 American Physiological Society. All rights reserved.",
year = "2019",
month = oct,
day = "7",
doi = "10.1152/ajplung.00275.2018",
language = "English (US)",
volume = "317",
pages = "L510--L521",
journal = "American Journal of Physiology - Lung Cellular and Molecular Physiology",
issn = "1040-0605",
publisher = "American Physiological Society",
number = "4",
}