Current and Emerging Biomarkers in Interstitial Lung Disease

Within the heterogeneous group of diseases that constitute interstitial lung disease, biomarkers allowing for early disease identification could provide an opportunity for timely and tailored intervention to preserve lung function and quality of life. Tools for accurate forecasting of individual disease behavior, disease activity monitoring, prognosis, expected treatment response, and treatment safety risks from the point of diagnosis would be highly advantageous, yet remain largely elusive. Limitations in reliability, poor reproducibility, and prohibitive costs have been factors impacting the widespread implementation of most candidate biomarkers to date. This review evaluates the current and emerging biomarkers that may enable personalized assessment in patients with interstitial lung disease to augment clinical decision-making. Readily available clinical and physiological parameters are considered, along with emerging AI-assisted, high-resolution CT imaging, and molecular biomarkers found in blood, exhaled breath, and bronchoscopic sampling. The emerging data for multidimensional index or risk scores are also discussed.