NordicPRO-C6™

PRO-C6 and Endotrophin

NordicPRO-C6™ is a fibroblast activity biomarker that quantifies type VI collagen formation and Endotrophin signaling to assess fibrogenesis across chronic diseases. It enables patient stratification, outcome prediction, and pharmacodynamic monitoring to optimize clinical trial design and therapeutic evaluation.

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A fibroblast activity biomarker that informs on the risk of outcome in multiple chronic diseases

As a prognostic biomarker, nordicPRO-C6™ supports patient selection by identifying individuals more likely to experience disease progression or clinical outcomes — helping enrich trial populations, boost statistical power, and increase the likelihood of success.

NordicPRO-C6™ has demonstrated value in cardiovascular, kidney, lung, and metabolic diseases, predicting disease progression and clinical outcomes (Figure 1). In Crohn’s disease (CD), patients can be differentiated into endotypes, with elevated levels observed in those with fibrostenotic strictures compared to those with luminal disease.

NordicPRO-C6™ has received a letter of support from the FDA encouraging its use to select HFpEF patients with high disease activity for enrollment in clinical trials.

As a pharmacodynamic marker, NordicPRO-C6™ provides a powerful tool for monitoring the efficacy of treatments that lower the risk of an outcome.

NordicPRO-C6™ measures the dangerous bioactive molecule Endotrophin, which promotes pro-fibrotic and pro-inflammatory signaling. The novel assay for full-length endotrophin (nordicEndotrophin™) specifically measures the signaling peptide.


NordicPRO-C6 Prognostic Biomarker
Figure 1. NordicPRO-C6™ as an outcome biomarker across various diseases

Distinct Roles of PRO-C6 and Endotrophin in Type VI Collagen Biology

The PRO-C6 and Endotrophin assays target distinct molecular aspects of type VI collagen biology.

  • NordicPRO-C6™ quantifies the overall formation and pool of type VI collagen by measuring the α3 chain, which contains 12 Von Willebrand factor (vWF) binding domains – more than any other known protein. These domains can directly bind and activate platelets independently of vWF, triggering the release of TGF-β and PDGF, two potent fibrogenic factors. This mechanism may represent a critical link between fibroblast activation, fibrosis, and wound healing. Type VI collagen is a central part of the fibrotic collagens.
  • NordicEndotrophin™ selectively measures Endotrophin, a 77-amino-acid hormone released during type VI collagen synthesis. Unlike the full α3 chain, Endotrophin lacks vWF binding domains but plays a direct and well-documented role in fibroblast activation and fibrogenesis. It represents the biologically active subpopulation of the total collagen VI formation peptides, of which many are fragmented.

Association between baseline levels of PRO-C6 and mortality in different chronic fibroinflammatory diseases.

Why measure PRO-C6 at Nordic Bioscience?

At Nordic Bioscience, our approach to measurement is rooted in decades of innovation and a deep understanding of fibrosis. As the originators of PRO‑C6, we perfected the biomarker over years of clinical trials, built on more than 30 years of expertise in extracellular matrix biomarkers.

Today, PRO-C6 is a well-known name for providing data that is both precise and actionable. PRO-C6 is available in three versions, each with distinct applications:

  1. NordicPRO-C6™ – Our standard research use only (RUO) assay, measured in our CAP/CLIA-certified lab as an exploratory endpoint or pharmacodynamic biomarker in phase I through phase IV clinical trials. It is available as part of our biomarker testing services and not for diagnostic use.
  2. NordicPRO-C6™ (manual ELISA kit for human use) – New! The kit can now be directly ordered from us. The kit is FOR RESEARCH USE ONLY (RUO) and can only be used in NON-CLINICAL settings. It can not be used IN DIAGNOSTIC PROCEDURES. To learn more or order, click here.
  3. NordicrPRO-C6™ (manual ELISA kit for use in rat and mouse) – New! The kit can now be directly ordered from us. The kit is FOR RESEARCH USE ONLY (RUO) and can only be used in NON-CLINICAL settings. It can not be used IN DIAGNOSTIC PROCEDURES. To learn more or order, click here.

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We focus on your research needs

  • Our nordicPRO‑C6™ assay is proven and validated over dozens of clinical trials and is trusted by leading global pharmaceutical partners.
  • Operated in a CAP/CLIA‑certified, ISO‑compliant laboratory, our methods provide a robust foundation for clinical decision‑making, offering clinical and regulatory excellence.
  • With a rapid 24-hour turnaround and an optimized sample requirement of just 60 µL, we provide operational efficiency. Our workflow is designed to support timely and efficient research.
  • Our exclusive ProteinFingerPrint Technology™  turns data into insight. We transform complex collagen turnover data into clear insights, empowering you to improve patient selection, monitor treatment efficacy, and drive precision in fibrosis research.

Patient selection for more efficient clinical trials

Clinical trials are a critical and costly step in drug development. Reducing trial size while maintaining robust data is essential for accelerating market entry and managing costs.

NordicPRO‑C6™ transforms clinical trial efficiency by enabling precise pre-stratification of patients. By identifying individuals with active fibroblasts who are most likely to respond to treatment, nordicPRO‑C6™ helps optimize patient selection, ensuring trials enroll the right participants from the start. This not only enhances trial success rates but also significantly reduces the number of enrollees needed—saving time, resources, and costs while increasing confidence in the therapeutic’s efficacy.

By integrating nordicPRO‑C6™ into clinical trial design, drug developers can streamline recruitment, improve study outcomes, and bring innovative fibrosis-targeted therapies to market faster.

Actionable insights into drug mode of action and prediction of drug response

Understanding a drug’s precise mode of action (MOA) is critical for evaluating safety, optimizing efficacy, and advancing precision medicine. However, in many cases, the exact MOA remains unclear. NordicPRO‑C6™ provides valuable insights into MOA by detecting active fibroblasts, a key process in disease progression and treatment response. By integrating nordicPRO‑C6™ into clinical trials, researchers gain a deeper understanding of how a drug interacts with fibrotic pathways, supporting data-driven decisions on safety, efficacy, and patient stratification.

Not all patients respond equally to treatment—many experience varying levels of efficacy and safety, while some fail to respond at all. This leads to wasted resources, ineffective care, and increased healthcare costs.

NordicPRO‑C6™ changes this by providing a powerful tool to predict treatment response in fibrotic diseases. By measuring active fibroblasts, nordicPRO‑C6™ helps identify patients who are most likely to benefit from specific therapies.

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Monitoring treatment efficacy and pharmacodynamics

NordicPRO‑C6™ offers a dynamic solution by enabling longitudinal monitoring of active fibroblasts, providing direct evidence of a drug’s impact on fibrotic pathways already in phase IB. By tracking changes in nordicPRO‑C6™ levels over time, researchers can assess whether a therapy is effectively reducing the activation of fibroblasts, reducing the risk of outcomes.

By integrating nordicPRO‑C6™ into clinical trials and treatment protocols, drug developers and clinicians gain a powerful pharmacodynamic biomarker that validates drug efficacy, supports regulatory decision-making, and accelerates the path to precision fibrosis therapies.

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    Nordic Bioscience’s assays, products, and services are for research use only and are not intended for medical or diagnostic purposes.

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