Canstatin Is Associated with Mortality Risk in Advanced Atherosclerosis

Canstatin, a type IV collagen fragment, is associated with risk of cardiovascular and all-cause mortality in patients with advanced atherosclerosis

Introduction

Atherosclerosis, a common underlying cause of cardiovascular disease, is defined by the formation of
plaques in the arterial walls. Changes in the ECM composition impact the risk for plaque rupture, which may cause acute complications (i.e. stroke or myocardial infarction (MI)). Type IV collagen is primarily known as a major component of basement membranes and has previously been reported to promote plaque stability. Canstatin is the non-collagenous C-terminal domain of type IV collagen alpha 2 chain. It is not only a by-product of proteolytic activity, but also a bioactive molecule. This study investigated if canstatin was associated with adverse outcomes in patients with advanced carotid atherosclerosis.

Poster

Conclusion

Higher circulating canstatin levels in patients undergoing carotid endarterectomy predicted cardiovascular mortality and all-cause mortality over 7.5 years. This suggests that canstatin is a potential novel tool for risk stratification in patients with advanced atherosclerosis, warranting further studies.

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    Collagen Type I Degradation Biomarkers Are Associated with Risk of Mortality After STEMI

    Collagen type I degradation biomarkers are associated with risk of mortality after ST-elevated
    myocardial infarction.

    Introduction

    Following ST-elevation myocardial infarction (STEMI), there is acute degradation of type I collagen (COL1), the primary structural protein of the myocardium. This process reflects extensive extracellular matrix remodeling, which may contribute to cardiac tissue destabilization and elevate the risk of subsequent adverse events. To better understand this pathological remodeling, we aimed to quantify COL1 using specific plasma biomarkers, including a novel signaling fragment of COL1 (C1SIG) and a more established COL1 degradation marker (C1M). Additionally, we investigated the prognostic value of these biomarkers for predicting all-cause mortality following a STEMI event.

    Poster

    Conclusion

    C1M and C1SIG are independently prognostic for mortality in STEMI patients after 1 year, in a multivariate
    model based on the Framingham Score. Assessing acute extracellular matrix processing in STEMI patients
    using COL1 biomarkers could be beneficial for predicting mortality and identifying a patient subset at
    increased risk of long-term outcome.

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      ACR70 Response and Its Dependence on Deep Tissue Efficacy

      Introduction

      Over the past decade, drugs developed for rheumatoid arthritis (RA) have been approved based on an ACR20 response rate of 60%. There is an increasing need for new RA drugs to achieve an ACR100 response in a significant portion of patients. Achieving ACR100 can profoundly improve patients’ quality of life by reducing pain, enhancing physical function, and decreasing fatigue.

      The key question remains: which patients are likely to achieve ACR100?

      An important aspect of RA pathogenesis involves the destruction and remodeling of bone, cartilage, and synovial tissue. Serum biomarkers that measure collagen and other extracellular matrix fragments can be used to assess disease activity at the tissue level. Examples include C1M (type I collagen destruction), C4M (type IV collagen destruction), and Osteocalcin (bone formation) [1].

      The aim of this study was to examine the demographic, clinical, and serum markers of tissue remodeling as predictors linked to ACR20, ACR50 and ACR70 responses to tocilizumab.

      Poster

      Conclusion

      While predictors of moderate response (ACR20) included clinical, demographic, and biomarker factors, predictors of significant response (ACR70) were exclusively biomarkers of extracellular matrix fragmentation. To achieve remission (ACR70 or ACR100) may require therapeutic interventions that specifically target and address tissue remodeling processes.

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        Serological Extracellular Matrix Fragments May Serve as Early Kidney Damage Biomarkers

        Serological extracellular matrix fragments may serve as early kidney damage biomarkers in children with defects in Alport genes

        Introduction

        Alport syndrome is a genetic disorder caused by variants in COL4A3, COL4A4, or COL4A5, which encode type IV collagen. The α3.α4.α5(IV) collagen network is a critical structural component of the glomerular and tubular basement membranes within the kidney’s extracellular matrix (ECM). Variants in this network compromise basement membrane integrity, leading to cell injury, inflammation, and fibrotic remodeling of the surrounding interstitial matrix, which contributes to progressive kidney dysfunction.

        We aim to identify serological protease-generated fragments of the ECM as potential early biomarkers of kidney damage.

        Poster

        Conclusion

        The following biomarkers were altered in children with Alport syndrome, compared to healthy donors, before the onset of detectable proteinuria:


        These biomarkers could potentially indicate early kidney damage and enable earlier initiation of kidney-protective treatments in children with Alport syndrome.

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          Type III and VI Collagen Have the Potential to Distinguish Between IPF and HP

          Type III and VI Collagen remodeling biomarkers have the potential to distinguish between IPF and HP

          Introduction

          IPF and HP are two ILDs with similar clinical phenotype but distinct management, making their precise separation critical. Serological biomarkers may assist in distinguishing the two. In this study we assessed the clinical value of type III and VI collagen remodeling biomarkers and their potential to act as a tool to distinguish between HP and IPF in two separate, independent cohorts.

          Poster

          Conclusion

          We conclude that nordicPRO-C3™ could distinguish between HP and IPF in the AUH-ILD cohort. Furthermore, the distinct collagen remodeling takes place in each disease. In conclusion, these findings suggest that ECM remodeling biomarkers could act as potential tools to distinguish between HP and IPF.

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            NordicPRO-C3™NordicPRO-C6™ in CTD-ILD: Results From the Phase IIb RECITAL Trial

            PRO-C3 and PRO-C6 fibrogenesis biomarkers in connective tissue disease-associated interstitial lung disease: results from the Phase IIb RECITAL trial

            Introduction

            ILD is a major cause of morbidity and mortality in connective tissue disease (CTD). Cyclophosphamide is an effective treatment for CTD-ILD, but is limited by side effects. Rituximab was tested as an alternative in the RECITAL phase IIb trial. The result was that both drugs improved lung function, but rituximab showed fewer adverse events.

            The aim of this study was to evaluate the effect of cyclophosphamide and rituximab on fibrogenesis in CTD-ILD.

            Poster

            Conclusion

            The decrease in nordicPRO-C6™ and nordicPRO-C3™ suggest that, besides their immunomodulatory effects, these drugs may also reduce fibrogenesis. Furthermore, nordicPRO-C3™ and nordicPRO-C6™, measured at baseline and as % change from baseline, are associated with FVC response. These findings highlight nordicPRO-C3™ and nordicPRO-C6™ as promising biomarkers for progressive CTD-ILD.

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              Type III and VI Collagen Remodeling Biomarkers’ Potential to Distinguish Between IPF and HP

              Type III and VI collagen remodeling biomarkers have the potential to distinguish
              between IPF and HP

              Introduction

              IPF and HP are two ILDs with similar clinical phenotype but distinct management, making their precise separation critical. Serological biomarkers may assist in this distinction. Extracellular matrix (ECM) remodeling is a hallmark of fibrosis. Collagen formation and degradation processes release peptide fragments into the blood that can be quantified by the nordicPRO-C3™ and nordicPRO-C6™ (type III and VI collagen formation), or the C3M and C6M (type III and VI collagen degradation) assays.

              In this study we assessed the clinical value of Type III and VI collagen remodeling biomarkers and their potential to act as a tool to distinguish between HP and IPF in two separate, independent cohorts.

              Poster

              Conclusion

              These findings suggest that ECM remodeling biomarkers such as nordicPRO-C3™ could act as potential tools to distinguish between HP and IPF.

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                NordicPRO-C3™ and NordicPRO-C6™ in Connective Tissue Disease-Associated Interstitial Lung Disease

                NordicPRO-C3™ and nordicPRO-C6™ fibrogenesis biomarkers in connective tissue disease-associated interstitial lung disease: results from the phase IIb RECITAL trial

                Introduction

                ILD is a major cause of morbidity and mortality in connective tissue disease (CTD). Cyclophosphamide is an effective treatment for CTD-ILD, but limited by side effects. In this study, we additionally tested rituximab as an alternative in the RECITAL phase IIb trial. Both drugs improved the lung function with rituximab showing fewer adverse events (Maher, 2022. Lancet Resp Med)

                Poster

                Conclusion

                The decrease in nordicPRO-C3™ and nordicPRO-C6™ suggest that, besides their immunomodulatory effects, these drugs may also reduce fibrogenesis. Both biomarkers, measured at baseline and as % change from baseline, are associated with FVC response. These findings highlight nordicPRO-C3™ and nordicPRO-C6™ as promising biomarkers for progressive CTD-ILD.

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                  Identifying Patients with Mild-Stage Emphysema in COPD via Machine Learning

                  Identifying biomarkers of mild-stage emphysema in COPD patients via interpretable machine learning

                  Introduction

                  Emphysema results from alveolar damage—causing abnormal extracellular matrix (ECM) remodeling and impaired lung function. Early detection in mild, often asymptomatic stages is key to timely intervention. Although computed tomography (CT) scans are the most accurate detection method, pathological changes may occur before emphysema becomes visible, highlighting the need for non-invasive early detection approaches.

                  This study aimed to develop a proof-of-concept machine learning (ML) pipeline to identify patients with mild-stage emphysema using circulating biomarkers.

                  Poster

                  Conclusion

                  ML demonstrates potential for early-stage emphysema diagnosis through biomarker-driven methods. Quantifying fragments of ECM remodeling—driven by immune cell activity and collagen formation—could potentially serve as early diagnostic biomarkers in patients without lung function decline.

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                    Tankyrase Inhibitor OM153 Exhibits Anti-Fibrotic Effects in a Scar-in-a-Jar Pulmonary Fibrosis Model

                    Introduction

                    Idiopathic pulmonary fibrosis (IPF) is a progressive, chronic and fatal lung disease with limited
                    treatment options. Fibroblast activation and ECM deposition is pivotal in development of IPF, thus
                    inhibiting fibrogenesis and ECM deposition is crucial for anti-fibrotic approaches to treat IPF.

                    This study aims to prove that tankyrase inhibition reduces fibrogenesis induced by a fibrotic cocktail (FC) in primary human lung fibroblasts derived from IPF patients and decreases extracellular matrix biomarkers nordicPRO-C3™ and nordicPRO-C6™.

                    Poster

                    Conclusion

                    These findings highlight the potential of tankyrase inhibiton as a therapeutic target for IPF and
                    support the use of the Scar–in-a-Jar model as an effective tool for IPF drug screening.

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