Progressive pulmonary fibrosis (PPF) is a debilitating lung condition, that eventually leads to the patient being starved of oxygen. Sufferers around the world are keen to see novel treatments developed to help provide relief. In efforts to deliver this a team of experts at the Tohoku Medical and Pharmaceutical University are working to identify micro RNA (miRNA) biomarkers which could enable targeted treatment for sufferers of this diverse disease and potentially lead to the development of new therapies. Dr Masahito Ebina is leading the research and he shares some of the work the team is involved in. ‘We are investigating peripheral circulating miRNA biomarkers we could test for with a simple blood sample in the clinic,’ he says. ‘At present, it is hard to differentiate between sufferers of idiopathic pulmonary fibrosis (IPF), fibrotic non-specific interstitial pneumonia (f-NSIP) and other forms of PPF, despite these diseases affecting the lungs in different ways.’ Ebina is also a clinician running pulmonary consultations at the University’s hospitals where he specialises in severe forms of asthma, sarcoidosis and PPF. ‘Because I am both a medical doctor and a researcher, I know the clinical features of my patients intimately,’ he highlights. ‘This really helps when interpreting blood test results, which otherwise may not mean much to someone with limited knowledge of the patient.’ He notes that current protein biomarkers indicating the presence of interstitial lung disease or PPF, are not sufficiently discriminatory and give the clinician little information on which to base a treatment plan or develop a prognosis. The researchers have already completed a comprehensive suite of investigations into the different lung morphologies that occur during the progression of variants of PPF, with a particular focus on IPF. All types of PPF are characterised by the scarring and thickening of connective tissue, mainly comprised of collagen. However, Edina points out that lung fibrosis in IPF and f-NSIP develops differently over time. ‘Fibrosis in IPF patients develops irregularly over time and is similar to the general condition called usual interstitial pneumonia,’ he says. ‘But fibrosis in the lungs of f-NSIP sufferers progresses more linearly and homogeneously over time.’ Therefore, being able to distinguish between these two conditions will help doctors and patients better understand how the disease will develop over time.