Sand JMB, et al. - Researchers tested their hypothesis that extracellular matrix (ECM) remodeling was altered during acute exacerbations of idiopathic interstitial pneumonia (IIP) and investigated this by serological neo-epitope biomarkers in this retrospective analysis. Biomarkers released by matrix metalloproteinase-mediated degradation of collagen type I (C1M), III (C3M), IV (C4M), and VI (C6M), elastin (ELM7), versican (VCANM), biglycan (BGM), and C-reactive protein (CRPM) were assessed. Notable changes were visible in the ECM remodeling profile during acute exacerbations of IIP, and a biomarker of versican degradation was found to be associated with mortality outcome. Possible utility of biomarkers of ECM remodeling was shown in the non-invasive assessment of acute exacerbations of IIP. Especially versican degradation, as measured serologically by VCANM, may have prognostic potential and help guide treatment for acute exacerbations.