Elhai M, et al. - Researchers assessed serum samples of 427 candidates to estimate the prognostic and diagnostic performance of 4 biomarkers ie, lung-epithelial-derived surfactant protein (SP-D), glycoprotein Krebs von den Lungen-6 (KL-6), CCL18 and OX40L concentrations with regards to interstitial lung disease (ILD) progression in systemic sclerosis (SSc). They estimated lung fibrosis by HRCT and PFTs. They observed CCL18 as an independent predictor of more than 10% decline in FVC and development of extensive disease de novo. Hence, they suggested CCL18 as a potential predictive marker for ILD progression. They also found an association of KL-6 and SP-D with lung fibrosis suggesting KL-6 as an assessment tool for lung fibrosis severity and SP-D as a relevant diagnostic biomarker of systemic sclerosis-interstitial lung disease.