{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:07:42Z","timestamp":1789052862053,"version":"build-2803163510"},"reference-count":37,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Idiopathic pulmonary fibrosis (IPF) may progress despite antifibrotic therapy, highlighting the need for biomarkers of early treatment-associated biological changes. This study aimed to assess the potential role of hepcidin in monitoring treatment response by evaluating pre- and post-treatment serum hepcidin levels in patients with IPF receiving antifibrotic therapy. Methods: This prospective observational cohort study included 38 clinically stable patients diagnosed with IPF according to the 2022 American Thoracic Society\/European Respiratory Society (ATS\/ERS)criteria between January and July 2025. Serum hepcidin was measured by ELISA at antifibrotic therapy initiation and month 3. Demographic data, pulmonary function tests, diffusing capacity for carbon monoxide (DLCO), and 6 min walk test results were recorded. Analyses were performed using SPSS 25.0. Results: Mean serum hepcidin decreased from 33.00 \u00b1 16.74 to 24.41 \u00b1 12.42 ng\/mL (p &lt; 0.001), with reductions observed in 30 of 38 patients (78.9%). Mean forced vital capacity (FVC) increased from 73.83 \u00b1 18.10% predicted to 77.74 \u00b1 15.70% predicted (p &lt; 0.001). Median DLCO increased from 68.50 (51.00\u201380.50)% predicted to 72.50 (60.00\u201383.75)% predicted (p &lt; 0.001). Six-minute walk distance did not change significantly (p = 0.078), nor did hemoglobin, C-reactive protein, or erythrocyte sedimentation rate. The change in hepcidin did not differ between the pirfenidone and nintedanib groups (p = 0.817). Although FVC and DLCO increased over three months, these short-term functional changes should be interpreted cautiously, as test familiarization, measurement variability, and regression to the mean cannot be excluded; therefore, they should not be considered evidence of fibrosis reversal or a direct treatment effect. Conclusions: Our study provides the first real-world data demonstrating a significant decrease in serum hepcidin following antifibrotic treatment in patients with IPF. These findings suggest that serum hepcidin may have potential clinical utility as a biomarker for assessing response to antifibrotic therapy in IPF.<\/jats:p>","DOI":"10.3390\/jcm15187023","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T14:11:22Z","timestamp":1789049482000},"page":"7023","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepcidin as a Biomarker of Response to Antifibrotic Therapy in Idiopathic Pulmonary Fibrosis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-3487-7721","authenticated-orcid":false,"given":"Gulcin","family":"Yilmaz Gunes","sequence":"first","affiliation":[{"name":"Department of Pulmonology, Band\u0131rma Training and Research Hospital, Bal\u0131kesir 10200, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Hikmet","family":"\u00c7oban","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Faculty of Medicine, Bal\u0131kesir University, Bal\u0131kesir 10145, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Fuat","family":"Erel","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Faculty of Medicine, Bal\u0131kesir University, Bal\u0131kesir 10145, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5338-7355","authenticated-orcid":false,"given":"Merve","family":"Ak\u0131\u015f Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Medical Biochemistry, Faculty of Medicine, Bal\u0131kesir University, Bal\u0131kesir 10145, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5180-9649","authenticated-orcid":false,"given":"Nurhan","family":"Sarioglu","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Faculty of Medicine, Bal\u0131kesir University, Bal\u0131kesir 10145, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8458-3535","authenticated-orcid":false,"given":"Mustafa","family":"Colak","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Faculty of Medicine, Bal\u0131kesir University, Bal\u0131kesir 10145, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0205-5075","authenticated-orcid":false,"given":"Merve","family":"Yumrukuz Senel","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, Faculty of Medicine, Bal\u0131kesir University, Bal\u0131kesir 10145, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1038\/s41420-024-02078-0","article-title":"Emerging roles of ferroptosis in pulmonary fibrosis: Current perspectives, opportunities and challenges","volume":"10","author":"Hu","year":"2024","journal-title":"Cell Death Discov."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez Fabrellas, E., Peris S\u00e1nchez, R., Sabater Abad, C., and Juan Samper, G. 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