Work

The clinical value of 68Ga-FAPI to evaluate the peritoneal fibrosis and its inherent molecule relationship with POSTN and DPP7

Year: 2026

Type: article

Abstract: Peritoneal fibrosis(PF) is a major cause of peritoneal membrane failure in peritoneal dialysis(PD) patients, lacking clear occurrence mechanism and reliable non-invasive diagnostic tools. Our study investigated the basic and clinical evidence of fibroblast activation protein (FAP) to detect and quantify PD-associated PF and related potential molecular protein. On the one hand, we evaluated the capacity of FAP in the process of peritoneal fibrosis, including in vitro experiment of human peritoneal mesothelial cells (HPMCs) dataset analysis of GSE162029, and a murine PF model established by daily intraperitoneal injection of 4.25% glucose solution for 2–4 weeks. Finally, 68 Ga-FAPI-04 PET/CT imaging was performed in animal models and patients. On the other hand, we detected the expression of periostin(POSTN), dipeptidyl peptidase 7(DPP7), and glucagon-like peptide-1 receptor(GLP-1 R) in model animals. Increased FAP expression in HPMCs was in a dose-dependent manner ( p < 0.01). Transcriptomic analysis confirmed FAP upregulation in glucose-exposed murine peritoneum. In the PF mouse model, with peritoneal transport function deteriorating over time ( p < 0.05), histology revealed elevated FAP expression strongly related to indicators of fibrosis. Crucially, 68 Ga-FAPI-04 PET/CT demonstrated significantly increased peritoneal maximum standardized uptake value(SUV max) in PF mice compared to controls( p < 0.05). Surprisingly, in patients undergoing dialysis for more than 24 months, a positive 68 Ga-FAPI-04 PET scan result was inversely correlated with Kt/V( p < 0.05). POSTN and DPP7 were elevated in model animals ( p < 0.05). FAP expression is significantly elevated during PD-associated PF development and the results of 68 Ga-FAPI-04 PET/CT, reflected peritoneal functional status and the degree of fibrosis to some extent. Meanwhile, the increase of POSTN and DPP7 were in positive correlation with FAP. The findings represents a promising transformative diagnostic tool for early detection and monitoring of PF and potential mechanism under PF. ChiCTR: ChiCTR2300079318. Registered 31 December 2023, https://www.chictr.org.cn/showproj.html?proj=214233

Source: Journal of Translational Medicine

DOI: 10.1186/s12967-026-08721-x