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Peer-reviewedCC BY-NC-ND 4.0Journal of Translational Medicine

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

  • Kaiying Xiao1,2
  • Yuting Zhang1
  • Hongpin Peng1
  • Meng Niu3
  • Ganze Li4
  • Xiaomeng Xu1
  • Xizhi Zhang1
  • Qianye Yang2
  • Ya Zhao4
  • Lijie He1
4 affiliations
  1. 1Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, No. 127 Changle West Road, Xi’an, 710032 China
  2. 2Grade 2021 Clinical Medicine (Five-Year Program), Basic Medical College, The Fourth Military Medical University, Xi’an, China
  3. 3Department of Nuclear Medicine, Xijing Hospital, The Fourth Military Medical University, Xi’an, China
  4. 4Department of Medical Microbiology and Parasitology, The Fourth Military Medical University, Xi’an, China
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Abstract

Background: 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.

Methods: 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, 68Ga-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.

Results: 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, 68Ga-FAPI-04 PET/CT demonstrated significantly increased peritoneal maximum standardized uptake value(SUVmax) in PF mice compared to controls(p < 0.05). Surprisingly, in patients undergoing dialysis for more than 24 months, a positive 68Ga-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).

Conclusion: FAP expression is significantly elevated during PD-associated PF development and the results of 68Ga-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.

Trial registration: ChiCTR: ChiCTR2300079318. Registered 31 December 2023, https://www.chictr.org.cn/showproj.html?proj=214233

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Cite

BibTeXRIS
BibTeX
@article{xiao2026clinical,
  title = {{The clinical value of 68Ga-FAPI to evaluate the peritoneal fibrosis and its inherent molecule relationship with POSTN and DPP7}},
  author = {Kaiying Xiao and Yuting Zhang and Hongpin Peng and Meng Niu and Ganze Li and Xiaomeng Xu and Xizhi Zhang and Qianye Yang and Ya Zhao and Lijie He},
  journal = {Journal of Translational Medicine},
  year = {2026},
  month = jul,
  doi = {10.1186/s12967-026-08721-x},
  url = {https://doi.org/10.1186/s12967-026-08721-x},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - The clinical value of 68Ga-FAPI to evaluate the peritoneal fibrosis and its inherent molecule relationship with POSTN and DPP7
AU  - Kaiying Xiao
AU  - Yuting Zhang
AU  - Hongpin Peng
AU  - Meng Niu
AU  - Ganze Li
AU  - Xiaomeng Xu
AU  - Xizhi Zhang
AU  - Qianye Yang
AU  - Ya Zhao
AU  - Lijie He
PY  - 2026
DA  - 2026/07/30
JO  - Journal of Translational Medicine
DO  - 10.1186/s12967-026-08721-x
UR  - https://doi.org/10.1186/s12967-026-08721-x
AB  - Background: 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.  Methods: 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, 68Ga-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.  Results: 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, 68Ga-FAPI-04 PET/CT demonstrated significantly increased peritoneal maximum standardized uptake value(SUVmax) in PF mice compared to controls(p < 0.05). Surprisingly, in patients undergoing dialysis for more than 24 months, a positive 68Ga-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).  Conclusion: FAP expression is significantly elevated during PD-associated PF development and the results of 68Ga-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.  Trial registration: ChiCTR: ChiCTR2300079318. Registered 31 December 2023, https://www.chictr.org.cn/showproj.html?proj=214233
SN  - 1479-5876
ER  -