Surprisingly, few other immunohistochemical studies have been published on ECM alteration compared with clinical endpoints, whereas several studies have confirmed by transcriptomics that gene expression of various ECM proteins including collagens, tenascin, osteopontin, fibronectin, and genes involved in ECM regulation is upregulated in IPF [30-32]. The gene discussed is SPP1; the disease is idiopathic pulmonary fibrosis.