The cytokines and enzymes that have been reported to be associated with the clinical course of IPF or CTD-ILDs include CC chemokine ligand 18 (CCL18), chitinase-3-like protein 1 (YKL 40), and interleukin-4 receptor alpha (IL-4Ra)12,14,15,19–22. This evidence concerns the gene CHI3L1 and idiopathic pulmonary fibrosis.