The usefulness of KL-6 and SP-D for the diagnosis and management of chronic hypersensitivity pneumonitis. Issue 12 (December 2015)

• Record Type: Journal Article
• Authors: Okamoto, Tsukasa; Fujii, Mayumi; Furusawa, Haruhiko; Tsuchiya, Kimitake; Miyazaki, Yasunari; Inase, Naohiko
• Is Part Of: Respiratory medicine. Volume 109:Issue 12(2015)
• Page Start: 1576
• Page End: 1581
• Publication Date: 2015-12
• Subjects: Hypersensitivity pneumonitis -- Idiopathic pulmonary fibrosis -- Krebs von den Lungen-6 -- Surfactant protein D -- Acute exacerbation; AE acute exacerbation -- ATS American thoracic society -- BAL bronchoalveolar lavage -- CRP C-reactive protein -- CVD-IP interstitial pneumonia associated with collagen vascular diseases -- ERS European respiratory society -- HP hypersensitivity pneumonitis -- IIPs idiopathic interstitial pneumonias -- ILD interstitial lung diseases -- IPF idiopathic pulmonary fibrosis -- KL-6 Krebs von den Lungen-6 -- LDH lactate dehydrogenase -- NSIP nonspecific interstitial pneumonia -- OP organizing pneumonia -- PaO2 partial pressure of arterial oxygen -- ROC receiver operating characteristics -- SP-D surfactant protein D -- UIP usual interstitial pneumonia -- %DLco percentage predicted diffusing lung capacity for carbon monoxide -- %VC percentage predicted vital capacity; Chest -- Diseases -- Periodicals; Chest -- Diseases -- Great Britain -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Appareil respiratoire -- Maladies -- Périodiques; Thorax -- Maladies -- Périodiques; Appareil respiratoire -- Maladies -- Traitement -- Périodiques; Electronic journals; 616.2
• DOI: 10.1016/j.rmed.2015.10.005
• Languages: English
• ISSNs: 0954-6111

Abstract

Abstract: Background: It is believed that Krebs von den Lungen-6 (KL-6) and surfactant protein D (SP-D) are useful biomarkers for the diagnosis of various types of interstitial lung diseases, including hypersensitivity pneumonitis (HP). The clinical features of chronic HP are similar to those of idiopathic interstitial pneumonias, especially idiopathic pulmonary fibrosis (IPF). Objective: We sought to clarify the usefulness of serum KL-6 and SP-D for the diagnosis and management of chronic HP. Methods: We examined serum KL-6 and SP-D levels and retrospectively evaluated the clinical parameters of acute HP (n = 35), chronic HP (n = 57), IPF (n = 54), collagen vascular disease-associated interstitial pneumonia (CVD-IP) (n = 67), and sarcoidosis (n = 47). We analyzed the relations between the two biomarkers and clinical data in chronic HP. Results: Serum KL-6 and SP-D levels in acute HP (2710 U/ml and 338 ng/ml, median) and chronic HP (1500 U/ml and 264 ng/ml, median) were significantly higher than in IPF, CVD-IP, and sarcoidosis. The area under the curve (AUC) values for serum KL-6 and SP-D between chronic HP and IPF were 0.771 and 0.729, respectively. Serum KL-6 levels in chronic HP were significantly higher during episodes of acute exacerbation than 1 month before acute exacerbation. The serum KL-6 levels had correlations with serum SP-D and the percentage of lymphocytes in bronchoalveolar lavage fluid. Conclusions: Serum KL-6 and SP-D levels are useful for the diagnosis and management of chronic HP. Graphical abstract: Highlights: Serum KL-6 and SP-D were higher in chronic HP than in IPF. The AUC for serum KL-6 and SP-D between chronic HP and IPF were 0.771 and 0.729. Serum KL-6 and SP-D one month after the prednisolone were decreased in chronic HP. Serum KL-6 in chronic HP was higher during AE than 1 month before AE. Serum KL-6 had correlations with SP-D and lymphocytes in BAL fluid.