Tsukasa Okamoto1, Mayumi Fujii2, Haruhiko Furusawa3, Kimitake Tsuchiya4, Yasunari Miyazaki5, Naohiko Inase6. 1. Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: tokamoto.pulm@tmd.ac.jp. 2. Department of Respiratory Medicine, Soka Municipal Hospital, 2-21-1, Soka, Soka City, Saitama 340-8560, Japan. Electronic address: mayumi-f@fk9.so-net.ne.jp. 3. Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: hfurusawa.pulm@tmd.ac.jp. 4. Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: tsucpulm@tmd.ac.jp. 5. Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: miyazaki.pilm@tmd.ac.jp. 6. Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan. Electronic address: ninase.pulm@tmd.ac.jp.
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.
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 hypersensitivitypneumonitis (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.
Authors: Hayley Barnes; Anna-Carin Olin; Kjell Torén; Charles McSharry; Iona Donnelly; Mona Lärstad; Carlos Iribarren; Patricia Quinlan; Paul D Blanc Journal: ERJ Open Res Date: 2020-10-05
Authors: Ganesh Raghu; Martine Remy-Jardin; Christopher J Ryerson; Jeffrey L Myers; Michael Kreuter; Martina Vasakova; Elena Bargagli; Jonathan H Chung; Bridget F Collins; Elisabeth Bendstrup; Hassan A Chami; Abigail T Chua; Tamera J Corte; Jean-Charles Dalphin; Sonye K Danoff; Javier Diaz-Mendoza; Abhijit Duggal; Ryoko Egashira; Thomas Ewing; Mridu Gulati; Yoshikazu Inoue; Alex R Jenkins; Kerri A Johannson; Takeshi Johkoh; Maximiliano Tamae-Kakazu; Masanori Kitaichi; Shandra L Knight; Dirk Koschel; David J Lederer; Yolanda Mageto; Lisa A Maier; Carlos Matiz; Ferran Morell; Andrew G Nicholson; Setu Patolia; Carlos A Pereira; Elisabetta A Renzoni; Margaret L Salisbury; Moises Selman; Simon L F Walsh; Wim A Wuyts; Kevin C Wilson Journal: Am J Respir Crit Care Med Date: 2020-08-01 Impact factor: 30.528