Kentaro Wakamatsu1, Nobuhiko Nagata2, Hiroyuki Kumazoe3, Keishi Oda4, Hiroshi Ishimoto4, Michihiro Yoshimi5, Shohei Takata5, Minako Hamada6, Yoshifusa Koreeda6, Kouji Takakura3, Miwa Ishizu3, Makiko Hara3, Shinji Ise3, Miiru Izumi3, Takashi Akasaki3, Sanae Maki3, Masaharu Kawabata6, Hiroshi Mukae4, Masayuki Kawasaki3. 1. Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan. Electronic address: wakamatsu-k@oomuta-h.com. 2. Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Japan. 3. Department of Respiratory Medicine, National Hospital Organization Omuta Hospital, Oaza, Tachibana, Omuta City 837-0911, Fukuoka Prefecture, Japan. 4. Department of Respiratory Disease, University of Occupational and Environmental Health, Japan. 5. Department of Respiratory Disease, National Hospital Organization Fukuoka-Higashi Medical Center, Japan. 6. Department of Respiratory Medicine, National Hospital Organization Minami Kyushu Hospital, Japan.
Abstract
BACKGROUND: The prognostic significance of serial measurements of serum KL-6 levels in patients with idiopathic pulmonary fibrosis (IPF) is unclear; hence, it was assessed in this study. METHODS: Medical records of 66 patients with IPF, who were not treated with pirfenidone prior to enrollment, were retrospectively reviewed for information on clinical progress, forced vital capacity (FVC), survival, and serum KL-6 levels. We assessed initial serum levels of KL-6, serial changes in serum KL-6 levels, yearly decline in FVC (ΔFVC), and the rate of decline (%ΔFVC). RESULTS: Patients with increased serum KL-6 levels during follow-up had a significantly steeper decline in ΔFVC than those with no KL-6 increase (-201 vs. -50.7ml/year; p=0.0001). Patients with both initial serum KL-6 ≥1000U/ml and serial increases in serum KL-6 had the steepest decline, while those with both initial serum KL-6 <1000ml and no serial increases in KL-6 had the least decline in ΔFVC and %ΔFVC. Relative to the non-increased KL-6 group, survival in the increased KL-6 group tended to be poorer (p=0.0530). Patients with both initial serum KL-6 values <1000U/ml and no serial increase in KL-6 had more favorable prognoses than those with serial increases in KL-6 or initial serum KL-6 values ≥1000U/ml (p<0.0044). Prognosis was significantly poorer in patients with serial KL-6 changes >51.8U/ml/year than in those with serial KL-6 changes <51.8U/ml/year (p=0.0009). CONCLUSION: Thus, serial serum KL-6 measurements can be useful for assessing prognosis in patients with IPF.
BACKGROUND: The prognostic significance of serial measurements of serum KL-6 levels in patients with idiopathic pulmonary fibrosis (IPF) is unclear; hence, it was assessed in this study. METHODS: Medical records of 66 patients with IPF, who were not treated with pirfenidone prior to enrollment, were retrospectively reviewed for information on clinical progress, forced vital capacity (FVC), survival, and serum KL-6 levels. We assessed initial serum levels of KL-6, serial changes in serum KL-6 levels, yearly decline in FVC (ΔFVC), and the rate of decline (%ΔFVC). RESULTS:Patients with increased serum KL-6 levels during follow-up had a significantly steeper decline in ΔFVC than those with no KL-6 increase (-201 vs. -50.7ml/year; p=0.0001). Patients with both initial serum KL-6 ≥1000U/ml and serial increases in serum KL-6 had the steepest decline, while those with both initial serum KL-6 <1000ml and no serial increases in KL-6 had the least decline in ΔFVC and %ΔFVC. Relative to the non-increased KL-6 group, survival in the increased KL-6 group tended to be poorer (p=0.0530). Patients with both initial serum KL-6 values <1000U/ml and no serial increase in KL-6 had more favorable prognoses than those with serial increases in KL-6 or initial serum KL-6 values ≥1000U/ml (p<0.0044). Prognosis was significantly poorer in patients with serial KL-6 changes >51.8U/ml/year than in those with serial KL-6 changes <51.8U/ml/year (p=0.0009). CONCLUSION: Thus, serial serum KL-6 measurements can be useful for assessing prognosis in patients with IPF.
Authors: Irina G Luzina; Erik P Lillehoj; Virginia Lockatell; Sang W Hyun; Katerina N Lugkey; Akihiro Imamura; Hideharu Ishida; Christopher W Cairo; Sergei P Atamas; Simeon E Goldblum Journal: J Pharmacol Exp Ther Date: 2020-11-02 Impact factor: 4.030
Authors: Anna Stainer; Paola Faverio; Sara Busnelli; Martina Catalano; Matteo Della Zoppa; Almerico Marruchella; Alberto Pesci; Fabrizio Luppi Journal: Int J Mol Sci Date: 2021-06-10 Impact factor: 5.923