Chaojun Hu1,2, Chanyuan Wu1,2, Enhao Yang1,2, Hui Huang3, Dong Xu1,2, Yong Hou1,2, Jiuliang Zhao1,2, Mengtao Li1,2, Zuojun Xu3, Xiaofeng Zeng4,5, Qian Wang6,7. 1. Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College &Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China. 2. Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No.1 Shuaifuyuan, Beijing, 100730, China. 3. Department of Respiratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College &Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China. 4. Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College &Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China. zengxfpumc@163.com. 5. Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No.1 Shuaifuyuan, Beijing, 100730, China. zengxfpumc@163.com. 6. Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College &Chinese Academy of Medical Sciences, No.1 Shuaifuyuan, Beijing, 100730, China. wangqian_pumch@126.com. 7. Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, No.1 Shuaifuyuan, Beijing, 100730, China. wangqian_pumch@126.com.
Abstract
OBJECTIVE: This cross-sectional study was designed to assess the clinical significance of the serum KL-6 in the diagnosis of interstitial lung disease (ILD) in patients with idiopathic inflammatory myopathy (IIM). METHODS: We measured serum KL-6 levels in 184 patients with IIM using a chemiluminescent enzyme immunoassay and compared KL-6 levels between patients with and without ILD, according to other clinical features. RESULTS: IIM patients with ILD had significantly higher serum KL-6 levels than those without ILD (776.5 [372.3-1378.8] vs. 297.5 [204.75-599.3] U/ml, P < 0.001). At a cut-off of 461.5 U/ml identified by ROC curve, serum KL-6 yielded a sensitivity of 70.2% and specificity of 73.9% for ILD in IIM patients. IIM patients with an elevated serum KL-6 were more likely to have clinical symptoms of mechanic's hands (P = 0.002), anti-Jo-1 antibody positivity (P = 0.021), dysphagia (P = 0.039), hoarseness (P < 0.001), and polyarthritis/polyarthralgia (P < 0.001). Significant inverse correlations were found between serum KL-6 levels and pulmonary function tests (P < 0.01), including forced vital capacity (FVC, %Pred), total lung capacity (TLC, %Pred), and diffusing capacity for carbon monoxide (DLCO, %Pred). CONCLUSIONS: Serum KL-6 offers high sensitivity and specificity for the diagnosis of IIM-associated ILD and is inversely correlated with pulmonary function deterioration. Serum KL-6 may represent a promising biomarker for monitoring ILD severity in IIM patients.
OBJECTIVE: This cross-sectional study was designed to assess the clinical significance of the serum KL-6 in the diagnosis of interstitial lung disease (ILD) in patients with idiopathic inflammatory myopathy (IIM). METHODS: We measured serum KL-6 levels in 184 patients with IIM using a chemiluminescent enzyme immunoassay and compared KL-6 levels between patients with and without ILD, according to other clinical features. RESULTS: IIM patients with ILD had significantly higher serum KL-6 levels than those without ILD (776.5 [372.3-1378.8] vs. 297.5 [204.75-599.3] U/ml, P < 0.001). At a cut-off of 461.5 U/ml identified by ROC curve, serum KL-6 yielded a sensitivity of 70.2% and specificity of 73.9% for ILD in IIM patients. IIM patients with an elevated serum KL-6 were more likely to have clinical symptoms of mechanic's hands (P = 0.002), anti-Jo-1 antibody positivity (P = 0.021), dysphagia (P = 0.039), hoarseness (P < 0.001), and polyarthritis/polyarthralgia (P < 0.001). Significant inverse correlations were found between serum KL-6 levels and pulmonary function tests (P < 0.01), including forced vital capacity (FVC, %Pred), total lung capacity (TLC, %Pred), and diffusing capacity for carbon monoxide (DLCO, %Pred). CONCLUSIONS: Serum KL-6 offers high sensitivity and specificity for the diagnosis of IIM-associated ILD and is inversely correlated with pulmonary function deterioration. Serum KL-6 may represent a promising biomarker for monitoring ILD severity in IIM patients.
Entities:
Keywords:
Dermatomyositis; Interstitial lung disease; KL-6; Polymyositis; Pulmonary function test
Authors: Sara Remuzgo-Martínez; Belén Atienza-Mateo; J Gonzalo Ocejo-Vinyals; Fernanda Genre; Verónica Pulito-Cueto; Víctor M Mora-Cuesta; David Iturbe-Fernández; Leticia Lera-Gómez; Raquel Pérez-Fernández; Diana Prieto-Peña; Juan Irure; Fredeswinda Romero-Bueno; Olga Sanchez-Pernaute; Rodrigo Alonso-Moralejo; Laura Nuño; Gema Bonilla; Esther F Vicente-Rabaneda; Ignacio Grafia; Sergio Prieto-González; Javier Narvaez; Ernesto Trallero-Araguas; Albert Selva-O'Callaghan; Oreste Gualillo; Lorenzo Cavagna; José M Cifrián; Elisabetta A Renzoni; Santos Castañeda; Raquel López-Mejías; Miguel A González-Gay Journal: Sci Rep Date: 2021-11-19 Impact factor: 4.379