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Clinical Significance of Serum KL-6 and Surfactant Protein D in Idiopathic Interstitial Pneumonias
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A1599 - Clinical Significance of Serum KL-6 and Surfactant Protein D in Idiopathic Interstitial Pneumonias
Author Block: C. Sakai1, M. Masuda1, S. Ano1, N. Kikuchi1, Y. Ishii2; 1Respiratory Medicine, Kasumigaura Medical Center, Tsuchiura, Ibaraki, Japan, 2Respiratory Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Rationale: Idiopathic interstitial pneumonias (IIPs) comprise a group of diffuse lung diseases of unknown etiology that primarily involve the lung interstitium. KL-6 and surfactant protein D (SP-D) have been reported to be useful biomarkers for the clinical diagnosis of IIPs. However, it remains unclear whether the levels of KL-6 and SP-D correlate in the course of IIPs, or they reflect distinct pathophysiology in IIPs. This study is conducted to clarify the roles of these biomarkers in determination of clinical classification, disease activity, and the response to therapy in patients with IIPs.
Methods: A total of 53 patients with IIPs, who were admitted to Kasumigaura Medical Center from May 2013 to April 2016, were recruited. The diagnosis and classification of IIPs were made based on the ATS/ERS statement. The patients were comprised of idiopathic pulmonary fibrosis (IPF; n=24), nonspecific interstitial pneumonia (NSIP; n=25), and idiopathic pleuroparenchymal fibroelastosis (iPPFE; n=4). We assessed the relationships between the serum levels of KL-6 and SP-D and several clinical parameters such as laboratory data, pulmonary function test, and disease extent on HRCT. In cases of corticosteroid treatment, we monitored the changes in the serum levels of KL-6 and SP-D after the treatment.
Results: The serum levels of KL-6 were significantly elevated in patients with NSIP when compared with those in patients with IPF or PPFE. The level of KL-6 was positively correlated with the extents of consolidation or ground-glass opacity and were negatively correlated with those of honeycomb changes on HRCT. The serum levels of SP-D declined more rapidly than those of KL-6 during corticosteroid treatment. Elevated levels of SP-D were observed in all the patients with iPPFE whereas those of KL-6 were confirmed in only one patient.
Conclusions: We conclude that KL-6 has the potential to be a useful marker to evaluate the clinicopathological features of IIPs. SP-D may be a sensitive marker to assess treatment response. Measurement of SP-D may also be useful for diagnosis of iPPFE.
Author Block: C. Sakai1, M. Masuda1, S. Ano1, N. Kikuchi1, Y. Ishii2; 1Respiratory Medicine, Kasumigaura Medical Center, Tsuchiura, Ibaraki, Japan, 2Respiratory Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Rationale: Idiopathic interstitial pneumonias (IIPs) comprise a group of diffuse lung diseases of unknown etiology that primarily involve the lung interstitium. KL-6 and surfactant protein D (SP-D) have been reported to be useful biomarkers for the clinical diagnosis of IIPs. However, it remains unclear whether the levels of KL-6 and SP-D correlate in the course of IIPs, or they reflect distinct pathophysiology in IIPs. This study is conducted to clarify the roles of these biomarkers in determination of clinical classification, disease activity, and the response to therapy in patients with IIPs.
Methods: A total of 53 patients with IIPs, who were admitted to Kasumigaura Medical Center from May 2013 to April 2016, were recruited. The diagnosis and classification of IIPs were made based on the ATS/ERS statement. The patients were comprised of idiopathic pulmonary fibrosis (IPF; n=24), nonspecific interstitial pneumonia (NSIP; n=25), and idiopathic pleuroparenchymal fibroelastosis (iPPFE; n=4). We assessed the relationships between the serum levels of KL-6 and SP-D and several clinical parameters such as laboratory data, pulmonary function test, and disease extent on HRCT. In cases of corticosteroid treatment, we monitored the changes in the serum levels of KL-6 and SP-D after the treatment.
Results: The serum levels of KL-6 were significantly elevated in patients with NSIP when compared with those in patients with IPF or PPFE. The level of KL-6 was positively correlated with the extents of consolidation or ground-glass opacity and were negatively correlated with those of honeycomb changes on HRCT. The serum levels of SP-D declined more rapidly than those of KL-6 during corticosteroid treatment. Elevated levels of SP-D were observed in all the patients with iPPFE whereas those of KL-6 were confirmed in only one patient.
Conclusions: We conclude that KL-6 has the potential to be a useful marker to evaluate the clinicopathological features of IIPs. SP-D may be a sensitive marker to assess treatment response. Measurement of SP-D may also be useful for diagnosis of iPPFE.
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