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The Evaluation of Neutrophil Gelatinase-Associated Lipocalin in Patients with Pulmonary Sarcoidosis
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A1514 - The Evaluation of Neutrophil Gelatinase-Associated Lipocalin in Patients with Pulmonary Sarcoidosis
Author Block: S. Kato, N. Inui, H. Yasui, H. Hozumi, M. Karayama, Y. Suzuki, K. Furuhashi, N. Enomoto, T. Fujisawa, Y. Nakamura, T. Suda; Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Rationale: Sarcoidosis is a systemic granulomatous disorder and its clinical course and prognosis are highly divergent. Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein and regarded as a critical component of the innate immune system. It has a high affinity for siderophores that bind to circulating and intracellular free iron. Elevated expression of NGAL has been detected in various diseases. This study aimed to examine the expression of NGAL in patients with pulmonary sarcoidosis. In addition, we examined whether NGAL could serve as a marker of disease activity and prognosis.
Methods: Ninety-six patients with pulmonary sarcoidosis were studied. Serum samples collected at the time of diagnosis were examined for NGAL by cellular enzyme-linked immunosorbent assay. The level of NGAL was compared with clinical, radiological and laboratory data. Data are expressed as the median (interquartile range).
Results: There were no significant differences in NGAL levels with sex, age, absolute neutrophil counts, estimate glomerular filtration rates or smoking pack-year histories. The level of NGAL in patients with sarcoidosis was 35.1 ng/mL (23.5-60.8). NGAL levels were not correlated with markers for disease activity. During the follow-up period, 26 patients (27.1%) deteriorated and received systemic corticosteroid therapy for organ dysfunction. In those patients, NGAL levels were significantly higher than in those who did not receive corticosteroid therapy (56.5 ng/mL [27.3-92.3] versus 34.3 ng/mL [23.0-53.0], p=0.0201). Six patients received corticosteroid therapy for the newly appearance of cardiac sarcoidosis and the median NGAL level was 22.1 ng/mL. Upon multivariate logistic regression analysis, elevated NGAL levels at diagnosis were associated with subsequent use of systemic corticosteroid therapy (hazard ratio, 1.20; 95% confidence interval, 1.09-1.31; p=0.0004).
Conclusion: NGAL may be a useful marker to predict the disease course of pulmonary sarcoidosis.
Author Block: S. Kato, N. Inui, H. Yasui, H. Hozumi, M. Karayama, Y. Suzuki, K. Furuhashi, N. Enomoto, T. Fujisawa, Y. Nakamura, T. Suda; Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Rationale: Sarcoidosis is a systemic granulomatous disorder and its clinical course and prognosis are highly divergent. Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein and regarded as a critical component of the innate immune system. It has a high affinity for siderophores that bind to circulating and intracellular free iron. Elevated expression of NGAL has been detected in various diseases. This study aimed to examine the expression of NGAL in patients with pulmonary sarcoidosis. In addition, we examined whether NGAL could serve as a marker of disease activity and prognosis.
Methods: Ninety-six patients with pulmonary sarcoidosis were studied. Serum samples collected at the time of diagnosis were examined for NGAL by cellular enzyme-linked immunosorbent assay. The level of NGAL was compared with clinical, radiological and laboratory data. Data are expressed as the median (interquartile range).
Results: There were no significant differences in NGAL levels with sex, age, absolute neutrophil counts, estimate glomerular filtration rates or smoking pack-year histories. The level of NGAL in patients with sarcoidosis was 35.1 ng/mL (23.5-60.8). NGAL levels were not correlated with markers for disease activity. During the follow-up period, 26 patients (27.1%) deteriorated and received systemic corticosteroid therapy for organ dysfunction. In those patients, NGAL levels were significantly higher than in those who did not receive corticosteroid therapy (56.5 ng/mL [27.3-92.3] versus 34.3 ng/mL [23.0-53.0], p=0.0201). Six patients received corticosteroid therapy for the newly appearance of cardiac sarcoidosis and the median NGAL level was 22.1 ng/mL. Upon multivariate logistic regression analysis, elevated NGAL levels at diagnosis were associated with subsequent use of systemic corticosteroid therapy (hazard ratio, 1.20; 95% confidence interval, 1.09-1.31; p=0.0004).
Conclusion: NGAL may be a useful marker to predict the disease course of pulmonary sarcoidosis.
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