Krebs von den Lungen-6 as a Potential Predictive Biomarker in Fibrosing Interstitial Lung Diseases

医学 内科学 生物标志物 胃肠病学 间质性肺病 肺活量 肺功能测试 肺功能 呼吸道疾病 特发性肺纤维化 扩散能力 生物化学 化学
作者
Christoph Lederer,Katharina Mayer,Vivien Somogyi,Katharina Kriegsmann,Mark Kriegsmann,Katharina Buschulte,Markus Polke,Peter Findeisen,Felix J.F. Herth,Michael Kreuter
出处
期刊:Respiration [S. Karger AG]
卷期号:102 (8): 591-600 被引量:5
标识
DOI:10.1159/000531945
摘要

Background: As fibrosing interstitial lung diseases (fILDs) are associated with high mortality, monitoring of disease activity under treatment is highly relevant. Krebs von den Lungen-6 (KL-6) is associated with the presence and severity of different fILDs, mainly in Asian patient populations. Objectives: Our aim was to evaluate KL-6 as a predictive biomarker in fILDs in Caucasian patients. Methods: Consecutive patients with fILDs were recruited prospectively and serum concentrations of KL-6 were measured at baseline (BL), after 6 and 12 months (6 Months, 12 Months). Clinical characteristics including pulmonary function tests were assessed at 6-monthly visits and correlated with KL-6 BL levels as well as with KL-6 level changes. Results: A total of 47 fILD patients were included (mean age: 65 years, 68% male). KL-6 levels at BL were significantly higher in fILD patients than in healthy controls (n = 44, mean age: 45, 23% male) (ILD: 1,757 ± 1960 U/mL vs. control: 265 ± 107 U/mL, p < 0.0001). However, no differences were noted between ILD subgroups. KL-6 decreased significantly under therapy (6M∆BL-KL6: −486 ± 1,505 mean U/mL, p = 0.032; 12M∆BL-KL6: −547 ± 1,782 mean U/mL, p = 0.041) and KL-6 level changes were negatively correlated with changes in pulmonary function parameters (forced vital capacity [FVC]: r = −0.562, p < 0.0001; DLCOSB: r = −0.405, p = 0.013). While neither absolute KL-6 levels at BL nor KL-6 level changes were associated with ILD progression (FVC decline ≥10%, DLCOSB decline ≥15% or death), patients with a stable FVC showed significantly decreasing KL-6 levels (p = 0.022). Conclusions: A decline of KL-6 under therapy correlated with a clinically relevant stabilization of lung function. Thus, KL-6 might serve as a predictive biomarker, which however must be determined by larger prospective cohorts.

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