Serum SP-A and KL-6 levels can predict the improvement and deterioration of patients with interstitial pneumonia with autoimmune features

Wang, Jingxian; Zheng, Peiyan; Huang, Zhifeng; Huang, Huimin; Xue, Mingshan; Liao, Chenxi; Sun, Baoqing; Zhong, Nanshan

doi:10.1186/s12890-020-01336-y

Cited by 20 publications

(22 citation statements)

References 30 publications

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“…(Mild ILD: n = 335, Severe ILD: n = 223). Mean (SD) concentrations of KL-6 for patients in progressive ILD and non-progressive ILD groups were collected from 12 studies ( 11 , 18 , 25 , 28 , 29 , 31 , 35 , 36 , 38 , 45 , 47 , 53 ). (Progressive ILD: n = 203, Non-progressive ILD: n = 511).…”

Section: Resultsmentioning

confidence: 99%

KL-6 as an Immunological Biomarker Predicts the Severity, Progression, Acute Exacerbation, and Poor Outcomes of Interstitial Lung Disease: A Systematic Review and Meta-Analysis

et al. 2021

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ObjectInterstitial lung disease (ILD) is a specific form of chronic fibrosing interstitial pneumonia with various etiology. The severity and progression of ILD usually predict the poor outcomes of ILD. Otherwise, Krebs von den Lungen-6 (KL-6) is a potential immunological biomarker reflecting the severity and progression of ILD. This meta-analysis is to clarify the predictive value of elevated KL-6 levels in ILD.MethodEBSCO, PubMed, and Cochrane were systematically searched for articles exploring the prognosis of ILD published between January 1980 and April 2021. The Weighted Mean Difference (WMD) and 95% Confidence Interval (CI) were computed as the effect sizes for comparisons between groups. For the relationship between adverse outcome and elevated KL-6 concentration, Hazard Ratio (HR), and its 95%CI were used to estimate the risk factor of ILD.ResultOur result showed that ILD patients in severe and progressive groups had higher KL-6 levels, and the KL-6 level of patients in the severe ILD was 703.41 (U/ml) than in mild ILD. The KL-6 level in progressive ILD group was 325.98 (U/ml) higher than that in the non-progressive ILD group. Secondly, the KL-6 level of patients in acute exacerbation (AE) of ILD was 545.44 (U/ml) higher than stable ILD. Lastly, the higher KL-6 level in ILD patients predicted poor outcomes. The KL-6 level in death of ILD was 383.53 (U/ml) higher than in survivors of ILD. The pooled HR (95%CI) about elevated KL-6 level predicting the mortality of ILD was 2.05 (1.50–2.78), and the HR (95%CI) for progression of ILD was 1.98 (1.07–3.67).ConclusionThe elevated KL-6 level indicated more severe, more progressive, and predicted the higher mortality and poor outcomes of ILD.

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Section: Resultsmentioning

confidence: 99%

KL-6 as an Immunological Biomarker Predicts the Severity, Progression, Acute Exacerbation, and Poor Outcomes of Interstitial Lung Disease: A Systematic Review and Meta-Analysis

et al. 2021

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“…In addition, higher levels of SP-A and KL-6 predicted severe decline in pulmonary function. 154 In addition, Kameda and colleagues 155 demonstrated that serum and BAL levels of CXCL9, CXCL10 and CXCL11 were significantly increased in patients with IPAF and CTD-ILD compared to IPF. Further studies are needed to validate the clinical significance of these novel biomarkers before becoming part of routine clinical assessment of patients with IPAF.…”

Section: Interstitial Pneumonia With Autoimmune Features (Ipaf)mentioning

confidence: 99%

Natural history and screening of interstitial lung disease in systemic autoimmune rheumatic disorders

Panagopoulos

Goules

Hoffmann-Vold

et al. 2021

Therapeutic Advances in Musculoskeletal

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Interstitial lung disease (ILD) is a relatively frequent manifestation of systemic autoimmune rheumatic disorders (SARDs), including systemic sclerosis (SSc), rheumatoid arthritis (RA), idiopathic inflammatory myopathies (IIM), systemic lupus erythematosus (SLE), primary Sjögren’s syndrome (pSS), and anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis. Interstitial pneumonia with autoimmune features (IPAF) has been proposed to describe patients with ILD who have clinical or serological findings compatible with SARDs but they are not sufficient for a definite diagnosis. ILD may present with different patterns among patients with SARDs, but most commonly as nonspecific interstitial pneumonia (NSIP), with the exception of RA and ANCA vasculitis that more often present with usual interstitial pneumonia (UIP). The natural history of ILD is quite variable, even among patients with the same SARD. It may present with subclinical features following a slow progressively course or with acute manifestations and clinically significant rapid progression leading to severe deterioration of pulmonary function and respiratory failure. The radiographic pattern of ILD, the extent of the disease, the baseline pulmonary function, the pulmonary function deterioration rate over time and clinical variables related to the primary SARD, such as age, sex and the clinical phenotype, are considered prognostic factors for SARDs-ILD associated with adverse outcomes and increased mortality. Different modalities can be employed for ILD detection including clinical evaluation, pulmonary function tests, high resolution computed tomography and novel techniques such as lung ultrasound and serum biomarkers. ILD may determine the clinical outcome of SARDs, since it is associated with significant morbidity and mortality and therefore screening of patients with SARDs for ILD is of great clinical importance.

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“…KL-6 levels were significantly higher in the patients with IPAF than in the patients with non-IPF interstitial fibrosis, non-fibrotic lung diseases, pneumonia and a healthy group [ 18 , 19 , 20 , 22 ]. The biomarker level, when compared to IPF, was varied depending on the study: it was significantly higher in IPAF in Kameda’s study, but comparable in Xue’s study [ 18 , 19 ].…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, in three studies, the serum KL-6 levels showed a negative correlation with the transfer factor for carbon monoxide (T LCO ) [ 19 , 20 , 22 ]. The results of the studies regarding the correlation between KL-6 and the percentage of predicted forced vital capacity value (%FVC) differed from study to study: there was no significant correlation with %FVC and the percentage of predicted forced expiratory volume in one second value (%FEV 1 ) in Wang’s publication, whilst the association with %FVC was described in Xue’s article [ 20 , 22 ].…”

Section: Resultsmentioning

confidence: 99%

Review: Serum Biomarkers of Lung Fibrosis in Interstitial Pneumonia with Autoimmune Features—What Do We Already Know?

Miądlikowska

Rzepka-Wrona

Miłkowska-Dymanowska

et al. 2021

JCM

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Interstitial pneumonia with autoimmune features (IPAF) belongs to a group of diseases called interstitial lung diseases (ILDs), which are disorders of a varied prognosis and course. Finding sufficiently specific and sensitive biomarkers would enable the progression to be predicted, the natural history to be monitored and patients to be stratified according to their treatment. To assess the significance of pulmonary fibrosis biomarkers studied thus far, we searched the PubMed, Medline and Cochrane Library databases for papers published between January 2015 and June 2021. We focused on circulating biomarkers. A primary review of the databases identified 38 articles of potential interest. Overall, seven articles fulfilled the inclusion criteria. This review aims to assess the diagnostic and prognostic value of molecules such as KL-6, SP-A, SP-D, circulating fibrocytes, CCL2, CXCL13, CXCL9, CXCL10 and CXCL11. All of these biomarkers have previously been studied in idiopathic pulmonary fibrosis (IPF) and connective tissue disease-associated interstitial lung disease (CTD-ILD). IPAF is a disorder of a heterogeneous nature. It explains the lack of coherent observations in terms of correlations with functional parameters. There is still no meta-analysis of pulmonary fibrosis biomarkers in IPAF. This is mainly due to the heterogeneity of the methodology and groups analysed in the research. More research in this area is needed.

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Serum SP-A and KL-6 levels can predict the improvement and deterioration of patients with interstitial pneumonia with autoimmune features

Cited by 20 publications

References 30 publications

KL-6 as an Immunological Biomarker Predicts the Severity, Progression, Acute Exacerbation, and Poor Outcomes of Interstitial Lung Disease: A Systematic Review and Meta-Analysis

KL-6 as an Immunological Biomarker Predicts the Severity, Progression, Acute Exacerbation, and Poor Outcomes of Interstitial Lung Disease: A Systematic Review and Meta-Analysis

Natural history and screening of interstitial lung disease in systemic autoimmune rheumatic disorders

Review: Serum Biomarkers of Lung Fibrosis in Interstitial Pneumonia with Autoimmune Features—What Do We Already Know?

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