Evaluation of changes in the serum levels of Krebs von den Lungen-6 and surfactant protein-D over time as important biomarkers in idiopathic fibrotic nonspecific interstitial pneumonia.

Authors:
Hideaki Yamakawa
Hideaki Yamakawa
Kashiwa Hospital
Japan
Eri Hagiwara
Eri Hagiwara
Kanagawa Cardiovascular and Respiratory Center
Satoshi Ikeda
Satoshi Ikeda
Tsuchiura Kyodo General Hospital
Japan
Tae Iwasawa
Tae Iwasawa
São Paulo University
Brazil
Erina Tabata
Erina Tabata
Kanagawa Cardiovascular and Respiratory Center
Yokohama | Japan
Ryo Okuda
Ryo Okuda
Tokyo Women's Medical University.
Akimasa Sekine
Akimasa Sekine
Kanagawa Cardiovascular and Respiratory Center

Respir Investig 2019 Apr 16. Epub 2019 Apr 16.

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, 6-16-1 Tomioka-higashi, Kanazawa-ku, Yokohama 236-0051, Japan. Electronic address:

Background: Some cases of idiopathic fibrotic nonspecific interstitial pneumonia (f-NSIP) show a progressive course that is similar to that of idiopathic pulmonary fibrosis. However, it is difficult to predict poor patient outcomes. This study aimed to evaluate whether serial changes in serum levels of Krebs von den Lungen-6 (KL-6) and surfactant protein-D (SP-D) can predict disease progression.

Methods: We retrospectively analyzed the medical records of 75 patients with idiopathic f-NSIP. Disease behavior was categorized into two groups depending on long-term change of pulmonary function: progressive type (≥5%/year relative decline in the slope of forced vital capacity [FVC] and/or ≥7.5%/year relative decline in the slope of %diffusing capacity of the lung for carbon monoxide [%D]) and stable type. Levels of KL-6 and SP-D and results of pulmonary function tests, which were performed parallelly, were reviewed and analyzed using a linear mixed-effects model.

Results: The study subjects comprised 62 patients with stable type and 13 patients with progressive type disease behavior. Among these subjects, 50 patients fulfilled the diagnostic criteria of interstitial pneumonia with autoimmune features (IPAF). Serum levels of both KL-6 and SP-D at baseline showed a negative correlation with %D, but not with FVC, and these biomarkers were not related to disease progression. Persistently high levels of KL-6 and SP-D correlated with progressive type disease behavior in idiopathic (non-IPAF) f-NSIP.

Conclusions: Changes in serum KL-6 and SP-D levels over time may provide useful predictive information on disease behavior during treatment in patients with idiopathic f-NSIP and especially in those with non-IPAF f-NSIP.

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Source
http://dx.doi.org/10.1016/j.resinv.2019.03.006DOI Listing
April 2019

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