The usefulness of KL-6 and SP-D for the diagnosis and management of chronic hypersensitivity pneumonitis

Tsukasa Okamotoe， Mayumi Fujiie， Haruhiko Furusawae， Kimitake Tsuchiyae， Yasunari Miyazakie， Naohiko Inasee

Background

It is believed that Krebs von den Lungen-6 (KL-6) and surfactant protein D (SP-D) are useful biomarkers for the diagnosis of various types of interstitial lung diseases, including hypersensitivity pneumonitis (HP). The clinical features of chronic HP are similar to those of idiopathic interstitial pneumonias, especially idiopathic pulmonary fibrosis (IPF).

Objective

We sought to clarify the usefulness of serum KL-6 and SP-D for the diagnosis and management of chronic HP.

Methods

We examined serum KL-6 and SP-D levels and retrospectively evaluated the clinical parameters of acute HP (n = 35), chronic HP (n = 57), IPF (n = 54), collagen vascular disease-associated interstitial pneumonia (CVD-IP) (n = 67), and sarcoidosis (n = 47). We analyzed the relations between the two biomarkers and clinical data in chronic HP.

Results

Serum KL-6 and SP-D levels in acute HP (2710 U/ml and 338 ng/ml, median) and chronic HP (1500 U/ml and 264 ng/ml, median) were significantly higher than in IPF, CVD-IP, and sarcoidosis. The area under the curve (AUC) values for serum KL-6 and SP-D between chronic HP and IPF were 0.771 and 0.729, respectively. Serum KL-6 levels in chronic HP were significantly higher during episodes of acute exacerbation than 1 month before acute exacerbation. The serum KL-6 levels had correlations with serum SP-D and the percentage of lymphocytes in bronchoalveolar lavage fluid.

Conclusions

Serum KL-6 and SP-D levels are useful for the diagnosis and management of chronic HP.

respiratory medicine

December 2015Volume 109, Issue 12, Pages 1576–1581

DOI: http://dx.doi.org/10.1016/j.rmed.2015.10.005 |