Evaluating the diagnostic and prognostic utility of serial KL-6 measurements in connective tissue disease patients at risk for interstitial lung disease: correlations with pulmonary function tests and high-resolution computed tomography.

Autor: Álvarez Troncoso J; Systemic Autoimmune Diseases Unit, Internal Medicine Department, Madrid, Spain. jorge.alvarez.troncoso@gmail.com., Porto Fuentes Ó; Internal Medicine Department, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain., Fernández Velilla M; Radiology Department, Hospital Universitario La Paz, Madrid, Spain., Gómez Carrera L; Neumology Department, Hospital Universitario La Paz, Madrid, Spain., Soto Abánades C; Systemic Autoimmune Diseases Unit, Internal Medicine Department, Madrid, Spain., Martínez Robles E; Systemic Autoimmune Diseases Unit, Internal Medicine Department, Madrid, Spain., Sorriguieta Torre R; Systemic Autoimmune Diseases Unit, Internal Medicine Department, Madrid, Spain., Ríos Blanco JJ; Systemic Autoimmune Diseases Unit, Internal Medicine Department, Madrid, Spain.
Jazyk: angličtina
Zdroj: BMC pulmonary medicine [BMC Pulm Med] 2024 Dec 05; Vol. 24 (1), pp. 603. Date of Electronic Publication: 2024 Dec 05.
DOI: 10.1186/s12890-024-03264-7
Abstrakt: Background: Interstitial lung diseases associated with connective tissue diseases (CTD-ILD) necessitate reliable biomarkers for effective management. This study assesses the utility of serial Krebs von den Lungen-6 (KL-6) measurements in predicting disease activity and progression in CTD-ILD patients.
Methods: In a prospective cohort study at a tertiary care center, 50 patients with CTD at risk of or diagnosed with ILD were enrolled. KL-6 levels and pulmonary function tests (PFTs) were measured at baseline, 6, and 12 months, alongside high-resolution computed tomography (HRCT).
Results: Initial KL-6 levels were inversely correlated with PFTs, with mean values starting at 504.96 U/mL (SD ± 508.46), escalating to 739.42 U/mL (SD ± 612.75) at 6 months, and peaking at 1150.27 U/mL (SD ± 1106.70) by 12 months, reflecting disease progression. Higher KL-6 levels were consistently linked with declines in Forced Vital Capacity (FVC) (p = 0.019) and Diffusing Capacity for Carbon Monoxide (DLCO) (p < 0.001). Radiologically, increased KL-6 correlated with subpleural thickening (p = 0.003), septal thickening (p = 0.036), ground-glass opacities (p = 0.018), and other signs of advanced ILD. Sensitivity and specificity of KL-6 for detecting ILD were 86.7% and 71.4%, respectively, at a ≥ 400 U/mL threshold, improving at higher thresholds. Over the study period, patients with elevated KL-6 levels demonstrated more pronounced radiological and functional deterioration.
Conclusion: Serial KL-6 measurements effectively reflect disease activity and progression in CTD-ILD, with strong correlations to functional and radiological outcomes. These findings support the use of KL-6 as a valuable biomarker in the routine clinical management of these complex disorders. Our study demonstrates the significant predictive value of KL-6 for both the diagnosis and monitoring of CTD-ILD, suggesting its integration into clinical practice can enhance patient care and treatment strategies.
Competing Interests: Declarations. Ethics approval and consent to participate: This study was conducted in accordance with the Declaration of Helsinki and approved by the Ethics Commission of the Hospital Universitario La Paz (Approval Number: PI-5929). All participants provided informed consent to participate in the study. The authors have reviewed and accepted the journal’s instructions for authors and comply with all conditions therein. Consent for publication: Not applicable as this manuscript does not contain any individual person’s data in any form (including individual details, images, or videos). Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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