定量检测血清KL-6水平在结节病性葡萄膜炎患者随访中的应用价值。

Usefulness of quantifying serum KL-6 levels in the follow-up of uveitic patients with sarcoidosis.

作者信息

Kitaichi Nobuyoshi, Ariga Toshihide, Kase Satoru, Yoshida Kauzhiko, Namba Kenichi, Ohno Shigeaki

机构信息

Department of Ophthalmology and Visual Sciences, Hokkaido University Graduate School of Medicine, Sapporo, Japan.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2006 Apr;244(4):433-7. doi: 10.1007/s00417-005-0081-9. Epub 2005 Aug 23.

DOI:10.1007/s00417-005-0081-9

PMID:16133026

Abstract

BACKGROUND

KL-6 is a human glycoprotein secreted by type II alveolar cells in the lung, and its serum levels increase in pneumonia of various causes. We previously reported that serum KL-6 levels in uveitis patients with sarcoidosis were significantly higher than those of other uveitis patients and healthy controls. Additionally, the combined measurement of serum KL-6 and angiotensin converting enzyme (ACE) was useful for screening uveitic patients to diagnose sarcoidosis. The purpose of the present study was to investigate the clinical usefulness of quantifying serum KL-6 levels for following-up the patients with sarcoidosis.

METHODS

Sera were obtained from 36 uveitic patients diagnosed with sarcoidosis and the same number of healthy volunteers. To examine the influence of systemic medication, we also collected blood samples from four more sarcoidosis patients, who were systemically treated with corticosteroid or angiotensin converting enzyme (ACE) inhibitor, an anti-hypertensive drug. The serum concentration of KL-6 was measured by a human KL-6 electrochemiluminescence immunoassay (ECLIA).

RESULTS

The mean KL-6 concentrations of sarcoidosis patients and healthy controls were 449.3+/-66.3 (mean+/-SE) and 192.1+/-11.3, respectively. The average levels of serum KL-6 were significantly elevated in sarcoidosis patients compared with healthy control subjects (P<0.001), and there were significant correlations between serum KL-6 and ACE levels in the patients with sarcoidosis (r=0.70 and P<0.0001). Moreover, serum KL-6 concentrations were less affected by systemic corticosteroid, and unaffected by ACE inhibitory drugs in contrast to ACE levels.

CONCLUSIONS

Measurement of serum KL-6 in the uveitic patients may be useful to follow-up the diagnosed sarcoidosis, as well as for diagnosing sarcoidosis, because the serum KL-6 level was well correlated with the ACE level, and less affected by systemic medication than ACE levels.

摘要

背景

KL-6是一种由肺内II型肺泡细胞分泌的人类糖蛋白，其血清水平在各种病因的肺炎中会升高。我们之前报道过，结节病性葡萄膜炎患者的血清KL-6水平显著高于其他葡萄膜炎患者和健康对照者。此外，联合检测血清KL-6和血管紧张素转换酶（ACE）有助于筛选葡萄膜炎患者以诊断结节病。本研究的目的是探讨定量检测血清KL-6水平在结节病患者随访中的临床应用价值。

方法

采集了36例诊断为结节病的葡萄膜炎患者以及相同数量健康志愿者的血清。为了研究全身用药的影响，我们还从另外4例接受皮质类固醇或血管紧张素转换酶（ACE）抑制剂（一种抗高血压药物）全身治疗的结节病患者中采集了血样。采用人KL-6电化学发光免疫分析法（ECLIA）检测血清KL-6浓度。

结果

结节病患者和健康对照者的平均KL-6浓度分别为449.3±66.3（均值±标准误）和192.1±11.3。与健康对照者相比，结节病患者的血清KL-6平均水平显著升高（P<0.001），结节病患者的血清KL-6与ACE水平之间存在显著相关性（r=0.70，P<0.0001）。此外，血清KL-6浓度受全身皮质类固醇的影响较小，与ACE水平相反，不受ACE抑制药物的影响。