Respiratory Diseases and Lung Transplantation Unit, AOUS - Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci, 16 -, 53100, Siena, Italy.
Diagnostic Imaging Unit, AOUS - Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy.
Inflammation. 2019 Apr;42(2):463-470. doi: 10.1007/s10753-018-00955-2.
Idiopathic pulmonary fibrosis (IPF) and non-specific interstitial pneumonia (NSIP) are the most frequent idiopathic interstitial pneumonias. The aim of this study was to evaluate concentrations of calgranulin B and Krebs von den Lungen 6 (KL-6) in bronchoalveolar lavage (BAL) fluid of patients with IPF and idiopathic NSIP (i-NSIP) with fibrotic pattern. Thirty patients with IPF (68.73 ± 8.63 years), 30 with i-NSIP (68.33 ± 7.45 years), and healthy controls were included in the study. Calgranulin B and KL-6 both proved to be significantly higher in BAL of IPF and i-NSIP patients than in healthy controls (p < 0.05). Calgranulin B showed several significant correlations with functional parameters (oxygen demand at rest, 6-min walking test (6MWT), and PFTs); KL-6 was correlated with oxygen demand at rest and during 6MWT. Patients with higher concentrations of both biomarkers (> 75th percentile) had more advanced disease with lower values of FEV1%, FVC%, RV%, TLC%, DLCO% of predicted, distance walked in 6MWT, and BAL neutrophil percentage. Calgranulin B and KL-6 in BAL proved to be reliable biomarkers of IPF and i-NSIP and to have prognostic meaning, discriminating severe and advanced patients. The combination of the two biomarkers can facilitate the stratification of severity.
特发性肺纤维化（IPF）和非特异性间质性肺炎（NSIP）是最常见的特发性间质性肺炎。本研究旨在评估特发性纤维化型 NSIP（i-NSIP）和 IPF 患者支气管肺泡灌洗液（BAL）中钙粒蛋白 B 和 KL-6 的浓度。本研究纳入 30 例 IPF 患者（68.73±8.63 岁）、30 例 i-NSIP 患者（68.33±7.45 岁）和健康对照组。结果显示，BAL 中钙粒蛋白 B 和 KL-6 在 IPF 和 i-NSIP 患者中均显著高于健康对照组（p<0.05）。钙粒蛋白 B 与功能参数（静息氧需求、6 分钟步行试验（6MWT）和 PFTs）有显著相关性；KL-6 与静息和 6MWT 期间的氧需求相关。两种生物标志物浓度较高（>75 百分位）的患者疾病更为严重，FEV1%、FVC%、RV%、TLC%、DLCO%预测值、6MWT 步行距离和 BAL 中性粒细胞百分比均较低。BAL 中的钙粒蛋白 B 和 KL-6 被证明是 IPF 和 i-NSIP 的可靠生物标志物，具有预后意义，可区分严重和晚期患者。两种生物标志物的联合使用可以促进严重程度的分层。
