Mostafa Amira Ismail, Salem Ayman Elsayed, Ahmed Heba Allah Moussa, Bayoumi Aml Ibrahim, Halim Radwa M Abdel, Samie Rasha M Abdel
Department of Chest Diseases, Faculty of Medicine, Cairo University, Shiekh Zayed City, Egypt.
Department of Chemical Pathology, Faculty of Medicine, Cairo University, Shiekh Zayed City, Egypt.
Tuberc Respir Dis (Seoul). 2021 Jul;84(3):200-208. doi: 10.4046/trd.2020.0122. Epub 2021 Apr 6.
Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with interstitial lung diseases (ILD). Serum KL-6/MUC1 levels have been demonstrated to be useful for the evaluation of various ILD. To determine the role of circulating KL-6 in evaluating the disease activity and management of HP.
An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured in both groups. Patients were further assessed based on chest high-resolution computed tomography (HRCT), pulmonary function test, 6-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings.
The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non-fibrotic HP group (1,900 IU/mL) as compared to the fibrotic group (1,200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as the duration of steroid therapy.
The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasizes the significant role of steroids in the stabilization of the disease.
过敏性肺炎（HP）是一种越来越被认可的弥漫性实质性肺疾病形式。Krebs von den Lungen-6（KL-6）现被归类为人MUC1粘蛋白，在间质性肺疾病（ILD）患者受影响的肺中，II型肺泡上皮细胞是KL-6/MUC1的主要细胞来源。血清KL-6/MUC1水平已被证明对评估各种ILD有用。为确定循环KL-6在评估HP疾病活动和管理中的作用。
对51例HP患者和20名健康对照进行了一项观察性横断面研究。测量了两组的血清KL-6水平。根据胸部高分辨率计算机断层扫描（HRCT）、肺功能测试、6分钟步行测试、超声心动图、支气管肺泡灌洗和/或经支气管活检对患者进行进一步评估。根据HRCT结果将患者分为纤维化组和非纤维化组。
与对照组相比，HP患者的血清KL-6中位数水平显著更高。发现非纤维化HP组的血清KL-6中位数水平（1900 IU/mL）高于纤维化组（1200 IU/mL）。血清KL-6水平与类固醇剂量以及类固醇治疗持续时间之间存在显著负相关。
非纤维化HP组中较高的KL-6水平表明，II型肺泡上皮细胞因肺泡损伤而产生的KL-6增加。血清KL-6水平与类固醇治疗剂量和持续时间之间的显著关联强调了类固醇在疾病稳定中的重要作用。
