Suryananda Titah Dhadhari, Yudhawati Resti
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Ann Med Surg (Lond). 2021 Sep;69:102673. doi: 10.1016/j.amsu.2021.102673. Epub 2021 Aug 12.
The main target of SARS-CoV2 is the alveolar type II (AT2) cells of the lung. SARS-CoV2 evades the innate immune system resulting in the release of proinflammatory cytokines (IL-1β, IL-6, TNF-α) which causes AT2 cell damage. Krebs von den Lungen (KL-6) is a specific biomarker of AT2 cell damage. KL-6 is produced in AT2 cells that are injured/regenerated.
Research that discusses the role of KL-6 in COVID-19 is still being debated and not much has been done in Indonesia.
This study was an analytical study with a prospective design on 75 COVID-19 patients who were treated. Subjects were divided into two large groups according to their degree of severity, 57 subjects with severe degrees and 18 subjects with non-severe degrees. The serum KL-6 levels were measured on days 0 and 6. Data were analyzed using paired -test and independent -test for data were normally distributed and Wilcoxon test and Mann Whitney test for data that were not normally distributed.
In this study, the mean serum KL-6 for day 0 in the severe group was higher than the non-severe group with values of 45.70 U/mL and 44.85 U/mL. On day 6, the mean serum KL-6 in the severe group was lower than that in the non-severe group with values of 41.3 U/mL and 41.95 U/mL. Serum KL-6 in the severe group experienced an even greater decrease than the non-severe group.
There was no significant association between serum KL-6 values on 0 days in the severity of COVID-19.
严重急性呼吸综合征冠状病毒2（SARS-CoV2）的主要靶标是肺的Ⅱ型肺泡上皮细胞（AT2）。SARS-CoV2逃避先天免疫系统，导致促炎细胞因子（白细胞介素-1β、白细胞介素-6、肿瘤坏死因子-α）释放，进而引起AT2细胞损伤。克雷伯氏肺细胞抗原（KL-6）是AT2细胞损伤的特异性生物标志物。KL-6在受损/再生的AT2细胞中产生。
关于KL-6在2019冠状病毒病（COVID-19）中作用的研究仍存在争议，且在印度尼西亚开展的相关研究较少。
本研究为一项前瞻性分析研究，纳入75例接受治疗的COVID-19患者。根据严重程度将受试者分为两大组，57例为重度组，18例为非重度组。在第0天和第6天测量血清KL-6水平。对于正态分布的数据，使用配对t检验和独立t检验进行分析；对于非正态分布的数据，使用威尔科克森检验和曼-惠特尼检验进行分析。
在本研究中，重度组第0天的血清KL-6均值高于非重度组，分别为45.70 U/mL和44.85 U/mL。在第6天，重度组的血清KL-6均值低于非重度组，分别为41.3 U/mL和41.95 U/mL。重度组血清KL-6的下降幅度比非重度组更大。
COVID-19严重程度与第0天血清KL-6值之间无显著关联。
