血清B细胞活化因子与结缔组织病相关间质性肺疾病中的肺部超声B线
Serum B-cell activating factor and lung ultrasound B-lines in connective tissue disease related interstitial lung disease.
作者信息
Wang Yukai, Xie Xuezhen, Zheng Shaoyu, Du Guangzhou, Chen Shaoqi, Zhang Weijin, Zhuang Jinghua, Lin Jianqun, Hu Shijian, Zheng Kedi, Mikish Angelina, Xu Zhuangyong, Zhang Guohong, Gargani Luna, Bruni Cosimo, Hoffmann-Vold Anna-Maria, Matucci-Cerinic Marco, Furst Daniel E
机构信息
Department of Rheumatology and Immunology, Shantou Central Hospital, Shantou, Guangdong, China.
Department of Radiology, Shantou Central Hospital, Shantou, Guangdong, China.
出版信息
Front Med (Lausanne). 2022 Dec 15;9:1066111. doi: 10.3389/fmed.2022.1066111. eCollection 2022.
OBJECTIVE
To investigate the role of serum B-cell activating factor (BAFF) and lung ultrasound (LUS) B-lines in connective tissue disease related interstitial lung disease (CTD-ILD), and their association with different ILD patterns on high resolution computed tomography (HRCT) of chest.
METHODS
We measured the levels of BAFF and KL-6 by ELISA in the sera of 63 CTD-ILD patients [26 with fibrotic ILD (F-ILD), 37 with non-fibrotic ILD (NF-ILD)], 30 CTD patients without ILD, and 26 healthy controls. All patients underwent chest HRCT and LUS examination.
RESULTS
Serum BAFF levels were significantly higher in CTD patients compared to healthy subjects (617.6 ± 288.1 pg/ml vs. 269.0 ± 60.4 pg/ml, < 0.01). BAFF concentrations were significantly different between ILD group and non-ILD group (698.3 ± 627.4 pg/ml vs. 448.3 ± 188.6 pg/ml, < 0.01). In patients with ILD, BAFF concentrations were significantly correlated with B-lines number ( = 0.37, 95% CI 0.13-0.56, < 0.01), KL-6 level ( = 0.26, 95% CI 0.01-0.48, < 0.05), and Warrick score ( = 0.33, 95% CI 0.09-0.53, < 0.01), although all correlations were only low to moderate. B-lines number correlated with Warrick score ( = 0.65, 95% CI 0.48-0.78, < 0.01), and KL-6 levels ( = 0.43, 95% CI 0.21-0.61, < 0.01). Patients with F-ILD had higher serum BAFF concentrations (957.5 ± 811.0 pg/ml vs. 516.1 ± 357.5 pg/ml, < 0.05), KL-6 levels (750.7 ± 759.0 U/ml vs. 432.5 ± 277.5 U/ml, < 0.05), B-lines numbers (174.1 ± 82 vs. 52.3 ± 57.5, < 0.01), and Warrick score (19.9 ± 4.6 vs. 13.6 ± 3.4, < 0.01) vs. NF-ILD patients. The best cut-off values to separate F-ILD from NF-ILD using ROC curves were 408 pg/ml for BAFF (AUC = 0.73, < 0.01), 367 U/ml for KL-6 (AUC = 0.72, < 0.05), 122 for B-lines number (AUC = 0.89, < 0.01), and 14 for Warrick score (AUC = 0.87, < 0.01) respectively.
CONCLUSION
Serum BAFF levels and LUS B-lines number could be useful supportive biomarkers for detecting and evaluating the severity and/or subsets of CTD-ILD. If corroborated, combining imaging, serological, and sonographic biomarkers might be beneficial and comprehensive in management of CTD-ILD.
目的
探讨血清B细胞活化因子（BAFF）和肺部超声（LUS）B线在结缔组织病相关间质性肺病（CTD-ILD）中的作用，以及它们与胸部高分辨率计算机断层扫描（HRCT）上不同ILD模式的相关性。
方法
我们采用酶联免疫吸附测定（ELISA）法检测了63例CTD-ILD患者[26例纤维化ILD（F-ILD），37例非纤维化ILD（NF-ILD）]、30例无ILD的CTD患者和26例健康对照者血清中BAFF和KL-6的水平。所有患者均接受胸部HRCT和LUS检查。
结果
与健康受试者相比，CTD患者血清BAFF水平显著升高（617.6±288.1 pg/ml对269.0±60.4 pg/ml，P<0.01）。ILD组和非ILD组的BAFF浓度有显著差异（698.3±627.4 pg/ml对448.3±188.6 pg/ml，P<0.01）。在ILD患者中，BAFF浓度与B线数量（r=0.37，95%CI 0.13-0.56，P<0.01）、KL-6水平（r=0.26，95%CI 0.01-0.48，P<0.05）和Warrick评分（r=0.33，95%CI 0.09-0.53，P<0.01）显著相关，尽管所有相关性仅为低到中度。B线数量与Warrick评分（r=0.65，95%CI 0.48-0.78，P<0.01）和KL-6水平（r=0.43，95%CI 0.21-0.61，P<0.01）相关。与NF-ILD患者相比，F-ILD患者的血清BAFF浓度（957.5±811.0 pg/ml对516.1±357.5 pg/ml，P<0.05）、KL-6水平（750.7±759.0 U/ml对432.5±277.5 U/ml，P<0.05）、B线数量（174.1±82对52.3±57.5，P<0.01）和Warrick评分（19.9±4.6对13.6±3.4，P<0.01）更高。使用ROC曲线将F-ILD与NF-ILD区分开的最佳截断值分别为：BAFF为408 pg/ml（AUC=0.73，P<0.01），KL-6为367 U/ml（AUC=0.72，P<0.05），B线数量为122（AUC=0.89，P<0.01），Warrick评分为14（AUC=0.87，P<0.01）。
结论
血清BAFF水平和LUS B线数量可能是检测和评估CTD-ILD严重程度和/或亚型的有用辅助生物标志物。如果得到证实，结合影像学、血清学和超声生物标志物在CTD-ILD的管理中可能是有益且全面的。
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