血清生物标志物与类风湿关节炎间质性肺疾病肺部受累的关联：来自韩国铁路队列基线数据
Association of Serum Biomarkers With Pulmonary Involvement of Rheumatoid Arthritis Interstitial Lung Disease: From KORAIL Cohort Baseline Data.
作者信息
Moon Jinyoung, Lee Jeong Seok, Yoon Young Im, Chang Sung Hae, Lee Yeon Ah, Ha You-Jung, Kang Eun Ha, Park Yong-Beom, Lee Hwajeong, Choe Jung-Yoon, Lee Eun Young
机构信息
Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea.
出版信息
J Rheum Dis. 2021 Oct 1;28(4):234-241. doi: 10.4078/jrd.2021.28.4.234.
OBJECTIVE
The increase in mortality in rheumatoid arthritis (RA) patients with interstitial lung disease (ILD) is well known However, there are few studies on serum markers that can evaluate acute exacerbation or prognosis in RA-ILD patients The purpose of this study was to identify the association between biomarkers and lung lesions in patients with RA-ILD.
METHODS
We analyzed 153 patients with serum samples in a prospective, multicenter cohort of Korean RA-ILD patients The serum levels of biomarkers, matrix metalloproteinase (MMP-7), surfactant protein-D (SP-D), and Krebs von den Lungen-6 (KL-6) were measured and correlated with forced vital capacity (FVC), diffusing capacity for carbon monoxide (DLCO) and the results of computed tomography (CT) CT results were interpreted semi-quantitatively according to the extent of lung lesions (grade 1, 0%∼25%; grade 2, 26%∼50%; grade 3, 51%∼75%; grade 4, 76%∼100%).
RESULTS
MMP-7, SP-D, and KL-6 were negatively correlated with FVC (MMP-7, r=-0267, p=0001; SP-D, r=-0250, p=0002; KL-6, r=-0223, p=0006) and DLCO (MMP-7, r=-0404, p<0001; SP-D, r=-0286, p=0001; KL-6, r=-0226, p=0007) In addition, MMP-7, SP-D, and KL-6 tended to increase with higher grades of lung lesions on CT (MMP-7, p=0013; SP-D, p<0001; KL-6, p<0001).
CONCLUSION
MMP-7, SP-D, and KL-6 can be used to evaluate the functional and anatomical status of lung involvement in the RA-ILD patients.
目的
类风湿关节炎（RA）合并间质性肺疾病（ILD）患者死亡率增加是众所周知的。然而，关于可评估RA-ILD患者急性加重或预后的血清标志物的研究较少。本研究的目的是确定RA-ILD患者生物标志物与肺部病变之间的关联。
方法
我们在一个前瞻性、多中心的韩国RA-ILD患者队列中分析了153例有血清样本的患者。测量生物标志物基质金属蛋白酶（MMP-7）、表面活性蛋白-D（SP-D）和克雷伯斯-冯-登-龙根-6（KL-6）的血清水平，并将其与用力肺活量（FVC）、一氧化碳弥散量（DLCO）以及计算机断层扫描（CT）结果相关联。根据肺部病变程度（1级，0%至25%；2级，26%至50%；3级，51%至75%；4级，76%至100%）对CT结果进行半定量解释。
结果
MMP-7、SP-D和KL-6与FVC呈负相关（MMP-7，r = -0.267，p = 0.001；SP-D，r = -0.250，p = 0.002；KL-6，r = -0.223，p = 0.006）以及与DLCO呈负相关（MMP-7，r = -0.404，p < 0.001；SP-D，r = -0.286，p = 0.001；KL-6，r = -0.226，p = 0.007）。此外，MMP-7、SP-D和KL-6在CT上往往随着肺部病变等级的升高而增加（MMP-7，p = 0.013；SP-D，p < 0.001；KL-6，p < 0.001）。
结论
MMP-7、SP-D和KL-6可用于评估RA-ILD患者肺部受累的功能和解剖状态。
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