Respiratory Diseases Unit, Department of Medical and Surgical Sciences & Neuro-Sciences, University of Siena, Siena, Italy.
Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
J Clin Lab Anal. 2024 Oct;38(19-20):e25108. doi: 10.1002/jcla.25108. Epub 2024 Sep 25.
Interstitial lung diseases (ILD) is a group of lung disorders characterized by interstitial lung thickening due to inflammatory and fibrotic processes. Krebs von den Lungen-6 (KL-6) is a molecule secreted by damaged type II alveolar pneumocytes in the alveolar space. The goal of the present study was to compare two detection methods of KL-6 in both bronchoalveolar lavage (BAL) and serum from ILD patients at the moment of diagnosis.
Patients with suspicious of ILD and followed at two Italian referral centres for rare lung diseases were included in the study. BAL fluid and serum were collected and analysed by chemiluminescent enzyme immunoassay (CLEIA) and fluorescent enzyme immunoassay (FEIA) methods provided by Tosoh Biosciences.
A total of 158 (mean age ± standard deviation, 61.5 ± 13.7, 65 females) patients were enrolled. A total of, 36 had diagnosis of idiopathic pulmonary fibrosis (IPF), 74 sarcoidosis, 15 connective tissue disease-ILD (CTD-ILD) and 33 other ILD. Diagnostic agreement between two methods was demonstrated for both BAL (r = 0.707, p < 0.0001) and serum (r = 0.816, p < 0.0001). BAL KL-6 values were lower than serum (p < 0.0001). IPF patients had higher serum KL-6 concentration than other ILDs (p = 0.0294), while BAL KL-6 values were lower in IPF than in non-IPF (p = 0.0023).
This study explored KL-6 concentrations through the CLEIA method in serum and BAL of patients with various ILDs, showing significant differences of biomarkers concentrations between IPF and other non-IPF ILDs. Our findings are promising as they provided further knowledge concerning KL-6 expression across different ILDs and may suggest its utility in differential diagnosis.
间质性肺疾病（ILD）是一组以肺泡空间中由于炎症和纤维化过程导致的间质肺增厚为特征的肺部疾病。Krebs von den Lungen-6（KL-6）是一种由受损的 II 型肺泡上皮细胞在肺泡空间中分泌的分子。本研究的目的是比较两种检测方法在ILD 患者诊断时支气管肺泡灌洗液（BAL）和血清中 KL-6 的检测结果。
纳入了在意大利两个罕见肺部疾病转诊中心就诊的疑似 ILD 患者。收集 BAL 液和血清，采用 Tosoh Biosciences 提供的化学发光酶免疫分析法（CLEIA）和荧光酶免疫分析法（FEIA）进行分析。
共纳入 158 名患者（平均年龄±标准差，61.5±13.7，65 名女性）。其中，36 名患者被诊断为特发性肺纤维化（IPF），74 名患者为结节病，15 名患者为结缔组织病-ILD（CTD-ILD），33 名患者为其他 ILD。两种方法在 BAL（r=0.707，p<0.0001）和血清（r=0.816，p<0.0001）中的诊断一致性均得到了证实。BAL KL-6 值低于血清（p<0.0001）。与其他 ILD 相比，IPF 患者的血清 KL-6 浓度更高（p=0.0294），而 IPF 患者的 BAL KL-6 值低于非 IPF 患者（p=0.0023）。
本研究通过 CLEIA 法在不同 ILD 患者的血清和 BAL 中检测 KL-6 浓度，结果显示 IPF 和其他非 IPF ILD 之间的生物标志物浓度存在显著差异。我们的发现很有前景，因为它们进一步了解了 KL-6 在不同 ILD 中的表达，并可能提示其在鉴别诊断中的应用。
