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血清KL-6和表面活性蛋白D:自身免疫相关间质性肺疾病中肺功能的标志物

Serum KL-6 and SP-D: Markers of Lung Function in Autoimmune-Related Interstitial Lung Diseases.

作者信息

Miądlikowska Ewa, Miłkowska-Dymanowska Joanna, Białas Adam Jerzy, Makowska Joanna Samanta, Lewandowska-Polak Anna, Puła Anna, Kumor-Kisielewska Anna, Piotrowski Wojciech Jerzy

机构信息

Department of Pneumology, Medical University of Lodz, 90-419 Lodz, Poland.

Department of Pulmonary Rehabilitation, Regional Medical Center for Lung Diseases and Rehabilitation, Blessed Rafal Chylinski Memorial Hospital for Lung Diseases, 91-520 Lodz, Poland.

出版信息

Int J Mol Sci. 2025 Jan 27;26(3):1091. doi: 10.3390/ijms26031091.

Abstract

This study evaluates the usefulness of serum KL-6, SP-D and TGF-β1 levels in assessing lung impairment and predicting interstitial lung disease (ILD) short-term progression in patients with interstitial pneumonia with autoimmune features (IPAF). A total of 24 patients with IPAF, 21 with connective tissue disease-associated ILD (CTD-ILD) and 23 with CTD without ILD were followed for 1 year. Serum levels of KL-6, SP-D and TGF-β1 were measured and their associations with disease severity and progression were analysed. KL-6, SP-D and TGF-β1 levels were significantly higher in IPAF and CTD-ILD patients compared to CTD without ILD ( < 0.0001, = 0.0005 and = 0.0001, respectively). KL-6 (r = 0.45, = 0.002) and SP-D (r = 0.35, = 0.02) levels correlated with lung involvement in HRCT in the ILD group. In IPAF, KL-6 levels correlated with pulmonary function tests (FVC%, TLCO%, and 6MWD) and SpO2, while SP-D correlated with 6MWD and SpO2. In CTD-ILD, KL-6 and SP-D levels were positively correlated with BAL cell count (KL-6: r = 0.58, = 0.04; SP-D: r = 0.63, and = 0.02). KL-6 also showed a negative correlation with the time since symptom onset (r = -0.51, = 0.02). No significant associations were found between the baseline biomarker levels and ILD progression risk. KL-6 and SP-D may serve as potential biomarkers for assessing lung impairment in IPAF, though their predictive value for short-term prognosis remains uncertain.

摘要

本研究评估血清KL-6、SP-D和转化生长因子-β1(TGF-β1)水平在评估自身免疫特征的间质性肺炎(IPAF)患者的肺损伤及预测间质性肺疾病(ILD)短期进展中的作用。共对24例IPAF患者、21例结缔组织病相关ILD(CTD-ILD)患者和23例无ILD的CTD患者进行了为期1年的随访。检测血清KL-6、SP-D和TGF-β1水平,并分析它们与疾病严重程度和进展的关系。与无ILD的CTD患者相比,IPAF和CTD-ILD患者的KL-6、SP-D和TGF-β1水平显著更高(分别为P<0.0001、P = 0.0005和P = 0.0001)。在ILD组中,KL-6(r = 0.45,P = 0.002)和SP-D(r = 0.35,P = 0.02)水平与HRCT上的肺部受累相关。在IPAF中,KL-6水平与肺功能测试(FVC%、TLCO%和6分钟步行距离[6MWD])及SpO2相关,而SP-D与6MWD和SpO2相关。在CTD-ILD中,KL-6和SP-D水平与支气管肺泡灌洗(BAL)细胞计数呈正相关(KL-6:r = 0.58,P = 0.04;SP-D:r = 0.63,P = 0.02)。KL-6还与症状出现后的时间呈负相关(r = -0.51,P = 0.02)。未发现基线生物标志物水平与ILD进展风险之间存在显著关联。KL-6和SP-D可能作为评估IPAF肺损伤的潜在生物标志物,尽管它们对短期预后的预测价值仍不确定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4df8/11817276/38a3935180bf/ijms-26-01091-g001.jpg

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