Alp Gizem Tuğçe, Vasi İbrahim, Alp Emre, Güler Aslıhan Avanoğlu, Karadeniz Hazan, Gülbahar Özlem, Erden Abdulsamet, Tufan Abdurrahman, Öztürk Mehmet Akif, Göker Berna, Haznedaroğlu Şeminur, Küçük Hamit
Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.
Division of Rheumatology, Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.
Biomark Med. 2025 May;19(9):349-355. doi: 10.1080/17520363.2025.2485014. Epub 2025 Apr 1.
Lungs are among the most affected organs in systemic sclerosis (SSc), with interstitial lung disease (ILD) being a leading cause of mortality. Biomarkers are increasingly explored for predicting SSc-ILD detection and progression. This study evaluates the roles of Krebs von den Lungen-6 (KL-6), surfactant protein D (SP-D), and peroxiredoxin-4 (PRDX-4) in diagnosing SSc-ILD and monitoring progression.
A total of 89 individuals (61 SSc patients and 28 healthy volunteers) were included. SSc patients were grouped based on pulmonary function tests and high-resolution computed tomography findings to determine SSc-ILD presence. Patients with SSc-ILD were further categorized by progressive pulmonary fibrosis (PPF) presence based on 2022 guidelines. Serum KL-6, SP-D, and PRDX-4 levels were measured using the Enzyme-Linked Immuno-Sorbent Assay method.
Of the 61 SSc patients, 34 (55.7%) had ILD. Serum KL-6 and PRDX-4 levels were significantly higher in SSc-ILD patients ( = 0.004 and = 0.012, respectively). KL-6, SP-D, and PRDX-4 levels were elevated in the PPF group compared to stable disease ( = 0.001). PRDX-4 showed the highest diagnostic performance for PPF (AUC: 0.936, sensitivity: 85.7%, specificity: 85%).
KL-6 is a well-established biomarker for SSc-ILD, but PRDX-4 offers superior diagnostic accuracy, especially in identifying PPF.
肺部是系统性硬化症（SSc）中受影响最严重的器官之一，间质性肺疾病（ILD）是主要的死亡原因。人们越来越多地探索生物标志物以预测SSc-ILD的检测和进展。本研究评估了克雷伯氏肺表面活性物质相关蛋白-6（KL-6）、表面活性蛋白D（SP-D）和过氧化物酶还原蛋白4（PRDX-4）在诊断SSc-ILD和监测疾病进展中的作用。
共纳入89名个体（61名SSc患者和28名健康志愿者）。根据肺功能测试和高分辨率计算机断层扫描结果对SSc患者进行分组，以确定是否存在SSc-ILD。根据2022年指南，将SSc-ILD患者进一步按是否存在进行性肺纤维化（PPF）分类。采用酶联免疫吸附测定法测量血清KL-6、SP-D和PRDX-4水平。
61名SSc患者中，34名（55.7%）患有ILD。SSc-ILD患者的血清KL-6和PRDX-4水平显著更高（分别为=0.004和=0.012）。与病情稳定组相比，PPF组的KL-6、SP-D和PRDX-4水平升高（=0.001）。PRDX-4对PPF的诊断性能最高（曲线下面积：0.936，敏感性：85.7%，特异性：85%）。
KL-6是SSc-ILD公认的生物标志物，但PRDX-4具有更高的诊断准确性，尤其是在识别PPF方面。
