Comparative study of serum surfactant protein-D and KL-6 concentrations in patients with systemic sclerosis as markers for monitoring the activity of pulmonary fibrosis

OBJECTIVE: To clarify the clinical significance of surfactant protein-D (SP-D) and KL-6 in the diagnosis and monitoring of pulmonary fibrosis (PF) in patients with systemic sclerosis (SSc), and to evaluate the differences between SP-D and KL-6. METHODS: Serum SP-D and KL-6 concentrations were determ...

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Bibliographic Details
Published in:Journal of rheumatology 2004-06, Vol.31 (6), p.1112-1120
Main Authors: YANABA, Koichi, HASEGAWA, Minoru, TAKEHARA, Kazuhiko, SATO, Shinichi
Format: Article
Language:English
Subjects:
Adult
Antigens - blood
Antigens, Neoplasm
Biological and medical sciences
Biomarkers
Female
Glycoproteins - blood
Humans
Longitudinal Studies
Male
Medical sciences
Middle Aged
Mucin-1
Mucins
Pneumology
Pulmonary Fibrosis - blood
Pulmonary Fibrosis - diagnosis
Pulmonary Surfactant-Associated Protein D - blood
Respiratory system : syndromes and miscellaneous diseases
Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis
Scleroderma, Systemic - blood
Scleroderma, Systemic - diagnosis
Severity of Illness Index
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Summary:OBJECTIVE: To clarify the clinical significance of surfactant protein-D (SP-D) and KL-6 in the diagnosis and monitoring of pulmonary fibrosis (PF) in patients with systemic sclerosis (SSc), and to evaluate the differences between SP-D and KL-6. METHODS: Serum SP-D and KL-6 concentrations were determined by ELISA in 42 SSc patients. In a retrospective longitudinal study, 83 serum samples from 6 SSc patients were analyzed during a followup period of 0.6-6.3 years. RESULTS: SP-D and KL-6 concentrations at the first visit were higher in patients with SSc, especially those with PF, compared with healthy controls. Increased concentrations of SP-D were associated with decreased DLCO and decreased vital capacity in SSc patients more strongly than those of KL-6. The sensitivity and specificity for PF were 91% and 88% for SP-D and 39% and 100% for KL-6, respectively. In the longitudinal study, both SP-D and KL-6 concentrations were associated with activity of PF in patients with SSc. SP-D concentrations changed more rapidly than KL-6 concentrations, in parallel with the PF activity. CONCLUSION: SP-D was a more sensitive marker for PF than KL-6. By contrast, KL-6 showed higher specificity than SP-D. Combined use of these 2 serum markers would be more helpful to diagnose and monitor the PF activity in patients with SSc than single use of each marker.
ISSN:0315-162X
1499-2752