PMID- 33267857 OWN - NLM STAT- MEDLINE DCOM- 20210809 LR - 20210809 IS - 1471-2466 (Electronic) IS - 1471-2466 (Linking) VI - 20 IP - 1 DP - 2020 Dec 2 TI - Serum SP-A and KL-6 levels can predict the improvement and deterioration of patients with interstitial pneumonia with autoimmune features. PG - 315 LID - 10.1186/s12890-020-01336-y [doi] LID - 315 AB - BACKGROUND: Some patients with interstitial pneumonia with autoimmune features (IPAF) showed a progressive course despite therapy. This study aimed to evaluate whether serial changes in the serum levels of surfactant protein-A (SP-A) and Krebs von den Lungen-6 (KL-6) can predict disease progression. METHODS: Sixty-four patients with IPAF and 41 patients with non-fibrotic lung disease (non-FLD) were examined. Based on long-term changes in lung function, 36 IPAF patients who were followed up for more than 3 months were divided into a progressive group (n = 9), an improvement group (n = 13), and a stable group (n = 14). Serum KL-6 and SP-A levels were measured. The sensitivity, specificity, cut-off value, and area under the curve (AUC) value for each of the indices were determined using receiver operating characteristic (ROC) curve analysis. The expression differences in these biomarkers and their correlation with disease severity were analyzed. RESULTS: Compared with non-FLD patients, serum SP-A and KL-6 levels in IPAF patients were increased significantly [SP-A: (p < 0.001); KL-6: (p < 0.001)] and negatively correlated with DLCO (SP-A: r(S) = - 0.323, p = 0.018; KL-6: r(S) = - 0.348, p = 0.0011). In patients with progressive disease, the posttreatment serum SP-A and KL-6 levels were increased significantly compared with pretreatment levels [SP-A: (p = 0.021); KL-6: (p = 0.008)]. In patients showing improvement, the levels were decreased significantly [SP-A (p = 0.007) and KL-6 (p = 0.002)]. Changes in serum biomarkers (Delta SP-A and Delta KL-6) were significantly negatively correlated with changes in lung function (Delta FVC, Delta DLCO and Delta FEV1) (r(S) = 0.482, p < 0.05). A significant positive correlation was found between Delta SP-A and Delta KL-6 (r(S) = 0.482, p < 0.001). CONCLUSIONS: Serum SP-A and KL-6 offer high sensitivity and specificity for the diagnosis of IPAF. The decrease in serum SP-A and/or KL-6 levels in patients with IPAF is related to the improvement in pulmonary function. SP-A and KL-6 may be important biomarkers for predicting disease progression in patients with IPAF. FAU - Wang, Jingxian AU - Wang J AD - Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, 510120, China. AD - National joint local engineering laboratory for Cell Engineering and Biomedicine Technique, Gui zhou Province Key Laboratory of Regenerative Medicine, Key Laboratory of Adult Stem Cell Translational Research (Chinese Academy of Medical Sciences), Guizhou Medical University, Guiyang, China. FAU - Zheng, Peiyan AU - Zheng P AD - Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, 510120, China. FAU - Huang, Zhifeng AU - Huang Z AD - Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, 510120, China. FAU - Huang, Huimin AU - Huang H AD - Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, 510120, China. FAU - Xue, Mingshan AU - Xue M AD - Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, 510120, China. FAU - Liao, Chenxi AU - Liao C AD - Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, 510120, China. FAU - Sun, Baoqing AU - Sun B AD - Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, 510120, China. sunbaoqing@vip.163.com. FAU - Zhong, Nanshan AU - Zhong N AD - Department of Allergy and Clinical Immunology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, 510120, China. nanshan@vip.163.com. LA - eng GR - NSFC 81871736/National Natural Science Foundation of China/ GR - ZH201818/Training Program of the first affiliated Hospital of Guangzhou Medical University/ GR - A2019224/Medical Research Fund Project of Guangdong Province/ GR - 20202A011017/Guangzhou Science and Technology Project of traditional Chinese Medicine and Integrated traditional Chinese and Western Medicine/ GR - SKLRD-MS-201906, SKLRD-OP-201803/State Key Laboratory of Respiratory Disease Foundation/ PT - Journal Article DEP - 20201202 PL - England TA - BMC Pulm Med JT - BMC pulmonary medicine JID - 100968563 RN - 0 (Biomarkers) RN - 0 (Mucin-1) RN - 0 (Pulmonary Surfactant-Associated Protein A) SB - IM MH - Adult MH - Aged MH - Area Under Curve MH - Biomarkers/blood MH - Disease Progression MH - Female MH - Humans MH - Idiopathic Interstitial Pneumonias/*blood/*diagnosis MH - Logistic Models MH - Male MH - Middle Aged MH - Mucin-1/*blood MH - Pulmonary Surfactant-Associated Protein A/*blood MH - ROC Curve MH - Respiratory Function Tests MH - Retrospective Studies MH - Risk Factors MH - Sensitivity and Specificity PMC - PMC7709263 OTO - NOTNLM OT - Interstitial pneumonia with autoimmune features OT - Krebs von den Lungen-6 OT - Non-fibrotic lung diseases OT - Surfactant protein-a COIS- The authors declare that they have no competing interests. EDAT- 2020/12/04 06:00 MHDA- 2021/08/10 06:00 PMCR- 2020/12/02 CRDT- 2020/12/03 05:27 PHST- 2020/06/19 00:00 [received] PHST- 2020/11/03 00:00 [accepted] PHST- 2020/12/03 05:27 [entrez] PHST- 2020/12/04 06:00 [pubmed] PHST- 2021/08/10 06:00 [medline] PHST- 2020/12/02 00:00 [pmc-release] AID - 10.1186/s12890-020-01336-y [pii] AID - 1336 [pii] AID - 10.1186/s12890-020-01336-y [doi] PST - epublish SO - BMC Pulm Med. 2020 Dec 2;20(1):315. doi: 10.1186/s12890-020-01336-y.