Circulating KL-6 levels in patients with drug induced pneumonitis
Circulating KL-6 levels in patients with drug induced pneumonitis
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DOI：
10.1136/thorax.58.10.872
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发表时间：
2003-10-01
期刊：
影响因子：
10
通讯作者：
Kohno, N
中科院分区：
文献类型：
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作者：
Ohnishi, H;Yokoyama, A;Kohno, N
背景：KL-6/MUC1 的循环水平是各种间质性肺疾病的敏感标志物。之前的病例报告表明，一些药物性肺炎患者的 KL-6 也可能升高。进行了一项研究以确定血清 KL-6 是否可以作为特定类型药物诱发肺炎的标志物。方法：由两名独立观察者分别审查 30 名药物诱发肺炎患者的高分辨率计算机断层扫描 (HRCT) 胸部扫描结果。肺炎分为四种主要模式：广泛的双侧实变（弥漫性肺泡损伤，DAD；n = 7），伴或不伴实变的纤维化（慢性间质性肺炎，CIP；n = 11），不伴纤维化的实变（闭塞性细支气管炎机化性肺炎或嗜酸粒细胞性肺炎，BOOP/EP；n = 8），以及不伴纤维化的弥漫性磨玻璃样混浊（超敏反应）肺炎，HP；n = 4)。采用夹心酶联免疫吸附法测定血清KL-6水平。结果：血清KL-6检测药物性肺疾病的总体敏感性为53.3%，低于检测其他间质性肺疾病的敏感性。然而，大多数 DAD 或 CIP 模式患者的 KL-6 水平升高（16/18；88.9%），并且与其临床病程密切相关。相比之下，所有具有 BOOP/EP 或 HP 模式的患者的血清 KL-6 水平均在正常范围内。结论：HRCT 扫描检测到的特定模式（例如 DAD 和 CIP，但不是 BOOP/EP 或 HP 模式）与药物性肺炎中循环 KL-6 水平升高相关。血清 KL-6 水平可以反映特定疾病的临床活动。
Background: The circulating level of KL-6/MUC1 is a sensitive marker for various interstitial lung diseases. Previous case reports have suggested that KL-6 may also be increased in some patients with drug induced pneumonitis. A study was undertaken to determine whether serum KL-6 could be a marker for particular types of drug induced pneumonitis.Methods: The findings of high resolution computed tomographic (HRCT) chest scans of 30 patients with drug induced pneumonitis were reviewed separately by two independent observers. The pneumonitis was classified into four predominant patterns: widespread bilateral consolidation ( diffuse alveolar damage, DAD; n = 7), fibrosis with or without consolidation ( chronic interstitial pneumonia, CIP; n = 11), consolidation without fibrosis ( bronchiolitis obliterans organising pneumonia or eosinophilic pneumonia, BOOP/EP; n = 8), and diffuse ground glass opacities without fibrosis ( hypersensitivity pneumonitis, HP; n = 4). Serum KL-6 levels were measured by a sandwich enzyme linked immunosorbent assay.Results: The overall sensitivity of serum KL-6 in detecting drug induced lung disease was 53.3%, which was lower than its sensitivity in detecting other interstitial lung diseases. However, the KL-6 level was increased in most patients with a DAD or CIP pattern (16/18; 88.9%) and was closely correlated with their clinical course. In contrast, serum KL-6 levels were within the normal range in all patients with a BOOP/EP or HP pattern.Conclusions: Particular patterns detected by HRCT scanning, such as DAD and CIP but not the BOOP/EP or HP patterns, are associated with increased circulating KL-6 levels in drug induced pneumonitis. Serum KL-6 levels may reflect the clinical activity of the particular disorders.