Decreased serum levels of Clara cell secretory protein (CC16) are associated with bronchiolitis obliterans and may permit early diagnosis in patients after allogeneic stem-cell transplantation
Decreased serum levels of Clara cell secretory protein (CC16) are associated with bronchiolitis obliterans and may permit early diagnosis in patients after allogeneic stem-cell transplantation
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DOI：
10.1097/01.tp.0000158354.39635.ab
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发表时间：
2005-05-27
期刊：
影响因子：
6.2
通讯作者：
Nord, M
中科院分区：
文献类型：
--
作者：
Mattsson, J;Remberger, M;Nord, M
背景闭塞性细支气管炎（130）是异基因干细胞移植（SCT）后常见的并发症，与高死亡率相关。早期诊断130例可改善预后。低水平的Clara细胞分泌蛋白（CC 16）先前已与肺移植受者中的130相关。在匹配的患者分析中，从8名130的患者、8名慢性移植物抗宿主病（GVHD）患者和8名既没有130也没有慢性GVHD的对照患者中收集血清样品。患者在诊断、预处理、供体匹配和GVHD预防方面进行匹配。另外7例BO患者也分别进行了分析。用酶联免疫吸附法测定CC 16。在匹配分析中，8例患者在SCT后中位数11.5个月（范围，4-13个月）诊断为130例，非匹配的130例患者在中位数12个月（范围，9-36个月）。在匹配的患者分析中，与仅患有慢性GVHD的患者或对照组相比，具有130的患者具有显著较低（P=0.03）或降低（P=0.02）的CC 16水平。在匹配的患者分析中，CC 16的测量显示灵敏度为88%，特异性为81%。以CC 16水平较低或与先前样品相比降低超过40%为标准，15例患者中有13例通过CC 16分析检测到BO。在13例患者中，有11例在130例临床诊断前的中位10个月（范围1-30个月）检测到CC 16的低值或降低值。低水平的CC 16与异基因SCT后的130相关。SCT后血清中CC 16的监测可能具有作为BO的早期标志物的潜力。
Background. Bronchiolitis obliterans (130) is a common complication and is associated with high mortality after allogeneic stem-cell transplantation (SCT). Early diagnosis of 130 may improve outcome. Low levels of Clara cell secretory protein (CC16) have previously been associated with 130 in lung transplant recipients.Methods. Serum samples were collected from eight patients with 130, eight patients with chronic graft-versus-host disease (GVHD), and eight control patients with neither 130 nor chronic GVHD in a matched patient analysis. Patients were matched for diagnosis, conditioning, donor match, and GVHD prophylaxis. Another seven patients with BO were also analyzed separately. CC 16 was measured with an enzyme-linked immunosorbent assay method.Results. In the matched analysis, eight patients were diagnosed with 130 at a median of 11.5 months (range, 4-13 months) after SCT and in nonmatched 130 patients at a median of 12 months (range, 9-36 months). In the matched patient analysis, patients with 130 had significantly lower (P=0.03) or decreasing (P=0.02) levels of CC16 compared with patients with only chronic GVHD or controls. In the matched patient analysis, measurement of CC16 showed a sensitivity of 88% and a specificity of 81%. With the criteria of low levels of CC16 or a decrease of more than 40% compared with the previous sample, BO was detected with analysis of CC16 in 13 of 15 patients. In 11 of the 13 patients, low or decreasing values of CC16 were detected at a median of 10 months (range, 1-30 months) before 130 was diagnosed clinically.Conclusions. Low levels of CC16 are associated with 130 after allogeneic SCT. Monitoring of CC16 in serum after SCT may have potential as an early marker for BO.