Correlation of serum Krebs von den Lungen-6 levels with fibrosis score on high resolution chest tomography and pulmonary function parameters in treatment naïve Idiopathic Pulmonary Fibrosis
KL-6 is released in the blood stream when these cells proliferate, are stimulated or injured and the permeability of the alveolar capillary barrier is altered. Hence, serum KL-6 is considered marker of alveolar damage in ILD. KL-6 has a prognostic value, as high levels >1000 U/ml are associated with a bad prognosis. While serum Krebs von den Lungen-6 (KL-6) has been found to be a helpful biomarker in interstitial lung diseases for evaluating disease severity and progression, especially in connective tissue disease-associated interstitial lung disease (CTD ILD) and idiopathic non-specific interstitial pneumonia (NSIP), data on correlation of serum KL-6 levels with radiological fibrosis and pulmonary function parameters is lacking in treatment naïve Idiopathic Pulmonary Fibrosis (IPF) patients.
The aim of our study was to estimate correlation of serum KL-6 levels with HRCT fibrosis score and lung function parameters in treatment naïve IPF patients. Serum KL-6 levels were measured in thirty-nine treatment naïve newly detected IPF patients using automated immunofluorescence enzyme assay (AIA) with ST AIA-PACK KL-6 by Tosoh Corporation– Bioscience Division, Tokyo, Japan.
Our study elucidates the relationship between serum KL-6 levels with the proportion of fibrosis on HRCT thorax, and association with clinical symptoms and lung function parameters in treatment naïve IPF patients. Serum KL-6 levels showed a positive correlation with the degree of fibrotic abnormalities on HRCT thorax and pulmonary function parameters, indicating a potential use of serum KL-6 in monitoring of parenchymal fibrosis in Idiopathic Pulmonary fibrosis. We found a negative correlation of serum KL-6 with pulmonary function parameters like FVC, DLco, Kco, TLC and 6MWD as depicted in results which is easily understood by the drop in values of these parameters with increasing fibrosis in IPF patients.
As serum level of KL-6 is directly related to amount of regeneration of type II alveolar epithelial cells, the serum levels may be low in early IPF with reticulations and the levels may rise as the damage proceeds and manifest radiologically as traction bronchiolectasis/bronchiectasis and honeycombing.
The study showed that high KL-6 level was an important discriminating factor of ILD and it might be a useful predictor for the severity of ILD.
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