Calgranulin B and KL-6 in Bronchoalveolar Lavage of Patients with IPF and NSIP
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ORIGINAL ARTICLE
Calgranulin B and KL-6 in Bronchoalveolar Lavage of Patients with IPF and NSIP David Bennett ,1,3 Martina Salvini,1 Annalisa Fui,1 Giuseppe Cillis,1 Paolo Cameli,1 Maria Antonietta Mazzei,2 Antonella Fossi,1 Rosa Metella Refini,1 and Paola Rottoli1
Idiopathic pulmonary fibrosis (IPF) and non-specific interstitial pneumonia (NSIP) are the most frequent idiopathic interstitial pneumonias. The aim of this study was to evaluate concentrations of calgranulin B and Krebs von den Lungen 6 (KL-6) in bronchoalveolar lavage (BAL) fluid of patients with IPF and idiopathic NSIP (i-NSIP) with fibrotic pattern. Thirty patients with IPF (68.73 ± 8.63 years), 30 with i-NSIP (68.33 ± 7.45 years), and healthy controls were included in the study. Calgranulin B and KL-6 both proved to be significantly higher in BAL of IPF and i-NSIP patients than in healthy controls (p < 0.05). Calgranulin B showed several significant correlations with functional parameters (oxygen demand at rest, 6-min walking test (6MWT), and PFTs); KL-6 was correlated with oxygen demand at rest and during 6MWT. Patients with higher concentrations of both biomarkers (> 75th percentile) had more advanced disease with lower values of FEV1%, FVC%, RV%, TLC%, DLCO% of predicted, distance walked in 6MWT, and BAL neutrophil percentage. Calgranulin B and KL-6 in BAL proved to be reliable biomarkers of IPF and i-NSIP and to have prognostic meaning, discriminating severe and advanced patients. The combination of the two biomarkers can facilitate the stratification of severity.
Abstract—
KEY WORDS: biomarkers; bronchoalveolar lavage; calgranulin B; KL-6; idiopathic pulmonary fibrosis; non-specific interstitial pneumonia.
INTRODUCTION Idiopathic pulmonary fibrosis (IPF) and non-specific interstitial pneumonia (NSIP) are the most frequent entities Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10753-018-00955-2) contains supplementary material, which is available to authorized users. 1
Respiratory Diseases and Lung Transplantation Unit, AOUS - Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci, 16 –, 53100 Siena, Italy 2 Diagnostic Imaging Unit, AOUS - Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy 3 To whom correspondence should be addressed at Respiratory Diseases and Lung Transplantation Unit, AOUS - Department of Medical, Surgical and Neurological Sciences, University of Siena, Viale Bracci, 16 –, 53100 Siena, Italy. E-mail: [email protected]
among the idiopathic interstitial pneumonias [1]. Idiopathic pulmonary fibrosis is defined as a specific form of chronic progressive fibrosing interstitial pneumonia of unknown cause, associated with the histopathologic and/or radiological pattern of usual interstitial pneumonia [2]. Non-specific interstitial pneumonia can present with two main variants: the fibrotic form or the cellular form dominated by inflammation, CT evidence of ground glass pattern, and histological evid
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