Plasma KL-6 predicts the development and outcome of bronchopulmonary dysplasia.
Circulating KL-6 is a specific indicator of pulmonary injury affecting the alveolar epithelium and interstitium. Our preliminary study suggested the usefulness of plasma KL-6 as a marker of bronchopulmonary dysplasia (BPD). To confirm the diagnostic value of KL-6 for BPD as well as to determine the reference range, we conducted a larger prospective study in 135 preterm infants <32 wk GA. Among the infants without oxygen dependence at a postconceptional age of 36 wk, the plasma KL-6 level showed no significant association with GA at any time. Among 42 infants <28 wk GA, plasma KL-6 levels were significantly higher in those with moderate/severe BPD compared with those with no/mild BPD. A plasma level of 199 U/mL at 1 wk or 232 U/mL at 2 wk was an excellent predictor of moderate/severe BPD <28 wk GA (positive predictive value of 83% and 80%, respectively). Unlike nonspecific markers of inflammation or fibrosis, KL-6 objectively reflects the severity of pulmonary injury irrespective of the treatment or the radiographic changes. Therefore, not only as a good marker, measurement of KL-6 may also help to provide new insights into the pathogenesis of BPD.
Ogihara
Tohru
T
Department of Neonatal Medicine, Perinatal Center, Osaka Medical College, Takatsuki, Osaka 569-8686, Japan. ped025@poh.osaka-med.ac.jp
Hirano
Kazuya
K
Morinobu
Takao
T
Kim
Han-Suk
HS
Ogawa
Satoru
S
Hiroi
Mayo
M
Oue
Shinya
S
Ban
Ryoichi
R
Hira
Seigo
S
Hasegawa
Masashi
M
Yamaoka
Shigeo
S
Yasui
Masako
M
D000951:Antigens, Neoplasm / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001997:Bronchopulmonary Dysplasia / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D018396:Mucin-1; D009077:Mucins / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D012372:ROC Curve; D012016:Reference Values; D015203:Reproducibility of Results
D000951:Antigens, Neoplasm; D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1; D009077:Mucins