title: Serum KL-6 level and the development of bronchiolitis obliterans syndrome in lung transplant recipients.
abstract: KL-6 is a glycoprotein expressed by pulmonary epithelial cells, and its serum level has been used as a marker of disease activity in a variety of respiratory illnesses. Previously, we showed that KL-6 was elevated in lung transplant recipients diagnosed with BOS. In this study, we followed serum KL-6 levels and lung functions prospectively in lung transplant recipients who were within the first five-yr post-transplant and had no evidence of BOS at the time of study entry. Mean peak KL-6 levels were 596.16 ± 309.32 U/mL in the nine recipients who developed BOS compared to 352.41 ± 140.68 in 36 recipients who did not (p = 0.05). Six of the nine patients with BOS had an absolute rise in KL-6 above baseline level >200 U/mL compared to two of the 37 who had the same increase in KL-6 but did not develop BOS. Using the 200 U/mL elevation of KL-6 from baseline as a threshold for a positive test would produce a sensitivity of 67%, specificity of 95%, PPV of 75%, and a NPV of 92%. In addition, mean KL-6 levels of patients during acute rejection were not significantly elevated compared to the prerejection mean KL-6 levels (p = 0.71). We conclude that serum KL-6 is a relatively specific marker of BOS in lung transplant recipients.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
authors.forename: Brent
authors.initials: B
authors.lastname: Haberman
authors.forename: Minh L
authors.initials: ML
authors.lastname: Doan
authors.forename: E O'Brian
authors.initials: EO
authors.lastname: Smith
authors.forename: Marc G
authors.initials: MG
authors.lastname: Schecter
authors.forename: George B
authors.initials: GB
authors.lastname: Mallory
authors.forename: Okan
authors.initials: O
authors.lastname: Elidemir
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001989:Bronchiolitis Obliterans / Q000097:blood / Q000150:complications* / Q000235:genetics*; D002648:Child; D005260:Female; D005355:Fibrosis / Q000473:pathology; D006801:Humans; D008171:Lung Diseases / Q000097:blood / Q000628:therapy*; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D018396:Mucin-1 / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C060192:MUC1 protein, human; D018396:Mucin-1