title: Surfactant protein-D is more useful than Krebs von den Lungen 6 as a marker for the early diagnosis of interstitial pneumonitis during pegylated interferon treatment for chronic hepatitis C.
abstract: OBJECTIVE
  To examine the usefulness of serum Krebs von den Lungen 6 (KL-6) and surfactant protein-D (SP-D) as markers of interstitial pneumonitis. Many antiviral therapies have become available for chronic hepatitis C, including pegylated interferon (PEGIFN) plus ribavirin. Since interstitial pneumonitis is a serious adverse drug reaction during interferon therapy, interferon treatment requires caution in respiratory disease patients. Hence, the predictors of interstitial pneumonitis have not been elucidated.
  
  
  METHODS
  Fifty-two chronic hepatitis C patients who received PEG-IFN plus ribavirin were studied; 14 patients received PEGIFN-α 2a, and 38 received PEG-IFN-α 2b. Serum KL-6 and SP-D levels were measured during treatment. Time changes in serum KL-6 and SP-D levels, as well as the presence of interstitial pneumonitis, were investigated.
  
  
  RESULTS
  No cases of pneumonitis in which both markers were below the standard values were seen. Interstitial pneumonitis developed in 1 of the 5 patients in whom both markers were above standard values. Patients whose KL-6 levels alone exceeded the standard value had bacterial pneumonia and emphysema, not interstitial pneumonitis. Though no correlation between SP-D and KL-6 levels was observed, KL-6 levels tended to increase after interstitial pneumonitis was detected on imaging, but SP-D levels increased before imaging detection.
  
  
  CONCLUSIONS
  It is important to monitor changes in levels of serum markers and other factors to avoid interstitial pneumonitis during PEG-IFN therapy. SP-D in particular may be important for early detection of interstitial pneumonitis.
authors: Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan. toruishi@ngt.saiseikai.or.jp
authors: Toru
authors: T
authors: Ishikawa
authors: Tomoyuki
authors: T
authors: Kubota
authors: Hiroyuki
authors: H
authors: Abe
authors: Kanae
authors: K
authors: Hirose
authors: Aiko
authors: A
authors: Nagashima
authors: Tadayuki
authors: T
authors: Togashi
authors: Keiichi
authors: K
authors: Seki
authors: Terasu
authors: T
authors: Honma
authors: Toshiaki
authors: T
authors: Yoshida
authors: Tomoteru
authors: T
authors: Kamimura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D004359:Drug Therapy, Combination; D042241:Early Diagnosis; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects*; D017563:Lung Diseases, Interstitial / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood*; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011237:Predictive Value of Tests; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood*; D011994:Recombinant Proteins / Q000009:adverse effects; D012254:Ribavirin / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D000077190:Interferon alpha-2; D016898:Interferon-alpha; C060192:MUC1 protein, human; D018396:Mucin-1; D037663:Pulmonary Surfactant-Associated Protein D; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a