Serum YKL-40 as predictor of outcome in hypersensitivity pneumonitis.
YKL-40, a chitinase-like protein mainly secreted by macrophages, neutrophils and epithelial cells, is increased in patients with idiopathic interstitial pneumonia and sarcoidosis. We aimed to investigate the role of YKL-40 as a biomarker in hypersensitivity pneumonitis (HP).72 HP patients, 100 interstitial lung disease (ILD) controls and 60 healthy controls were studied. YKL-40 was measured by ELISA in serum and bronchoalveolar lavage fluid (BALF) at baseline and follow-up. The relationship between YKL-40 levels, clinical variables and disease outcome was evaluated.Baseline serum YKL-40 levels were significantly higher in HP patients than in healthy controls (p<0.001), but lower than in patients with other ILDs. Baseline BALF YKL-40 levels in HP patients were the highest among ILD patients. In HP patients, serum YKL-40 correlated with the diffusing capacity of the lung for carbon monoxide at baseline (p<0.01) and over time (p<0.001). HP patients whose disease progressed or who died had higher baseline YKL-40 levels than those who remained stable and survived (p<0.001). At a cut-off of 119 ng·mL-1, the baseline serum YKL-40 level predicted disease progression (hazard ratio 6.567; p<0.001), and at a cut-off of 150 ng·mL-1was associated with mortality (hazard ratio 9.989; p<0.001).Serum YKL-40 may be a useful prognostic biomarker in HP patients.
Interstitial and Rare Lung Disease Unit, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany.|Dept of Respiratory Medicine, The First Affiliated Hospital of University of South China, Hengyang, P.R. China.
Xiaoping
X
Long
Interstitial and Rare Lung Disease Unit, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany.
Xuan
X
He
Dept of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Shinichiro
S
Ohshimo
Dr. von Haunersches Kinderspital, University of Munich, Member of the German Center for Lung Research, Munich, Germany.
Matthias
M
Griese
Dept of Neurosciences, Faculty of Medicine and Dentistry, Basque Country University, Bilbao, Spain.
Rafael
R
Sarria
General and Experimental Pathology, Ruhr University, Bochum, Germany.
Josune
J
Guzman
Interstitial and Rare Lung Disease Unit, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany.
Ulrich
U
Costabel
Interstitial and Rare Lung Disease Unit, Ruhrlandklinik, University of Duisburg-Essen, Essen, Germany francesco.bonella@ruhrlandklinik.uk-essen.de.
Francesco
F
Bonella
D000542:Alveolitis, Extrinsic Allergic / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry; D016022:Case-Control Studies; D000071451:Chitinase-3-Like Protein 1 / Q000097:blood*; D018450:Disease Progression; D005260:Female; D005858:Germany; D006801:Humans; D053208:Kaplan-Meier Estimate; D017563:Lung Diseases, Interstitial / Q000097:blood* / Q000175:diagnosis*; D008264:Macrophages / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils / Q000378:metabolism; D012372:ROC Curve; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1