• J. Intern. Med. · Jun 2012

    KL-6: a serological biomarker for interstitial lung disease in patients with polymyositis and dermatomyositis.

    • M Fathi, S Barbasso Helmers, and I E Lundberg.
    • Department of Respiratory Medicine and Allergy, Karolinska University Hospital, Solna, Sweden. maryam.fathi@karolinska.se
    • J. Intern. Med. 2012 Jun 1; 271 (6): 589-97.

    ObjectivesTo investigate whether Caucasian patients with polymyositis (PM) or dermatomyositis (DM) and interstitial lung disease (ILD) have elevated serum levels of KL-6 compared with patients without ILD and whether KL-6 could be used as a marker for ILD activity and treatment efficacy of ILD in PM/DM.Design And MethodsThirty patients with PM/DM (seven with ILD) and 17 age- and sex-matched healthy controls were included in a retrospective, cross-sectional analysis. Twelve patients were followed for longitudinal evaluation. ILD was defined as restrictive lung function impairment with radiographic signs of ILD. Serum KL-6 levels were measured using a sandwich enzyme immunoassay kit. Groups were compared by Mann-Whitney U-test.ResultsPM/DM patients with ILD had significantly higher median serum KL-6 levels compared with those without ILD: 995 (range 533-2318) versus 322 (range 132-1225) U mL(-1) (P = 0.0002). Median serum levels of healthy controls were 225 (range 136-519) U mL(-1) . Serum levels of KL-6 were inversely correlated with percentages of forced expiratory volume in 1 s (FEV1), vital capacity (VC), total lung capacity (TLC), forced VC, diffusing capacity of carbon monoxide (DLco), maximal voluntary ventilation at 40 breaths min(-1) and residual volume (RV). Changes in KL-6 levels showed a significant inverse correlation with changes in percentage FEV1, TLC, DLco and RV. At a cut-off level of 549 U mL(-1) (mean ± 2.5 SD for controls), the sensitivity and specificity for diagnosis of ILD were 83% and 100%, respectively.ConclusionThe level of serum KL-6 may serve as measure of ILD in patients with PM/DM and is a promising biomarker for use in clinical practice to assess clinical response to treatment.© 2011 The Association for the Publication of the Journal of Internal Medicine.

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