• Takuya Samukawa, Tsutomu Hamada, Hirofumi Uto, Masakazu Yanagi, Go Tsukuya, Tsuyoshi Nosaki, Masahiro Maeda, Takashi Hirano, Hirohito Tsubouchi, and Hiromasa Inoue.
• Department of Pulmonary Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima, Japan.
• BMC Pulm Med. 2012 Jan 1;12:55.

BackgroundNapsin A, an aspartic protease, is mainly expressed in alveolar type-II cells and renal proximal tubules and is a putative immunohistochemical marker for pulmonary adenocarcinomas. This study sought to determine whether napsin A could be measured in the serum to evaluate its relationship to idiopathic pulmonary fibrosis (IPF) and determine whether renal dysfunction might affect serum napsin A levels.MethodsSerum levels of napsin A were measured in 20 patients with IPF, 34 patients with lung primary adenocarcinoma, 12 patients with kidney diseases, and 20 healthy volunteers. Surfactant protein (SP)-A, SP-D, and Krebs von den Lungen-6 (KL-6) levels in serum and pulmonary function tests were also evaluated in IPF patients.ResultsCirculating levels of napsin A were increased in patients with IPF, as compared with healthy controls, and they correlated with the severity of disease. Moreover, the serum napsin A levels were not elevated in patients with pulmonary adenocarcinoma or renal dysfunction. The distinguishing point between IPF and the controls was that the area under the receiver operating characteristic curve (ROC) of napsin A was larger than that of KL-6, SP-A, or SP-D.ConclusionThese findings suggest that serum napsin A may be a candidate biomarker for IPF.

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