KL-6 concentration in pulmonary epithelial lining fluid is a useful prognostic indicator in patients with acute respiratory distress syndromeReport as inadecuate




KL-6 concentration in pulmonary epithelial lining fluid is a useful prognostic indicator in patients with acute respiratory distress syndrome - Download this document for free, or read online. Document in PDF available to download.

Respiratory Research

, 12:32

First Online: 01 December 2011Received: 09 November 2010Accepted: 22 March 2011

Abstract

BackgroundKL-6 is a mucin-like glycoprotein expressed on the surface of alveolar type II cells. Elevated concentrations of KL-6 in serum and epithelial lining fluid ELF in patients with acute respiratory distress syndrome ARDS have been previously reported; however, kinetics and prognostic significance of KL-6 have not been extensively studied. This study was conducted to clarify these points in ARDS patients.

MethodsThirty-two patients with ARDS who received mechanical ventilation under intubation were studied for 28 days. ELF and blood were obtained from each patient at multiple time points after the diagnosis of ARDS. ELF was collected using a bronchoscopic microsampling procedure, and ELF and serum KL-6 concentrations were measured.

ResultsKL-6 levels in ELF on days 0 to 3 after ARDS diagnosis were significantly higher in nonsurvivors than in survivors, and thereafter, there was no difference in concentrations between the two groups. Serum KL-6 levels did not show statistically significant differences between nonsurvivors and survivors at any time point. When the highest KL-6 levels in ELF and serum sample from each patient were examined, KL-6 levels in both ELF and serum were significantly higher in nonsurvivors than in survivors. The optimal cut-off values were set at 3453 U-mL for ELF and 530 U-mL for serum by receiver operating characteristic ROC curve analyses. Patients with KL-6 concentrations in ELF higher than 3453 U-mL or serum concentrations higher than 530 U-mL had significantly lower survival rates up to 90 days after ARDS diagnosis.

ConclusionsELF and serum KL-6 concentrations were found to be good indicators of clinical outcome in ARDS patients. Particularly, KL-6 levels in ELF measured during the early period after the diagnosis were useful for predicting prognosis in ARDS patients.

List of abbreviationsALIacute lung injury

ANOVAanalysis of variance

ARDSacute respiratory distress syndrome

AUCarea under the curve

BALFbronchoalveolar lavage fluid

BMSbronchoscopic microsampling

ELFepithelial lining fluid

ILDinterstitial lung disease

ROCreceiver operating characteristic

Electronic supplementary materialThe online version of this article doi:10.1186-1465-9921-12-32 contains supplementary material, which is available to authorized users.

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Author: Tomohiro Kondo - Noboru Hattori - Nobuhisa Ishikawa - Hiroshi Murai - Yoshinori Haruta - Nobuyuki Hirohashi - Koichi Taniga

Source: https://link.springer.com/







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