Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Role of Krebs von den Lungen-6 (KL-6) in Assessing Hypersensitivity Pneumonitis

  • Mostafa, Amira Ismail (Department of Chest Diseases, Faculty of Medicine, Cairo University) ;
  • Salem, Ayman Elsayed (Department of Chest Diseases, Faculty of Medicine, Cairo University) ;
  • Ahmed, Heba Allah Moussa (Department of Chest Diseases, Faculty of Medicine, Cairo University) ;
  • Bayoumi, Aml Ibrahim (Department of Chest Diseases, Faculty of Medicine, Cairo University) ;
  • Halim, Radwa M. Abdel (Department of Chemical Pathology, Faculty of Medicine, Cairo University) ;
  • Samie, Rasha M. Abdel (Department of Internal Medicine, Faculty of Medicine, Cairo University)
  • Received : 2020.10.09
  • Accepted : 2021.04.05
  • Published : 2021.07.31
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Abstract

Background: Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with interstitial lung diseases (ILD). Serum KL-6/MUC1 levels have been demonstrated to be useful for the evaluation of various ILD. To determine the role of circulating KL-6 in evaluating the disease activity and management of HP. Methods: An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured in both groups. Patients were further assessed based on chest high-resolution computed tomography (HRCT), pulmonary function test, 6-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings. Results: The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non-fibrotic HP group (1,900 IU/mL) as compared to the fibrotic group (1,200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as the duration of steroid therapy. Conclusion: The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasizes the significant role of steroids in the stabilization of the disease.

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References

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