Serum YKL-40 as predictor of outcome in hypersensitivity pneumonitis

[摘要] 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 119xe2x80x85ngxc2xb7mLxe2x88x921; the baseline serum YKL-40 level predicted disease progression (hazard ratio 6.567; p<0.001); and at a cut-off of 150xe2x80x85ngxc2xb7mLxe2x88x921 was associated with mortality (hazard ratio 9.989; p<0.001).Serum YKL-40 may be a useful prognostic biomarker in HP patients.

[学科分类] 呼吸医学