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Comparative Study of Serum Surfactant Protein-D and KL-6 Concentrations in Patients with Systemic Sclerosis as Markers for Monitoring the Activity of Pulmonary Fibrosis
KOICHI YANABA, MINORU HASEGAWA, KAZUHIKO TAKEHARA, and SHINICHI SATO
ABSTRACT.
Methods. Serum SP-D and KL-6 concentrations were determined by ELISA in 42 SSc patients. In a retrospective longitudinal study, 83 serum samples from 6 SSc patients were analyzed during a followup period of 0.6–6.3 years. Results. SP-D and KL-6 concentrations at the first visit were higher in patients with SSc, especially those with PF, compared with healthy controls. Increased concentrations of SP-D were associated with decreased DLCO and decreased vital capacity in SSc patients more strongly than those of KL-6. The sensitivity and specificity for PF were 91% and 88% for SP-D and 39% and 100% for KL-6, respectively. In the longitudinal study, both SP-D and KL-6 concentrations were associated with activity of PF in patients with SSc. SP-D concentrations changed more rapidly than KL-6 concentrations, in parallel with the PF activity. Conclusion. SP-D was a more sensitive marker for PF than KL-6. By contrast, KL-6 showed higher specificity than SP-D. Combined use of these 2 serum markers would be more helpful to diagnose and monitor the PF activity in patients with SSc than single use of each marker. (J Rheumatol 2004;31:1112-20) Key Indexing Terms:
SYSTEMIC SCLEROSIS
From the Department of Dermatology, Kanazawa University Graduate School of Medical Science, Kanazawa; and the Department of Dermatology, Jikei University School of Medicine, Tokyo, Japan. K. Yanaba, MD, Department of Dermatology, Kanazawa University Graduate School of Medical Science, Department of Dermatology, Jikei University School of Medicine; M. Hasegawa, MD; K. Takehara, MD; S. Sato, MD, Department of Dermatology, Kanazawa University Graduate School of Medical Science. Address reprint requests to Dr. S. Sato, Department of Dermatology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8641, Japan. E-mail: s-sato@med.kanazawa-u.ac.jp Submitted June 23, 2003; revision accepted December 15, 2003.
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