Serum KL-6 as a biomarker to predict progression at one year in interstitial lung disease
Por:
Bonella, F, Sanchez, MCV, d'Alessandro, M, Millan-Billi, P, Santos, RF, Schroeder, N, Bastos, HN, Molina-Molina, M, Pernaute, OS, Villegas, DC, Bargagli, E
Publicada:
9 oct 2025
Resumen:
About one third of non-IPF ILD patients progresses over time. Serum KL-6, a lung epithelial mucin type 1, is an established marker to assess disease severity in ILD but its ability to predict progression needs to be further explored. To investigate whether serum KL-6 is of additional value to stratify the patients for the risk of developing clinical or functional progression at one year. ILD patients from 6 European centers were retrospectively enrolled. Disease progression was defined as relative decline >= 10% in FVC or >= 15% in DLco from baseline. Serum KL-6 was measured using a full-automated chemiluminescent immunoassay (Fujirebio). Comparative logistic regression was used to identify predictors of progression at one year. 303 patients were included. 37% developed progression after one year from KL-6 measurement. A stepwise selection was used to identify and include five predictors of progression in a risk score: age, gender, BMI, FVC, and KL-6. The final model was superior to KL-6 alone to predict progression at one year, with 55% sensitivity, 73% specificity and 67% accuracy at a cut-off of 5. Patients were stratified in low and high risk of progression at one year based on the cut-off of 5, with a similar accuracy for IIP 0.687 and CTD-ILD 0.720 but not for HP. Serum KL-6 levels, included in a risk score with other clinical and functional variables, may help to better stratify patients for the risk of disease progression at one year, compared to any individual predictor.
Filiaciones:
Bonella, F:
Univ Duisburg Essen, Ruhrlandklin Univ Hosp, Ctr Interstitial & Rare Lung Dis, Pneumol Dept, Essen, Germany
ILD & SARC Core Network, European Reference Network ERN LUNG, Frankfurt, Germany
Sanchez, MCV:
Autonomous Univ Madrid, Jimenez Diaz Fdn Univ Hosp, Immunol Dept, Madrid, Spain
d'Alessandro, M:
Univ Siena, Resp Dis & Lung Transplant Unit, Siena, Italy
Millan-Billi, P:
Hosp Santa Creu & Sant Pau, Dept Resp Med, Barcelona, Spain
Santos, RF:
Univ Porto, i3S Inst Res & Innovat Hlth, Porto, Portugal
Schroeder, N:
Univ Duisburg Essen, Ruhrlandklin Univ Hosp, Ctr Interstitial & Rare Lung Dis, Pneumol Dept, Essen, Germany
Bastos, HN:
Univ Porto, i3S Inst Res & Innovat Hlth, Porto, Portugal
Univ Porto, Univ Hosp Ctr Sao Joao, Fac Med, RISE Hlth Res Network, Porto, Portugal
Molina-Molina, M:
Bellvitge Univ Hosp IDIBELL Barcelona, CIBERES Bellvitge Biomed Res Inst, Pulmonol Serv, ILD Unit, Barcelona, Spain
Pernaute, OS:
Autonomous Univ Madrid, Jimenez Diaz Fdn Univ Hosp, Rheumatol Dept, Madrid, Spain
Villegas, DC:
Hosp Santa Creu & Sant Pau, Dept Resp Med, Barcelona, Spain
Bargagli, E:
Univ Siena, Resp Dis & Lung Transplant Unit, Siena, Italy
Green Submitted, gold
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