How is KL-6 used in rheumatology and immunology?

 1. What is KL-6?

KL-6 is recognized as a valid indicator of lung injury and pulmonary fibrosis, and is expressed on the surface of type II alveolar epithelial cells, in normal lung tissue and terminal bronchiolar epithelial cells. It is expressed in very small amounts, and is enhanced in degenerative (proliferating, regenerating, or damaged) type II alveolar epithelial cells, which is directly related to interstitial lung disease (ILD). Therefore, KL-6 is a new serum non-invasive preferred marker for the detection of interstitial pneumonia (ILD). Today, let's learn about the clinical applications of KL-6 as an early marker of ILD in the field of rheumatology.

2. KL-6 can be used as an independent predictor of early progression of systemic sclerosis-associated interstitial lung disease (SSc-ILD).

The study studied 82 patients with early SSc-ILD with a mean duration of 2.3 years, and the percentage of forced vital capacity FVC% within the first year varied from -23% to 38%, the baseline KL-6 level was higher in the patients than in the healthy control group, higher KL-6 levels were able to predict a faster decline in FVC% after 1 year, using the cut-off value of 1273 U/ml determined in the previous study, KL-6 maintained predictive significance in the univariate model, indicating that the mean FVC% of KL-6-positive patients The annualized percentage change decreased by 7%. The study also mentions the potential and limitations of KL-6 and CCL-18 as biomarkers of SSc-ILD in other studies, and highlights the independent predictive value of KL-6 in predicting the early progression of SSc-ILD.

3. KL-6 is used for early screening of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).

Lung ultrasound B-ray (LUS) and serum KL-6 are inexpensive, non-invasive, radiation-free measurements that can be used to screen patients with RA for ILD. These biomarkers can be used as an initial measure in combination with respiratory symptoms and subsequently confirmed by HRCT and PFT to achieve early diagnosis of RA-ILD. Overall, this paper highlights the potential of LUS and KL-6 in the early identification and management of RA-ILD, and proposes a preliminary screening and follow-up algorithm aimed at improving the long-term prognosis of patients with RA-ILD.

4. KL-6 detection advantages

(1) Sensitivity: KL-6 can reflect the damage and/or regeneration of alveolar epithelial cells, so it has high sensitivity in the early detection of alveolar epithelial cell damage.

(2) Specificity: KL-6 is mainly expressed on the surface of alveolar epithelial cells and bronchiolar epithelial cells, and when these cells are damaged, the level of KL-6 rises, so its expression in specific lung diseases has certain specificity.

(3) Predictive value: The level of KL-6 correlates with the severity of ILD, which can predict the progression of the disease and the prognosis of patients.

(4) Relevance: KL-6 levels were significantly correlated with HRCT performance and PFT variables, providing clinicians with a biomarker that complements existing diagnostic tools.

(5) Ancillary diagnosis: In some cases, when imaging and other diagnostic methods are unclear or difficult to obtain, KL-6 can be used as an adjunct to help diagnose.

(6) Cost-effectiveness: Detection of KL-6 may be cost-effective relative to other diagnostic methods, especially in resource-limited settings.

(7) Applicable to a wide range of people: environment, smoking, occupational exposure to dust, drugs, etc. are all influencing factors, and regular testing is recommended for relevant groups.


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