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Lung transplantation for ILD
Published in Muhunthan Thillai, David R Moller, Keith C Meyer, Clinical Handbook of Interstitial Lung Disease, 2017
A number of studies have attempted to address the factors that could predict disease progression in IPF. Serological tests that may act as surrogate markers include surfactant protein D (SP-D), KL-6, LDH and erythrocyte sedimentation rate (ESR) (7). Limited data suggest that KL-6 may predict response to treatment in the rapidly progressive IPF group (8). Prasse et al. suggested that elevated levels of CCL18 predict change in forced vital capacity (FVC) and total lung capacity (TLC) at 6 months (9). Interestingly, SP-D levels decrease following bilateral lung transplant (BLT) but remain elevated after single lung transplant (SLT), perhaps indicating that in some individuals this biomarker may be useful (10). Hypoalbuminaemia at the time of transplantation has also been shown to be an independent risk factor for mortality in an analysis of United Network for Organ Sharing (UNOS) data (11). However, despite these promising studies no single biomarker has yet been universally adopted for lung transplantation assessment.
Pseudomonas aeruginosa
Published in Dongyou Liu, Laboratory Models for Foodborne Infections, 2017
Stavria Panayidou, Yiorgos Apidianakis
Moreover, P. aeruginosa elastase B, protease PASP, MucD, and, to a lesser degree, alkaline protease contribute significantly to the pathogenesis of keratitis.62–64 Furthermore, induction of the triggering receptor expressed on myeloid cells-2 (TREM-2) upon infection in cornea scrapes triggers PI3K/Akt signaling to confer resistance against P. aeruginosa infection.65 In contrast, induction of myeloid-related protein-8 (MPR8) and MRP14 upon infection in cornea scrapes, despite promoting bacterial clearance, induces inflammation and concomitant susceptibility to infection.66 Three additional proteins, the extracellular matrix protein Lumican, the Surfactant Protein D (SP-D), and the C-X-C motif chemokine 10 (CXCL10) protect against P. aeruginosa keratitis in mice.67–69
Indications for lung transplantation and patient selection
Published in Wickii T. Vigneswaran, Edward R. Garrity, John A. Odell, LUNG Transplantation, 2016
Joshua S. Mason, Julia B. Becker, Edward R. Garrity
Some experimental biomarkers have been associated with decreased survival, although to date none are used routinely in clinical practice. CCL18 levels greater than 150 ng/mL were associated with significantly higher mortality, with a hazard ratio of 8.0 after adjustment for age, sex, and baseline pulmonary function.178 In samples from 241 patients with IPF, concentrations of the plasma proteins matrix metalloproteinase-7 (MMP-7), intercellular adhesion molecule 1 (ICAM-1), interleukin-8 (IL-8), vascular cell adhesion molecule 1 (VCAM-1), and S100 calcium-binding protein A12 (S100A12) predicted poor transplant-free survival, with MMP-7, ICAM-1, and IL-8 also predicting poor overall survival.179 Patients with IPF and both surfactant protein D (SP-D) and KL6/MUC1 have shorter survival and more symptoms than do those who have only SP-D elevated.180 Patients with elevated circulating fibrocytes (>5% of total blood leukocytes), which is thought to be a marker for disease activity, were found to have substantially reduced mean survival.181
Identification and management of connective tissue disease-associated interstitial lung disease: evidence-based Japanese consensus statements
Published in Expert Review of Respiratory Medicine, 2023
Masataka Kuwana, Masashi Bando, Yutaka Kawahito, Shinji Sato, Takafumi Suda, Yasuhiro Kondoh
Chest HRCT was also agreed to be an option for both diagnosing and assessing the severity of ILD in CTD patients, while chest X-ray can be employed for diagnosis. Given this consensus and other evidence in this area [19], HRCT is considered to play a crucial role for diagnosis. The panelists agreed that serum biomarkers such as KL-6 and surfactant protein D (SP-D) [20–22] may also be useful for diagnosis as well as assessment of severity. Other tests agreed to be useful for assessing severity included the 6-minute walk test, FVC, DLco, and SpO2. It was also felt that patient-reported outcomes such as dyspnea and health-related QOL (assessed with validated instruments such as the Medical Research Council dyspnea scale and the St George’s Respiratory Questionnaire [23], respectively) should be considered for assessing severity.
KL-6 is a long-term disease-activity biomarker for interstitial lung disease associated with polymyositis/dermatomyositis, but is not a short-term disease-activity biomarker
Published in Modern Rheumatology, 2019
Masanori Hanaoka, Yasuhiro Katsumata, Hidenaga Kawasumi, Yasushi Kawaguchi, Hisashi Yamanaka
Serum KL-6 levels were routinely measured in our hospital central laboratory in patients with or suspected of having PM/classic DM and CADM as per our daily clinical practice using a chemiluminescent enzyme immunoassay. KL-6 has been approved by the Japanese health insurance system as a diagnostic marker for ILDs since 1999 and is generally measured throughout Japan [11]. A clinical cut-off value of 500 U/mL has been established for distinguishing patients with ILDs from healthy subjects and patients with lung diseases other than ILDs [11]. In addition, the levels of serum surfactant protein D (SP-D), another glycoprotein secreted by type II pneumocytes, and ferritin were also measured by enzyme-linked immunosorbent assays in some patients as per our daily clinical practice. The manufacturer’s cut-off value for serum SP-D was 110 ng/mL. We have proposed a cut-off value for serum ferritin of 500 ng/mL for RP-ILD with PM/DM [12].
A review on proteomics analysis to reveal biological pathways and predictive proteins in sulfur mustard exposed patients: roles of inflammation and oxidative stress
Published in Inhalation Toxicology, 2019
Hojat Borna, Seyed Hojjat Hosseini Qale Noe, Asghar Beigi Harchegani, Nima Rahmani Talatappe, Mahdi Ghatrehsamani, Mostafa Ghanei, Alireza Shahriary
Mehrani et al. (2009) detected a significant reduction in level surfactant protein-A (SP-A) isoforms in BAL fluid of SM exposed patients 30 years after exposure (Table 1). Interestingly, this reduction was associated with the severity of pulmonary dysfunction. A more recent study reported decreased expression of the surfactant protein-D (SP-D) in lung biopsies from SM-exposed patients at chronic phase of injury (Tahmasbpour et al., 2018). Decreased level of SP-A was also reported in patients with hypersensitive pneumonitis and idiopathic pulmonary fibrosis (Wattiez et al., 2000).