RT Journal Article
SR Electronic
T1 Clinical Utility of YKL-40 in Polymyositis/dermatomyositis-associated Interstitial Lung Disease
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.170373
DO 10.3899/jrheum.170373
A1 Hironao Hozumi
A1 Tomoyuki Fujisawa
A1 Noriyuki Enomoto
A1 Ran Nakashima
A1 Yasunori Enomoto
A1 Yuzo Suzuki
A1 Masato Kono
A1 Masato Karayama
A1 Kazuki Furuhashi
A1 Akihiro Murakami
A1 Naoki Inui
A1 Yutaro Nakamura
A1 Tsuneyo Mimori
A1 Takafumi Suda
YR 2017
UL http://www.jrheum.org/content/early/2017/07/11/jrheum.170373.abstract
AB Objective Interstitial lung disease (ILD) is involved in polymyositis/dermatomyositis (PM/DM), a disease associated with poor prognoses. Chitinase-3-like-1 protein (YKL-40) has pleiotropic biological activities involved in inflammation, cell proliferation, and tissue remodeling; however, the clinical application of YKL-40 remains limited. We investigated the clinical significance of YKL-40 in PM/DM−ILD. Methods Sixty-nine consecutive patients with PM/DM–ILD and 34 healthy controls were analyzed. We measured baseline and followup serum YKL-40 using an ELISA, evaluated the association of YKL-40 with clinical variables and survival, and examined YKL-40 expression in lung specimens from patients with PM/DM–ILD using immunohistochemistry. Results Serum YKL-40 levels were significantly greater in patients with PM/DM–ILD compared with healthy controls (p < 0.0001). Serum YKL-40 was correlated with arterial oxygen pressure (r = –0.40, p < 0.001) and percent-predicted DLCO (r = –0.41, p = 0.01) in patients with PM/DM–ILD. Multivariate Cox hazard analysis demonstrated that higher serum YKL-40 and lower percent-predicted forced vital capacity were independently associated with a poor prognosis. Immunohistochemistry analysis demonstrated that YKL-40 expression was enhanced in aggregated intraalveolar macrophages and hyperproliferative alveolar epithelial cells in patients with PM/DM–ILD. Conclusion YKL-40 is a promising biomarker for evaluating PM/DM−ILD activity/severity and predicting disease prognosis. Insights into YKL-40 might help elucidate the pathogenesis of PM/DM−ILD.