Levels of YKL-40 in pleural effusions and blood from patients with pulmonary or pleural disease

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• 作者：Hak-Ryul Kim^a ; Chang-Duk Jun^b ; Koung-Sun Lee^c ; ^d ; Ji-Hyun Cho^c ; ^d ; Eun-Taik Jeong^a ; Sei-Hoon Yang^a ; Young-Jin Lee^c ; ^d ; Do-Sim Park^c ; ^d ; ^{emailds@hanmail.net}
• 关键词：ADA ; adenosine deaminase ; AUC ; area under the receiver operating characteristic curve ; BNP ; B-type natriuretic peptide ; CEA ; carcinoembriogenic antigen ; CLP ; chitinase-like protein ; COPD ; chronic obstructive pulmonary disease ; CPE ; cardiogenic pleural eff
• 刊名：Cytokine
• 出版年：2012
• 期刊代码：97_10434666
• 类别：imm
• 出版时间：June, 2012
• 卷：58
• 期：3
• 页码：336-343
• 文件大小：436 K

摘要

ass="h4">Background

YKL-40 (a chitinase-like protein) is an inflammatory biomarker that is associated with lung injury pathogenesis. We aimed to identify the diagnostic values of YKL-40 in pleural effusions and to evaluate circulating YKL-40 levels during multiple etiological pulmonary/pleural diseases and the role of YKL-40 as a monitoring marker of inflammatory pulmonary disease.

ass="h4">Methods

Pleural YKL-40 (n = 197), YKL-39 (the most homologous chitinase-like protein to human YKL-40), and conventional pleural marker levels were measured in patients with pulmonary/pleural disease. Additionally, serum YKL-40 and YKL-39 levels were analyzed in both patients and controls (n = 432) and serially monitored in patients with asthma (n = 27) or pneumonia (n = 22).

ass="h4">Results

Pleural YKL-40 levels were higher than those in the serum and highest in tuberculous pleural effusions (TPEs; 1181 ng/mL), followed by parapneumonic, malignant, and cardiogenic effusions (560 ng/mL). The diagnostic accuracy of pleural YKL-40 (0.78) for discriminating between tuberculous and malignant effusion was comparable to or greater than those of YKL-39, total protein, C-reactive protein and CYFRA 21-1, and lower than those of adenosine deaminase (p < 0.05) and carcinoembriogenic antigen (p = 0.05). Serum YKL-40 levels were higher in the pneumonia group than in the cancer, asthma, or control groups. Following treatment, serum YKL-40 levels were more greatly reduced in pneumonia patients than in asthma patients. Serum YKL-39 levels did not differ between patients and controls.

ass="h4">Conclusions

Pleural YKL-40 levels are elevated in TPEs and have fairly good diagnostic efficacy for detecting TPEs. However, adenosine deaminase is more efficient for detecting TPEs than pleural YKL-40. Serum YKL-40 levels are highest during pneumonia compared to common pulmonary/pleural diseases and are more useful for monitoring pneumonia than asthma.