Serum YKL-40 and Serum Krebs von den Lungen-6 as Potential Predictive Biomarkers for Rheumatoid Arthritis-Associated Interstitial Lung Disease

Immunol Invest. 2024 Aug;53(6):989-1000. doi: 10.1080/08820139.2024.2366966. Epub 2024 Jun 20.

Abstract

Background: Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis (RA) and is associated with a poor prognosis. However, the role of blood biomarkers in RA-associated interstitial lung disease (RA-ILD) is ill-defined. We aim to evaluate the role of YKL-40 and Krebs von den Lungen-6 (KL-6) in the diagnosis and severity evaluation of RA-ILD.

Methods: 45 RA-non-ILD patients and 38 RA-ILD patients were included. The clinical data and the levels of YKL-40 and KL-6 were measured and collected for all patients. The risk factors for RA-ILD were analyzed and their correlation with relevant indicators and predictive value for RA-ILD was explored.

Results: The levels of YKL-40 and KL-6 in RA-ILD patients were higher than RA-non-ILD patients (p < .001). Both YKL-40 and KL-6 were correlated with the incidence of RA-ILD. The predictive power of combined KL-6 and YKL-40 for the presence of ILD was 0.789, with a sensitivity and specificity at 73.7% and 73.3%, respectively. In RA-ILD patients, both YKL-40 and KL-6 were positively correlated with the Scleroderma Lung Study (SLS) I score and negatively correlated with pulmonary function.

Conclusions: KL-6 and YKL-40 might be a useful biomarker in the diagnosis and severity evaluation of RA-ILD.

Keywords: Biomarker; KL-6; YKL-40; interstitial lung disease; rheumatoid arthritis.

MeSH terms

  • Aged
  • Arthritis, Rheumatoid* / blood
  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / diagnosis
  • Biomarkers* / blood
  • Chitinase-3-Like Protein 1* / blood
  • Female
  • Humans
  • Lung Diseases, Interstitial* / blood
  • Lung Diseases, Interstitial* / diagnosis
  • Lung Diseases, Interstitial* / etiology
  • Male
  • Middle Aged
  • Mucin-1* / blood
  • Predictive Value of Tests
  • Prognosis
  • Sensitivity and Specificity
  • Severity of Illness Index

Substances

  • Biomarkers
  • CHI3L1 protein, human
  • Chitinase-3-Like Protein 1
  • MUC1 protein, human
  • Mucin-1