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Plasma KL-6 as a Potential Biomarker for Bronchopulmonary Dysplasia in Preterm Infants
Petya Radulova1,2, Margaritka Boncheva3, Gencho Nachev3
1Department of Obstetrics and Gynecology, Medical University of Sofia, Zdrave 2 Street, Sofia 1431, Bulgaria.
Insights
Plasma KL-6 shows promise as a biomarker for predicting bronchopulmonary dysplasia (BPD) in extremely preterm infants. Elevated KL-6 levels can help identify infants at higher risk for developing BPD early on.
Area of Science:
- Neonatology
- Pulmonology
- Biomarker Research
Background:
- KL-6 is recognized as a biomarker indicating interstitial lung injury, with levels increasing during the repair process.
- Bronchopulmonary dysplasia (BPD) is a significant complication affecting preterm infants, characterized by lung injury.
Purpose of the Study:
- To investigate the predictive capability of plasma KL-6 levels for the development of BPD in extremely preterm infants.
- To assess the utility of KL-6 as an early screening tool for BPD risk.
Main Methods:
- Ninety-five extremely preterm infants (<28 weeks gestational age) were categorized into moderate/severe BPD and no/mild BPD groups.
- Plasma KL-6 levels were measured on postnatal days 7 and 14.
- Binary logistic regression and Receiver Operating Characteristic (ROC) curve analyses were employed to evaluate predictive factors.
Main Results:
- Infants with lower gestational age (<26 weeks) exhibited significantly higher KL-6 levels on days 7 and 14 compared to those born at >25 weeks.
- On day 7, KL-6, mechanical ventilation, and PDA were significant predictors of BPD (AUC=0.86).
- On day 14, KL-6, gestational age, mechanical ventilation, PDA, antenatal steroids, and gender were significant predictors (AUC=0.91), with higher sensitivity and accuracy.
Conclusions:
- Plasma KL-6 demonstrates potential as a valuable screening biomarker for identifying preterm infants at elevated risk of developing BPD.
- Early detection through KL-6 measurement can aid in timely interventions and management strategies for BPD.
Background:
KL-6 is a biomarker of interstitial lung injury and increases during repair.
Aim:
Our aim was to determine the predictive value of plasma KL-6 for the development of bronchopulmonary dysplasia (BPD) in preterm infants.
Methods:
Ninety-five extremely preterm infants (EPIs), born at <28 gestational age (GA), were divided into two main BPD groups as follows: the moderate/severe and the no/mild group. KL-6 was analyzed on days 7 and 14. Binary logistic regression analyses and ROC curve analyses were performed.
Results:
Infants <26 + 0 weeks' GA have higher mean KL-6 than infants >25 + 6 weeks' GA on 7 and 14 days (335 vs. 286 U/ml and 378 vs. 260 U/ml; p = 0.005 and 0.018, respectively). In the binary regression model at KL-6 day 7, three of the prognostic factors remained significant-mechanical ventilation OR: 10.38 (95% CI: 3.57-30.14), PDA OR: 6.39 (95% CI: 0.87-46.74), and KL-6 OR: 4.98 (95% CI: 1.54-16.08). The AUC was 0.86 with a sensitivity and specificity of 79% at a cutoff value ≥0.34. In the binary regression model at KL-6 day 14, six of the prognostic factors were significant-PDA OR: 23.34 (95% CI: 2.14-254.24), KL-6 OR: 13.59 (95% CI: 3.19-57.96), GA OR: 4.58 (95% CI: 1.16-18.06), mechanical ventilation OR: 4.45 (95% CI: 1.23-16.16), antenatal steroids OR: 0.19 (95% CI: 0.04-0.95), and gender (female OR: 0.30 (95% CI 0.08-1.12)). The AUC was 0.91, and the sensitivity and accuracy for a cutoff ≥0.37 were 89% and 85%, respectively.
Conclusion:
KL-6 could be a useful screening biomarker for early detection of infants at increased risk for developing BPD.
