肺损伤的血清生物标志物和风险的进展的风湿性关节炎相关的间歇性肺部疾病
Sung Hae Chang1, Yong-Beom Park2, Gregory C McDermott3
1S.H. Chang, MD, PhD, MPH, Soonchunhyang University, Division of Rheumatology, Department of Internal Medicine, Cheonan, South Korea, and Brigham and Women's Hospital, Division of Rheumatology, Inflammation, and Immunity and Harvard Medical School, Boston, Massachusetts, USA, and Soonchunhyang University Cheonan Hospital, Division of Rheumatology, Department of Internal Medicine, Cheonan, South Korea.
像KL-6和hSP-D这样的肺损伤生物标志物可以预测类风湿性关节炎相关的间歇性肺病 (RA-ILD) 的进展. 连续KL-6测量对于监测疾病进展特别有用.
科学领域:
- 肺部病理学 肺部病理学
- 类风湿病学 类风湿病学
- 生物标志物研究 生物标志物研究
背景情况:
- 类风湿性关节炎相关的间歇性肺病 (RA-ILD) 是一种具有可变进展的严重并发症.
- 确定可靠的生物标志物来预测RA-ILD进展对于患者管理和治疗决策至关重要.
研究的目的:
- 调查血清肺损伤生物标志物的基线水平和变化,包括Krebs von den Lungen 6 (KL-6),人类表面活性蛋白D (hSP-D) 和矩阵金属蛋白酶7 (MMP-7),与RA-ILD进展相关.
- 评估这些生物标志物对潜在队列疾病恶化的预测价值.
主要方法:
- 一项前性队列研究 (KORAIL) 招募了通过CT成像确认的RA和ILD患者.
- 使用2022年ATS/ERS/JRS/LACTF指南对渐进性肺纤维化 (PPF) 进行ILD进展的定义.
- 使用多变量考克斯回归分析来评估基线和随访生物标志物水平与ILD进展之间的关联,并对混因素进行调整.
主要成果:
- 在136名RA-ILD患者中,随访时间平均为3.0年,34.6%的患者出现了进展.
- 较高的基线KL-6和hSP-D水平与ILD进展的风险增加显著相关.
- 随访1年后增加KL-6水平显示出与进展的最强相关性 (∆KL-6 HR 2.00).
结论:
- 该前性研究将PPF标准应用于RA-ILD,发现34.6%的患者在3年内进展.
- 基线KL-6和hSP-D的升高,以及KL-6随时间的变化,与RA-ILD进展有关.
- 对肺损伤生物标志物的连续测量,特别是KL-6,可以帮助预测RA-ILD的进展,并指导患者监测和治疗策略.
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