Can YKL-40 be used as a biomarker for interstitial lung disease?

Abstract

Background: Interstitial lung disease (ILD) has a poor prognosis and lacks specific biomarkers for early diagnosis, assessment of disease severity, and prognosis. YKL-40 levels were found to be elevated in patients with ILD, but these results are inconsistent. Therefore, we conducted a systematic review and meta-analysis to accurately study the relation between YKL-40 and ILD. Methods: We performed a systematic literature search in many databases (PubMed, Embase, the China National Knowledge Infrastructure, and Wanfang databases) and commercial Internet search engines to identify studies involving the role of YKL-40 in patients with ILD. The weighted mean difference with its 95% confidence interval were used to investigate the effect sizes. If obvious heterogeneity was found in the meta-analysis, the level of YKL-40 was directly compared by the Mann-Whitney test. Results: Sixteen eligible articles were finally identified. The results showed that the serum YKL-40 levels of patients with idiopathic pulmonary fibrosis, connective tissue-related ILD, sarcoidosis, cryptogenic tissue pneumonia, asbestosis-ILD, and idiopathic nonspecific interstitial pneumonia were higher than those in controls, but there was no increase in patients with pulmonary alveolar proteinosis. We also found that there are certain differences in the serum YKL-40 levels in patients with different types of ILD. The results showed that the bronchoalveolar lavage fluid YKL-40 levels of patients with idiopathic pulmonary fibrosis were significantly higher than that in controls. A systematic review indicated that there were correlations between the serum YKL-40 levels and lung function in patients with different ILD. In addition, YKL-40 may be used as a valuable biomarker for survival, with risk ratios ranging from 1.006 to 10.9. Conclusions: This study suggests that YKL-40 may be a useful biomarker for the diagnosis and prognosis of ILD.

Diagnosis of Fibrotic Hypersensitivity Pneumonitis: Is There a Role for Biomarkers?

“…It is not surprising, thus, that it has been described as a biomarker in diseases characterized by inflammation, fibrosis and remodeling, IPF and sarcoidosis among them [ 109 , 110 , 111 , 112 ]. In fact, the usefulness of YKL-40 in the diagnosis of ILD (versus healthy controls) was summarized in a systematic review and meta-analysis, which revealed overall highest serum levels in sarcoidosis when compared with other ILDs [ 113 ]. Unfortunately, studies on HP were not included.…”

Molecular Pathogenesis of Fibrosis, Thrombosis and Surfactant Dysfunction in the Lungs of Severe COVID-19 Patients

“…It is also involved in an alternative mode of macrophage activation [ 120 ]. A systematic review conducted by Tong et al showed that YKL-40 serum levels were higher in patients with interstitial lung disease (ILD), which includes PF, than in the control group [ 125 ]. Similar results were also obtained by Majewski et al in which the YKL-40 serum concentration was statistically significantly higher in patients with idiopathic pulmonary fibrosis than in healthy people [ 126 ].…”

Predictors of progression in idiopathic inflammatory myopathies with interstitial lung disease

“…Black ethnicity Chua et al [39] IIM subtypes ARS Vojinovic et al [11] CADM Gan et al [38] Clinical manifestations or complications Older age of onset Huang et al [40] Mechanic's hand Huang et al [40] Polyarthritis Vojinovic et al [11] Dyspnea Vojinovic et al [11] Facial rash Vojinovic et al [11] Without myositis Vojinovic et al [11] Laboratory tests Lower CPK levels Vojinovic et al [11] MAAs or MSAs Antisynthetase antibody Vojinovic et al [11] Chua et al [39] Li et al [41] Anti-Jo1 Vojinovic et al [11] Huang et al [40] Li et al [41] Anti-OJ Vojinovic et al [11] Anti-PL7 Hervier et al [42] Anti-PL12 Hervier et al [42] Anti-Ro52 Vojinovic et al [11] Huang et al [40] Anti-MDA5 antibody Li et al [10] Cao et al [44] Chen et al [45] Biomarkers Ferritin Gono et al [46] IL-18 Gono et al [46] KL-6 Takanashi et al [47] Ohnishi et al [48] Wang et al [49] Surfactant protein-D Ohnishi et al [48] Serum sCD163 levels Zuo et al [50] Enomoto et al [51] Median sCD206 levels Shen et al [52] Serum YKL-40 levels Jiang et al [12] Hozumi et al [13] Tong et al [53] Serum CYFRA21-1 levels Gan et al [38] CD4 + CXCR4 + T cells% Wang et al [35] Pulmonary function tests FVC% Chua et al [39] DL CO % Chua et al [39] Imaging E...…”

“…ILD. [12,13,53] Tumor-associated antigens were observed in IIM-ILD; further investigation revealed that the higher serum level of cytokeratin-19 fragment (CYFRA21-1) was a risk factor for ILD. [38] Peripheral CD4 + CXCR4 + T cells, which promote pulmonary fibroblast proliferation via IL-21, are potential biomarkers associated with the severity and prognosis of IIM-ILD.…”