Diagnostic and prognostic values of Club cell protein 16 (CC16) in critical care patients with acute respiratory distress syndrome

Abstract

BackgroundAcute respiratory distress syndrome (ARDS) is a critical condition characterized by bilateral pulmonary infiltrates and severe hypoxemia. This study aimed to evaluate the diagnostic and prognostic values of Club cell protein 16 (CC16) in critical care patients with ARDS.MethodsIn this retrospective observational study, 83 patients with ARDS and 129 non‐ARDS patients on ICU admission were enrolled. The differences in serum CC16 and other laboratory indicators between two groups were analyzed. The sensitivity, specificity, positive and negative predictive values, and accuracy of CC16 as a diagnostic marker on ICU admission were determined by receiver operating characteristic (ROC) curve analysis. The correlation between serum CC16 levels and the severity of ARDS as quantified by PaO2/FiO2 ratio were further assessed. CC16 levels were compared between survivors and non‐survivors. The relationships between CC16 levels and duration of ICU and hospitalization were evaluated.ResultsThe serum CC16 levels in ARDS patients were significantly higher than that in non‐ARDS patients (54.44±19.62 vs 24.13±12.32 ng/mL, P=.001). ROC analysis showed that the sensitivity, specificity, positive predictive value, and negative predictive value were 90.4%, 79.8%, 74.2%, and 92.8%, respectively, when the cut‐off value was set at 33.3 ng/mL. CC16 levels were correlated with the severity of ARDS. The serum CC16 levels were significantly greater in non‐survivors than in survivors from the ARDS group. CC16 levels were associated with ICU stay but not hospital stay.Conclusions CC16 may serve as a diagnostic and stratification marker for ARDS. However, it provided limited prognostic information for ARDS.

Renal dysfunction reduces the diagnostic and prognostic value of serum CC16 for acute respiratory distress syndrome in intensive care patients

“…According to previous research by our group, increased serum CC16 levels can help clinicians identify ARDS in critical care patients with normal renal function [ 10 ], and this finding was confirmed in the present study. However, RD, whether in the form of AKI or CKD, also was found to raise the serum CC16 level, reducing the specificity of serum CC16 for ARDS and altering the diagnostic cutoff points for ARDS.…”

“…Previously, we found that an increased serum CC16 level (cutoff point at ≥33.3 ng/ml) can predict the onset of ARDS and is negatively correlated with the PaO 2 /FiO 2 ratio among ARDS patients [ 10 ]. However, we later observed that renal dysfunction (RD) separately raises the serum CC16 level.…”

The rCC16 Protein Protects Against LPS-Induced Cell Apoptosis and Inflammatory Responses in Human Lung Pneumocytes

“…Our previous clinical research showed that CC16 can serve as a highly specific biomarker for the diagnosis and treatment of ARDS ( Lin et al., 2018 ). In addition, increasing the CC16 content in the serum or lung tissues can inhibit the expression of various inflammatory factors, such as HMGB1, thereby reducing the inflammatory response ( Pang et al., 2015 ).…”

Early increase in anti-inflammatory biomarkers is associated with the development of multiple organ dysfunction syndrome in severely injured trauma patients

“…In a study of 101 polytrauma patients with severe chest trauma, higher levels of CC-16 were found at admission and day 2 in patients who developed pneumonia compared with patients without pneumonia 17. Furthermore, patients with ARDS from multiple causes including trauma showed higher levels of CC-16 compared with patients without ARDS 39. In this study, 28.1% of patients with MODS also fulfilled the ARDS criteria, which could partly explain the association of CC-16 with the development of MODS in this study.…”