Extrinsic interstitial lung disease activity markers

Orlova, Galina P.; Суркова, Елена; Лапин, С. В.

doi:10.18093/0869-0189-2016-26-2-180-185

Cited by 4 publications

(1 citation statement)

References 17 publications

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“…KL-6 является информативным маркером для оценки активности и прогрессирования экзогенного аллергического альвеолита (ЭАА) [24]. Авторы показали высокую чувствительность и специфичность KL-6 как маркера активности ЭАА и целесообразность мониторирования уровня KL-6 и альвеоломуцина в сыворотке крови для оценки эффективности терапии ЭАА и экзогенного токсического альвеолита.…”

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Peripheral Blood Biomarker Krebs von den Lungen 6 (KL-6) for Interstitial and Other Lung Diseases

Суркова,

Будник,

Иванова

et al. 2024

Рецепт

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В статье обсуждается диагностическая и прогностическая значимость сывороточного биомаркера Krebs von den Lungen 6 (KL-6) при различных интерстициальных и других заболеваниях легких. Показана возможность использования биомаркера KL-6 для прогнозирования течения и исхода заболевания, тяжести и оценки активности отдельных интерстициальных болезней легких. Отмечено, что повышение уровня KL-6 ассоциируется с тяжестью легочного фиброза. Биомаркер KL-6 может быть использован для прогнозирования развития легочного фиброза и других осложнений COVID-19. Материал содержит рекомендации экспертной группы ATS/ERS/JRS/АЛАТ по использованию сывороточных биомаркеров для дифференциальной диагностики идиопатического легочного фиброза от других интерстициальных заболеваний легких. Подчеркивается необходимость дальнейшего проведения исследований для получения доказательной базы клинической эффективности биомаркера KL-6 (в т. ч. в совокупности с другими биомаркерами). The diagnostic and prognostic significance of the serum biomarker Krebs von den Lungen-6 (KL-6) in various interstitial and other lung diseases is discussed. The possibility of using the KL-6 biomarker for predicting the course and outcome of the disease, severity and evaluation of the activity of individual interstitial lung diseases is shown. It was noted that an increase in the level of KL-6 is associated with the severity of pulmonary fibrosis. The KL-6 biomarker can be used to predict the development of pulmonary fibrosis and other complications of COVID-19. The material contains the recommendations of the ATS/ERS/JERS/ALAT expert group on the use of serum biomarkers for differential diagnosis of idiopathic pulmonary fibrosis from other interstitial pulmonary diseases are given. The necessity of further research is emphasized in order to obtain an evidence base for the clinical efficacy of the KL-6 biomarker (including in combination with other biomarkers).

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Peripheral Blood Biomarker Krebs von den Lungen 6 (KL-6) for Interstitial and Other Lung Diseases

Суркова,

Будник,

Иванова

et al. 2024

Рецепт

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Toxic and infectious lung injury differential diagnosis specifics in oncohematological patients

Yanbukhtina,

Zyuzgin,

Shneyder

et al. 2023

Onkogematologiâ

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Background. Assessment of lung injury in oncohematological patients is a relevant problem, since the spectrum of pathological changes is wide and includes pulmonary infections, tumor cell infiltration, cardiogenic and non-cardiogenic pulmonary edema, bronchiolitis obliterans, interstitial pneumonitis, post-radiation and post-inflammatory pneumofibrosis, pulmonary vasculopathy and pleural effusion. At the moment there are no approved recommendations with criteria of differential diagnosis for these conditions, in particular, with differences between the most common therapy complication represented by pulmonary infections and poorly explored drug-induced toxic lesions.Aim. Identification of criteria for pneumotoxicity, allowing for differential diagnosis with pulmonary infections developing during chemotherapy, according to data routinely obtained in real clinical practice.Materials and methods. The study group included 38 patients with cytotoxic and autoimmune lung injury caused by specific therapy (group 1); the comparison group included 38 patients with infectious lesions receiving the same antitumor drugs (group 2). The data of the anamnesis, clinical course, instrumental studies and standard laboratory tests was studied retrospectively. For statistical analysis, the Mann–Whitney, χ2, Kruskal–Wallis tests were used. ROC analysis was performed to assess the sensitivity and specificity of various factors in relation to toxic damage.Results. Patients with lymphomas predominated in group of toxic lung injury (63 %). In patients who underwent allogeneic hematopoietic stem cells transplantation, toxic complications developed in the period from 35 to 1289 days, infectious – from 4 to 43 days. Statistically significant differences were obtained in the presence of a concomitant state of an altered immune response: 32 % of patients in the toxic lesion group versus 5 % in the infectious group had a history of allergy, and, in contrast to the infectious lesion group, in the toxic lesion group autoimmune diseases were detected. The main symptom in patients of the first group was shortness of breath, which was observed in 68 % of cases, of the second – an increased body temperature, observed in 92 % of cases; cough was also a common symptom – in 19 % and 13 % of patients respectively. In 58 % of patients of the second group, concomitant mucositis was detected, while in the first group this complication did not occur in any of them. The most common radiological pattern (71 % of cases in each group) was ground-glass opacities, in patients of the second group often combined with infiltrative changes and thickening of the bronchial walls (in 53 and 42 % of cases respectively). Among laboratory results, the largest differences between groups were observed in the leukocyte levels (with an average level of 2.5 . 109 / L in the infectious group versus 6 . 109 / L in the toxic group), eosinophils (with an average of 3.6 % in the toxic group versus 1.75 % in the infectious group), C-reactive protein (with an average level of 146.7 mg / L in the infectious group versus 52.4 mg / L in the toxic group), and creatinine (with an average of 0.085 mmol / L in the toxic group versus 0.071 mmol / L in the infectious group).Conclusion. The data obtained in this research indicates the value of taking an anamnesis and the importance of performing additional studies in patients with suspected drug-induced lung injury, as well as identifies risk groups. Based on the revealed differences, a scale for the differential diagnosis of drug-induced toxic and infectious lung damage, which includes the results of publicly available research methods, with high sensitivity and specificity, was proposed. Further research for more specific, but, at the same time, universal for various drugs, criteria for toxic lung damage is relevant.

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Questions of ethical regulation of immunobiological therapy of some occupational lung diseases

2021

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Objective. Taking into account a high prevalence of occupational pathology associated with the exposure of industrial aerosols, to analyze the principles of therapy used for patients with these diseases. Materials and methods. The regulating medical documents, the data of preventive medical examinations as well as the principles of therapy applied for patients with occupational diseases, which are presented in scientific literarure, are analyzed. Results. The role of harmful production factors in the formation of pneumoconiosis and alveolitis, which join the group of interstitial lung diseases (ILD), has been proved. The outcome of these occupational diseases is fibrosing alveolitis with the development of diffuse pulmonary fibrosis. In the treatment of ILD, immunobiological drugs (IBD) are used to suppress the immune processes selectively affecting the monoclonal antibodies, blocking of which interrupts inflammation and in 90 % of cases stops the further development of the disease. Conclusions. The use of immunobiological drugs in clinical practice should be carried out within the framework of ethical and legal regulation between the patient and the doctor.

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Extrinsic interstitial lung disease activity markers

Cited by 4 publications

References 17 publications

Peripheral Blood Biomarker Krebs von den Lungen 6 (KL-6) for Interstitial and Other Lung Diseases

Peripheral Blood Biomarker Krebs von den Lungen 6 (KL-6) for Interstitial and Other Lung Diseases

Toxic and infectious lung injury differential diagnosis specifics in oncohematological patients

Questions of ethical regulation of immunobiological therapy of some occupational lung diseases

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