KL-6 and Surfactant Proteins A and D in Serum and Bronchoalveolar Lavage Fluid in Patients with Acute Eosinophilic Pneumonia

Daimon, Tadahisa; Tajima, Shunji; Oshikawa, Katsuhisa; Bando, Masashi; Ohno, Shoji; Sugiyama, Yukihiko

doi:10.2169/internalmedicine.44.811

Cited by 28 publications

(22 citation statements)

References 30 publications

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“…Elevated KL-6 levels in bronchoalveolar lavage (BAL) fluid have been demonstrated in pulmonary alveolar proteinosis, hypersensitivity pneumonitis, sarcoidosis, acute respiratory distress syndrome and idiopathic pulmonary fibrosis,22 29 30 and in various ILDs elevated serum KL-6 levels have been correlated with BAL levels 26 27. In adults, 500 U/ml has been suggested as an upper limit of normal for serum levels 21. While not as well defined in children, studies reporting healthy paediatric controls have consistently reported serum KL-6 levels below this cut-off and that these levels do not vary with age 18 20 28 31 – 34.…”

Section: Discussionmentioning

confidence: 99%

“…Investigators have demonstrated increased expression of KL-6 on regenerating alveolar cells in patients with various types of ILD, with correspondingly high serum levels 16 17. Such elevated KL-6 levels have also been reported in various forms of chILD,18 while normal levels are seen in asthma, bronchiolitis, pertussis, common viral and bacterial pneumonias, and acute eosinophilic pneumonia 19 – 21. Furthermore, while KL-6 levels have been correlated with disease activity, they do not appear to be affected by steroid therapy 22…”

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confidence: 97%

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Serum KL-6 differentiates neuroendocrine cell hyperplasia of infancy from the inborn errors of surfactant metabolism

Doan

Elidemir

Dishop

et al. 2009

Thorax

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Background: The study was conducted in order to determine if the glycoprotein KL-6 is a useful biomarker in differentiating neuroendocrine cell hyperplasia of infancy (NEHI), a benign form of children's interstitial lung disease, from the more severe inborn errors of surfactant metabolism (IESM), since their clinical presentation can be similar. Methods: Serum KL-6 levels were measured in 10 healthy control children, 6 with NEHI and 13 with IESM (4 with surfactant protein C (SP-C) and 9 with ABCA3 mutations). The initial clinical presentation, findings on previous CT scans and interstitial lung disease (ILD) scores at the time of KL-6 testing were compared. Correlations of KL-6 levels with age and with interval from lung biopsy were evaluated. Results: The median (range) KL-6 levels were 265 (1-409), 194 (47-352), 1149 (593-4407) and 3068 (726-9912) U/ml for the control, NEHI, SP-C and ABCA3 groups, respectively. When compared with the control and NEHI groups, median KL-6 levels were significantly higher in the SP-C (p,0.01; p = 0.01, respectively) and ABCA3 groups (p,0.001; p = 0.001, respectively); however, there was no difference between the control and NEHI groups (p = 0.91). An inverse relationship was seen between KL-6 levels and age in the IESM groups, but not in the NEHI or control groups. Children with NEHI had similar presenting clinical features and were equally symptomatic at the time of KL-6 measurement as those with IESM.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 97%

Serum KL-6 differentiates neuroendocrine cell hyperplasia of infancy from the inborn errors of surfactant metabolism

Doan

Elidemir

Dishop

et al. 2009

Thorax

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“…[1][2][3][4][5][6][7][8][9][10][11][12] In bronchoalveolar lavage, sterile saline is administered into the bronchoalveolar space and aspirated by syringe. …”

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confidence: 99%

“…[1][2][3][4][5][6]8) Furthermore, the absolute concentration of albumin itself in BALF may allow characterization of interstitial lung disorders. 9,10) Therefore a sensitive and simple method for determining trace amounts of albumin in BALF is desirable.…”

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confidence: 99%

Fluorimetric Determination of Trace Amounts of Albumin in Bronchoalveolar Lavage Fluid with Eriochrome Cyanine R

Sato

Saito

Chikuma

et al. 2007

Biological & Pharmaceutical Bulletin

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Bronchoalveolar lavage has been widely used to recover cells, proteins, and small molecules from the alveolar space of the lower respiratory tract since the first report of Reynolds and Newball over three decades ago.1) The analysis of these components is of wide diagnostic and investigative value. [1][2][3][4][5][6][7][8][9][10][11][12] In bronchoalveolar lavage, sterile saline is administered into the bronchoalveolar space and aspirated by syringe. 1)Because recovery of the components in bronchoalveolar lavage fluid (BALF) varies from sample to sample, their concentrations are usually normalized relative to those of albumin. [1][2][3][4][5][6]8) Furthermore, the absolute concentration of albumin itself in BALF may allow characterization of interstitial lung disorders.9,10) Therefore a sensitive and simple method for determining trace amounts of albumin in BALF is desirable.Dye-binding methods are widely used for the determination of proteins, 13) and spectrophotometric methods using bromocresol green are most commonly used in clinical assays of human serum albumin (HSA).14-17) However, the specificity for HSA in the bromocresol green method is not very high. The bromocresol purple method is also used in clinical measurement of HSA, and is more selective for HSA than the bromocresol green method. 18,19) However, the bromocresol purple method is not applicable to BALF samples of low albumin concentration.Saito et al. 20,21) reported a highly sensitive fluorimetric method using chromazurol S (CAS) for the determination of trace albumin, and pointed out that several reagents analogous to CAS including eriochrome cyanine R (ECR) are promising.22) Subsequently, Ci and Chen 23) reported a fluorimetric method for the determination of HSA using ECR. They used 308 nm as the excitation wavelength. However, Saito's group reported that the HSA-ECR complex showed visible excitation and emission spectra and low reagent blank at pH <4.0. Ultraviolet radiation may give rise to fluorescence of other components. Therefore in the present study we investigated the fluorimetric determination method of human albumin using ECR and visible range as excitation wavelength. This technique was applied to determine trace amounts of human albumin in BALF samples. MATERIALS AND METHODS ReagentsThe chemicals used in the present study were obtained from the sources indicated as follows: Eriochrome cyanine R (ECR), Merck AG (Darmstadt, Germany); human serum albumin (HSA), fraction V grade, and goat anti-HSA antiserum, Sigma Chemical Co. (St. Louis, U.S.A.); 3,3Ј,5,5Ј-tetramethylbenzidine, Nacalai Tesque Inc. (Kyoto, Japan). All solutions were prepared using water purified with a Milli-Q water system (Millipore Corp., Bedford, U.S.A.). Polystyrene balls were obtained from Sekisui Chemical Co., Ltd. (Tokyo, Japan). Bronchoalveolar Lavage Informed consent was obtained from all patients. Fifty milliliters of warm saline was infused through the work channel of a bronchoscope then withdrawn by gentle aspiration. The lavage was repeated 6 times, and a...

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“…Recently, it has been found that AEP patients have elevated surfactant protein-A (SP-A) and surfactant protein-D (SP-D) when compared with healthy individuals. 10 Important CT findings include thickening of bronchovascular bundles (in a random anatomic distribution) and pleural effusions. 11 Histologic findings of eosinophilic pneumonia include interstitial and alveolar eosinophilia with diffuse alveolar damage.…”

Section: Discussionmentioning

confidence: 99%

Acute Eosinophilic Pneumonia

Contreras

Rossi

Schwartz

2007

Pathology Case Reviews

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Acute eosinophilic pneumonia is an acute febrile illness of unknown etiology without other systemic manifestations. It can present itself as an acute respiratory distress-like syndrome, which responds to corticosteroid therapy and does not relapse after discontinuation of therapy. Here we present the case of a 51-year-old man with borderline hypertension who presented to our institution with a 2-week history of sinus congestion and gradual onset of shortness of breath. Acute eosinophilic pneumonia was diagnosed on wedge biopsies and improved with corticosteroid treatment. This case report focuses on acute eosinophilic pneumonia and reviews the clinical, radiologic, and morphologic findings, with an emphasis on differential diagnosis.

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KL-6 and Surfactant Proteins A and D in Serum and Bronchoalveolar Lavage Fluid in Patients with Acute Eosinophilic Pneumonia

Abstract: Abstract

Cited by 28 publications

References 30 publications

Serum KL-6 differentiates neuroendocrine cell hyperplasia of infancy from the inborn errors of surfactant metabolism

Serum KL-6 differentiates neuroendocrine cell hyperplasia of infancy from the inborn errors of surfactant metabolism

Fluorimetric Determination of Trace Amounts of Albumin in Bronchoalveolar Lavage Fluid with Eriochrome Cyanine R

Acute Eosinophilic Pneumonia

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