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Associations of the Serum KL-6 with Severity and Prognosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

  • RESEARCH
  • COPD
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Abstract

Background

As a biomarker of alveolar-capillary basement membrane injury, Krebs von den Lungen-6 (KL-6) is involved in the occurrence and development of pulmonary diseases. However, the role of the KL-6 in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has yet to be elucidated. This prospective study was designed to clarify the associations of the serum KL-6 with the severity and prognosis in patients with AECOPD.

Methods

This study enrolled 199 eligible AECOPD patients. Demographic data and clinical characteristics were recorded. Follow-up was tracked to evaluate acute exacerbation and death. The serum KL-6 concentration was measured via an enzyme-linked immunosorbent assay.

Results

Serum KL-6 level at admission was higher in AECOPD patients than in control subjects. The serum KL-6 concentration gradually elevated with increasing severity of AECOPD. Pearson and Spearman analyses revealed that the serum KL-6 concentration was positively correlated with the severity score, monocyte count and concentrations of C-reactive protein, interleukin-6, uric acid, and lactate dehydrogenase in AECOPD patients during hospitalization. A statistical analysis of long-term follow-up data showed that elevated KL-6 level at admission was associated with longer hospital stays, an increased risk of future frequent acute exacerbations, and increased severity of exacerbation in COPD patients.

Conclusion

Serum KL-6 level at admission is positively correlated with increased disease severity, prolonged hospital stay and increased risk of future acute exacerbations in COPD patients. There are positive dose–response associations of elevated serum KL-6 with severity and poor prognosis in COPD patients. The serum KL-6 concentration could be a novel diagnostic and prognostic biomarker in AECOPD patients.

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Funding

This work was supported by the National Natural Science Foundation of China (82100078, 82270071), Anhui Provincial Clinical Research Transformation Project (202204295107020014, 202204295107020056), Research Funds of Center for Big Data and Population Health of IHM (JKS2022007), the Scientific Research of Health Commission in Anhui Province (AHWJ2021b091) and the University Natural Science Research Project of Anhui Province (2023AH030117), Anhui Medical University Foundation (2021xkj159), Talent Project of Colleges and Universities in Anhui Province (gxyp2021169) and National Natural Science Foundation Incubation Program of the Second Affiliated Hospital of Anhui Medical University (2019GQFY06).

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Author notes

  1. Yu Wang and Jun Fei have contributed equally to this work.

Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China

    Yu Wang, Jun Fei, Juan Xu, Zhen-Yu Cheng, Jin Yang, Hui Zhao & Lin Fu

  2. Institute of Respiratory Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China

    Jun Fei, Jin Yang, Hui Zhao & Lin Fu

  3. Department of Toxicology, Anhui Medical University, Hefei, 230032, Anhui, China

    Lin Fu

  4. Department of Thoracic Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, 230601, Anhui, China

    Yi-Cheng Ma & Ju-Hong Wu

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Contributions

LF, HZ, and JY contributed to its design and conception. YW, and JF drafted the manuscript. JX, Z-YC, Y-CM, and J-HW contributed to study design and carried out the studies. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jin Yang, Hui Zhao or Lin Fu.

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The authors declare no competing interests.

Ethical Approval

This study was performed in compliance with the Declaration of Helsinki and was approved by the Ethics Committee of the Second Affiliated Hospital of Anhui Medical University (YX2021-146).

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Informed consent was obtained from all individual participants included in the study.

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Wang, Y., Fei, J., Xu, J. et al. Associations of the Serum KL-6 with Severity and Prognosis in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Lung 202, 245–255 (2024). https://doi.org/10.1007/s00408-024-00702-5

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