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Increase of KL-6 in sera of uveitis patients with sarcoidosis

  • Clinical Investigation
  • Published:
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Abstract

Background

KL-6 is a human glycoprotein secreted by type II alveolar cells in lung, and its serum levels increase in pneumonia of various causes. KL-6 is a member of the MUC-1 family, which is expressed in lung, cornea, and conjunctiva. The purpose of the present study was to investigate the clinical usefulness of quantifying serum KL-6 levels for diagnosing sarcoidosis in patients with uveitis.

Methods

Sera were obtained from 24 uveitis patients diagnosed with sarcoidosis, 37 uveitis patients with other etiologies, and 138 healthy control subjects. Serum concentration of KL-6 was determined by a human KL-6 electrochemiluminescence immunoassay.

Results

The average level of KL-6 in the sera of uveitis patients with sarcoidosis was 387 U/ml. This was significantly higher than in healthy subjects and uveitis patients with other etiologies. The KL-6 measurements identified 45.8% of sarcoidosis-positive patients. When the KL-6 results were combined with serum angiotensin-converting enzyme (ACE) concentrations, 87.5% of sarcoidosis patients were identified, compared to 66.7% using ACE results alone. The combined measurement identified 10.8% of the non-sarcoid patients and 0.72% of healthy subjects as positive (false positive).

Conclusion

Combined measurements of serum KL-6 and ACE may be useful as a screening for sarcoidosis in uveitis patients.

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References

  1. Berry M, Ellingham RB, Corfield AP (2000) Membrane-associated mucins in normal human conjunctiva. Invest Ophthalmol Vis Sci 41:398–403

    PubMed  Google Scholar 

  2. Blackburn GF, Shah HP, Kenten JH, Leland J, Kamin RA, Link J, Peterman J, Powell MJ, Shah A, Talley DB, et al (1991) Electrochemiluminescence detection for development of immunoassays and DNA probe assays for clinical diagnostics. Clin Chem 37:1534–1539

    CAS  PubMed  Google Scholar 

  3. Forrester JV, Okada AA, BenEzra D, Ohno S, eds (1998) Posterior segment intraocular inflammation guidelines. Kugler, The Hague

  4. Goda C, Kotake S, Sasamoto Y, Yoshikawa K, Okamoto T, Matsuda H (1998) [Clinical manifestations and diagnosis of patients with sarcoidosis]. Nippon Ganka Gakkai Zasshi 102:106–110

    PubMed  Google Scholar 

  5. Hamada H, Kohno N, Akiyama M, Hiwada K (1992) Monitoring of serum KL-6 antigen in a patient with radiation pneumonia. Chest 101:858–860

    PubMed  Google Scholar 

  6. Henderly DE, Genstler AJ, Smith RE, Rao NA (1987) Changing patterns of uveitis. Am J Ophthalmol 103:131–136

    PubMed  Google Scholar 

  7. Hiraga Y (1989) Annual Report of Diffuse Lung Disease Research Committee. The Ministry of Health and Welfare, Japan

  8. Hirasawa Y, Kohno N, Yokoyama A, Inoue Y, Abe M, Hiwada K (1997) KL-6, a human MUC1 mucin, is chemotactic for human fibroblasts. Am J Respir Cell Mol Biol 17:501–507

    PubMed  Google Scholar 

  9. Imai T, Takase M, Takeda S, Kougo T (2002) Serum KL-6 levels in pediatric patients: reference values for children and levels in pneumonia, asthma, and measles patients. Pediatr Pulmonol 33:135–141

    Article  PubMed  Google Scholar 

  10. Inatomi T, Spurr-Michaud S, Tisdale AS, Gipson IK (1995) Human corneal and conjunctival epithelia express MUC1 mucin. Invest Ophthalmol Vis Sci 36:1818–1827

    PubMed  Google Scholar 

  11. Inoue Y, Barker E, Daniloff E, Kohno N, Hiwada K, Newman LS (1997) Pulmonary epithelial cell injury and alveolar-capillary permeability in berylliosis. Am J Respir Crit Care Med 156:109–115

    CAS  PubMed  Google Scholar 

  12. Kijlstra A, Rothova A, Baarsma GS, Zaal MJ, Fortuin ME, Schweitzer C, Glasius E, de Jong PT (1987) Computer registration of uveitis patients. Doc Ophthalmol 67:139–143

    PubMed  Google Scholar 

  13. Kitaichi N, Kotake S, Sasamoto Y, Namba K, Matsuda A, Ogasawara K, Onoé K, Matsuda H, Nishihira J (1999) Prominent increase of macrophage migration inhibitory factor in the sera of patients with uveitis. Invest Ophthalmol Vis Sci 40:247–250

    PubMed  Google Scholar 

  14. Kitaichi N, Kotake S, Mizue Y, Matsuda H, Onoé K, Nishihira J (2000) Increase of macrophage migration inhibitory factor in sera of patients with iridocyclitis. Br J Ophthalmol 84:1423–1425

    Article  PubMed  Google Scholar 

  15. Kobayashi J, Kitamura S (1995) KL-6: a serum marker for interstitial pneumonia. Chest 108:311–315

    CAS  PubMed  Google Scholar 

  16. Kobayashi J, Kitamura S (1996) Serum KL-6 for the evaluation of active pneumonitis in pulmonary sarcoidosis. Chest 109:1276–1282

    PubMed  Google Scholar 

  17. Kohno N, Akiyama M, Kyoizumi S, Hakoda M, Kobuke K, Yamakido M (1988) Detection of soluble tumor-associated antigens in sera and effusions using novel monoclonal antibodies, KL-3 and KL-6, against lung adenocarcinoma. Jpn J Clin Oncol 18:203–216

    CAS  PubMed  Google Scholar 

  18. Kohno N, Kyoizumi S, Awaya Y, Fukuhara H, Yamakido M, Akiyama M (1989) New serum indicator of interstitial pneumonitis activity. Sialylated carbohydrate antigen KL-6. Chest 96:68–73

    CAS  PubMed  Google Scholar 

  19. Kohno N, Awaya Y, Oyama T, Yamakido M, Akiyama M, Inoue Y, Yokoyama A, Hamada H, Fujioka S, Hiwada K (1993) KL-6, a mucin-like glycoprotein, in bronchoalveolar lavage fluid from patients with interstitial lung disease. Am Rev Respir Dis 148:637–642

    PubMed  Google Scholar 

  20. Kotake S, Furudate N, Sasamoto Y, Yoshikawa K, Goda C, Matsuda H (1996) Characteristics of endogenous uveitis in Hokkaido, Japan. Graefes Arch Clin Exp Ophthalmol 234:599–603

    PubMed  Google Scholar 

  21. Kotake S, Kitaichi N, Ohno S (2002) Macrophage migration inhibitory factor in uveitis. Int Ophthalmol Clin 42:99–103

    Google Scholar 

  22. Narita M, Nakayama M, Yamada S, Togashi T (2001) Elevated KL-6 levels in fatal measles pneumonia. Eur J Pediatr 160:454–455

    Article  PubMed  Google Scholar 

  23. Nishimura J, Ito K, Asai Y, Kohno N, Hiwada K, Kobayashi J, Kitamura S (1997) Development of an electrochemiluminescence immunoassay for KL-6. Respir Mol Med 1:76–82

    Google Scholar 

  24. Ohara K, Okubo A, Kamata K, Sasaki H, Kobayashi J, Kitamura S (1993) Transbronchial lung biopsy in the diagnosis of suspected ocular sarcoidosis. Arch Ophthalmol 111:642–644

    PubMed  Google Scholar 

  25. Oyama T, Kohno N, Yokoyama A, Hirasawa Y, Hiwada K, Oyama H, Okuda Y, Takasugi K (1997) Detection of interstitial pneumonitis in patients with rheumatoid arthritis by measuring circulating levels of KL-6, a human MUC1 mucin. Lung 175:379–385

    PubMed  Google Scholar 

  26. Ronday MJ, Stilma JS, Barbe RF, McElroy WJ, Luyendijk L, Kolk AH, Bakker M, Kijlstra A, Rothova A (1996) Aetiology of uveitis in Sierra Leone, west Africa. Br J Ophthalmol 80:956–961

    CAS  PubMed  Google Scholar 

  27. Rothova A (2000) Ocular involvement in sarcoidosis. Br J Ophthalmol 84, 110–116

    Google Scholar 

  28. Semenzato G, Bortoli M, Agostini C (2002) Applied clinical immunology in sarcoidosis. Curr Opin Pulm Med 8:441–444

    Article  PubMed  Google Scholar 

  29. Tran VT, Auer C, Guex-Crosier Y, Pittet N, Herbort CP (1994) Epidemiological characteristics of uveitis in Switzerland. Int Ophthalmol 18:293–298

    PubMed  Google Scholar 

  30. Uyama M (2002) Uveitis in sarcoidosis. Int Ophthalmol Clin 42:143–150

    PubMed  Google Scholar 

  31. Yokoyama A, Kohno N, Hamada H, Sakatani M, Ueda E, Kondo K, Hirasawa Y, Hiwada K (1998) Circulating KL-6 predicts the outcome of rapidly progressive idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 158:1680–1684

    CAS  PubMed  Google Scholar 

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Acknowledgement

The authors are grateful to Dr. Andrew W. Taylor (The Schepens Eye Research Institute & The Harvard Medical School, Boston, MA, USA) for his helpful discussions and to the Eisai Co., Ltd. (Tokyo, Japan) for their technical cooperation. This work was supported by a Grant-in-Aid for JSPS Fellows (Japan Society for the Promotion of Science, Tokyo, Japan).

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Correspondence to Nobuyoshi Kitaichi.

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Kitaichi, N., Kotake, S., Shibuya, H. et al. Increase of KL-6 in sera of uveitis patients with sarcoidosis. Graefe's Arch Clin Exp Ophthalmol 241, 879–883 (2003). https://doi.org/10.1007/s00417-003-0762-1

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  • DOI: https://doi.org/10.1007/s00417-003-0762-1

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