Serum and BALF YKL-40 levels are predictors of survival in idiopathic pulmonary fibrosis

Nicoline M. Korthagen, Coline H.M. Van Moorsel, Nicole P. Barlo, Henk J.T. Ruven, Adrian Kruit, Michiel Heron, Jules M.M. Van Den Bosch, Jan C. Grutters

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86 Citations (Scopus)

Abstract

Background: The chitinase-like protein YKL-40 is a serum biomarker in diseases with fibrosis, inflammation and tissue remodelling. Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease that is hallmarked by these processes. The aim of this study was to investigate the potential of YKL-40 as a prognostic biomarker for survival in IPF patients. Methods: Serum and bronchoalveolar lavage fluid (BALF) levels of YKL-40 at the time of diagnosis and a promoter polymorphism in CHI3L1, the gene encoding YKL-40, were determined in 85 IPF patients and 126 controls. The relationship between YKL-40 levels and clinical parameters was evaluated. Kaplan-Meier and Cox regression analyses were used to examine the association between YKL-40 levels and survival. Results: Serum and BALF YKL-40 levels were significantly higher in patients than in healthy controls (p < 0.001). The - 329 A/G polymorphism had a significant influence on BALF YKL-40 levels and the influence on serum YKL-40 levels showed a trend towards significance in IPF patients. IPF patients with high (> 79 ng/ml) serum or high BALF YKL-40 (> 17 ng/ml) levels had significantly shorter survival than those with low YKL-40 levels in serum or BALF. In patients with both low serum and low BALF YKL-40 levels no IPF related mortality was observed. Cox regression modelling showed that there were no confounding factors. Conclusions: The - 329 polymorphism was associated with serum and BALF YKL-40 levels in IPF patients. High serum and BALF YKL-40 levels are associated with poor survival in IPF patients and could be useful prognostic markers for survival in IPF.

Original languageEnglish
Pages (from-to)106-113
Number of pages8
JournalRespiratory Medicine
Volume105
Issue number1
DOIs
Publication statusPublished - Jan 2011

Keywords

  • CHI3L1
  • Chitinase-like proteins
  • Interstitial lung disease
  • Single nucleotide polymorphism
  • YKL-40

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