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DOI:    [Accepted]
Role of Krebs von den lungen-6 (KL-6) in assessing hypersensitivity pneumonitis
Amira Ismail Mostafa1, Heba Allah Moussa Ahmed1, Aml Ibrahim Bayoumi1, Rasha M. AbdelSamie2, Radwa M Abdel Halim3, Ayman Elsayed Salem1
1chest department, faculty of medicine Cairo university
2Internal medicine department, faculty of medicine Cairo university
3chemical pathology department, faculty of medicine Cairo university
Correspondence:  Amira Ismail Mostafa, Tel: 02001224977400, Fax: 02001002983983, 
Received: 9 October 2020   • Revised: 7 March 2021   • Accepted: 5 April 2021
Hypersensitivity pneumonitis (HP) is an increasingly recognized form of diffuse parenchymal lung disease. Krebs von den Lungen-6 (KL-6) is now classified as a human MUC1 mucin protein, and regenerating type II pneumocytes are the primary cellular source of KL-6/MUC1 in the affected lungs of patients with ILD. Serum KL-6/MUC1 levels have been demonstrated to be useful for evaluating various ILD. Objectives: To determine the role of circulating KL-6 in evaluating the disease activity and management of HP.
An observational cross-sectional study was conducted on 51 patients with HP and 20 healthy controls. Serum KL-6 levels were measured. Patients were further assessed by chest high-resolution computed tomography (HRCT), pulmonary function tests, six-minute walk test, echocardiography, bronchioalveolar lavage, and/or transbronchial biopsy. Patients were divided into the fibrotic and non-fibrotic groups according to the HRCT findings.
The median serum KL-6 levels were significantly higher in HP patients as compared to the control group. The median serum KL-6 levels were found to be higher in the non -fibrotic HP group (1900 IU/mL) as compared to the fibrotic group (1200 IU/mL). There was a significant inverse correlation between serum KL-6 serum level and the dose of steroids as well as duration of steroid therapy.
The presence of higher KL-6 levels in the non-fibrotic HP group implies its enhanced production by regenerating pneumocytes in response to alveolar injury. The significant association between serum KL-6 levels and the dose and the duration of steroid therapy emphasized the important role of steroids in stabilization of the disease.
Key Words: Hypersensitivity pneumonitis, Serum biomarker, KL-6, Assessment of severity

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