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Human epididymis protein 4 is a new biomarker to predict the prognosis of progressive fibrosing interstitial lung disease
Authors:Naoki Nishiyama  Masahiro Masuo  Yoshihisa Nukui  Tomoya Tateishi  Mitsuhiro Kishino  Ukihide Tateishi  Kaori Morota  Kazuyuki Ohbo  Yasunari Miyazaki
Institution:1. Department of Respiratory Medicine, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan;2. Department of Diagnostic Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan;3. Scientific Affairs, Diagnostics Division, Abbott Japan LLC, 3-5-27 Mita Minato-ku, Tokyo, 108-6305, Japan;4. Department of Histology and Cell Biology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan;1. Department of Respiratory Medicine, Ichinomiya-nishi Hospital, Ichinomiya, Japan;2. Department of Radiology, Ichinomiya-nishi Hospital, Ichinomiya, Japan;1. Nihon University School of Medicine, Division of Respiratory Medicine, Itabashi, Tokyo, Japan;2. Ishikawa Prefectural Central Hospital, Kanazawa, Ishikawa, Japan;3. Nagaoka Red Cross Hospital, Nagaoka, Niigata, Japan;4. AstraZeneca, Morristown, NJ, USA;5. AstraZeneca, Gaithersburg, MD, USA;6. AstraZeneca K.K., Osaka, Osaka, Japan;1. Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan, 5-1-1 Nabeshima, Saga, Saga prefecture, 849-8501, Japan;2. Department of Otolaryngology, Head & Neck Surgery, Faculty of Medicine, Saga University, Saga, Japan, 5-1-1 Nabeshima, Saga, Saga prefecture, 849-8501, Japan;1. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Hokkaido, Japan;2. Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
Abstract:BackgroundThe clinical course and prognosis of progressive fibrosing interstitial lung diseases (PF-ILDs) vary between individuals. Notably, predictive serum biomarkers for disease management are needed. Serum human epididymis protein 4 (HE4) is reportedly elevated in patients with idiopathic pulmonary ?brosis (IPF); however, its clinical utility remains unknown. We evaluated the potential of serum HE4 as a biomarker for patients with PF-ILD.MethodsSerum HE4 was measured in a retrospective study consisting of 34 patients with PF-ILD and 40 healthy volunteers. The relationship between serum HE4 levels and clinical parameters or prognosis was investigated. To validate the significance of results obtained, a prospective observational study was performed in 37 patients presenting PF-ILD and 40 control patients without PF-ILD.ResultsSerum HE4 levels were higher in patients with PF-ILD than in healthy volunteers (P < 0.01). Moreover, serum HE4 levels correlated with the extent of honeycombing on chest high-resolution computed tomography (r = 0.41, P = 0.015). In multivariate analysis using the Cox proportional hazard model, higher HE4 levels (>238 pmol/L) were associated with an elevated mortality risk; hazard ratio (HR) 7.27, 95% CI 1.56–34.0, P = 0.01 in the derivation cohort; HR 44.3, 95% CI 4.19–468, P < 0.01 in validation cohort.ConclusionsSerum HE4 levels may serve as a new diagnostic and prognostic biomarker for patients with PF-ILD.
Keywords:Human epididymis protein 4  Progressive fibrosing interstitial lung disease  Honeycombing  Prognosis  Biomarker  CHP"}  {"#name":"keyword"  "$":{"id":"kwrd0040"}  "$$":[{"#name":"text"  "_":"chronic hypersensitivity pneumonia  CTD"}  {"#name":"keyword"  "$":{"id":"kwrd0050"}  "$$":[{"#name":"text"  "_":"connective tissue disease  DLCO"}  {"#name":"keyword"  "$":{"id":"kwrd0060"}  "$$":[{"#name":"text"  "_":"diffusing capacity for carbon monoxide  eGFR"}  {"#name":"keyword"  "$":{"id":"kwrd0070"}  "$$":[{"#name":"text"  "_":"estimated glomerular filtration rate  FEV1"}  {"#name":"keyword"  "$":{"id":"kwrd0080"}  "$$":[{"#name":"text"  "_":"forced expiratory volume  FVC"}  {"#name":"keyword"  "$":{"id":"kwrd0090"}  "$$":[{"#name":"text"  "_":"forced vital capacity  HE4"}  {"#name":"keyword"  "$":{"id":"kwrd0100"}  "$$":[{"#name":"text"  "_":"human epididymis protein 4  HV"}  {"#name":"keyword"  "$":{"id":"kwrd0110"}  "$$":[{"#name":"text"  "_":"healthy volunteer  HRCT"}  {"#name":"keyword"  "$":{"id":"kwrd0120"}  "$$":[{"#name":"text"  "_":"high-resolution computed tomography  IIPs"}  {"#name":"keyword"  "$":{"id":"kwrd0130"}  "$$":[{"#name":"text"  "_":"idiopathic interstitial pneumonias  ILD"}  {"#name":"keyword"  "$":{"id":"kwrd0140"}  "$$":[{"#name":"text"  "_":"interstitial lung disease  IPF"}  {"#name":"keyword"  "$":{"id":"kwrd0150"}  "$$":[{"#name":"text"  "_":"idiopathic pulmonary ?brosis  KL-6"}  {"#name":"keyword"  "$":{"id":"kwrd0160"}  "$$":[{"#name":"text"  "_":"Krebs von den Lungen 6  NSIP"}  {"#name":"keyword"  "$":{"id":"kwrd0170"}  "$$":[{"#name":"text"  "_":"nonspecific interstitial pneumonia  PF-ILD"}  {"#name":"keyword"  "$":{"id":"kwrd0180"}  "$$":[{"#name":"text"  "_":"progressive fibrosing-interstitial lung disease  SP-D"}  {"#name":"keyword"  "$":{"id":"kwrd0190"}  "$$":[{"#name":"text"  "_":"surfactant protein D  UIP"}  {"#name":"keyword"  "$":{"id":"kwrd0200"}  "$$":[{"#name":"text"  "_":"usual interstitial pneumonia  VA"}  {"#name":"keyword"  "$":{"id":"kwrd0210"}  "$$":[{"#name":"text"  "_":"alveolar volume
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