Source: Annual Congress 2011 - Bronchoalveolar lavage and biomarkers in diffuse parenchymal lung disease
Disease area: Interstitial lung diseases

Abstract

KL-6, and Surfactant Protein (SP)-A and SP-D have been reported as sensitive markers for interstitial lung disease (ILD). However, a more useful serum marker for diagnosis and activity of ILD may be found in napsin A, an asparatic protease, mainly expressed in alveolar type-II cells and the kidney. This study sought to evaluate the diagnostic and monitoring value of napsin A in patients with ILD in comparison with KL-6, SP-A, and SP-D, and to determine whether serum napsin A levels reflect renal dysfunction.
Subjects consisted of 34 patients with ILD, 20 patients with lung adenocarcinoma, 12 patients with kidney disease, and 20 healthy subjects. Serum samples were analyzed for each marker by ELISA. The area under the receiver operating characteristic curves (AUC) were used to determine appropriate cut-off levels resulting in optimal diagnostic accuracy using napsin A as a marker; differences in serum levels of these markers were investigated. Further, 10 patients with ILD were treated and evaluated for treatment efficacy and usefulness of napsin A as a monitoring marker.
The AUC values for ILD patients in comparison with control subjects were 0.949 for napsin A, 0.978 for KL-6, 0.896 for SP-A, and 0.791 for SP-D. As specific markers to distinguish ILD from lung cancer, the AUC values were 0.907 for napsin A, 0.939 for KL-6, 0.762 for SP-A, and 0.672 for SP-D. The accuracy of changes in these serum markers reflecting response to therapy were 80% for napsin A, 50% for KL-6, 70% for SP-A, and 70% for SP-D. Moreover, serum napsin A level reflected no renal dysfunction.
Serum napsin A is a novel diagnostic and monitoring marker for ILD that is superior to SP-A and SP-D, and equivalent to KL-6.

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Citations should be made in the following way:
T. Samukawa, T. Hamada, G. Tsukuya, H. Inoue (Kagoshima, Japan). Serum napsin A is a novel diagnostic and monitoring marker for interstitial lung disease. Eur Respir J 2011; 38: Suppl. 55, 4774

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