Valuable Serum Markers in Pulmonary Alveolar Proteinosis.

Shenyun Shi,Lulu Chen,Xiaohua Qiu,Xin Yan,Qi Zhao,Yonglong Xiao

doi:10.1155/2019/9709531

Abstract

Objective Several serum markers were reported to reflect the severity of pulmonary alveolar proteinosis (PAP). The aim of this study is to investigate a reliable and facile marker to access and monitor the clinical course of PAP in a large cohort. Methods PAP patients from January 2010 to June 2018 were enrolled. Hospital records were used as data sources. The levels of various serum indicators were detected. We evaluated the correlation between pulmonary function test results and clinical variables. Results Diffusion capacity for carbon monoxide (DLCO) level was positively correlated with the level of high-density lipoprotein cholesterol (HDL-C) (P < 0.05) in 122 patients of PAP at baseline. The levels of HDL-C and DLCO significantly increased while carcinoembryonic antigen (CEA), CYFRA21-1, neuron-specific enolase (NSE), and lactic dehydrogenase (LDH) levels decreased six months after granulocyte-macrophage colony-stimulating factor (GM-CSF) inhalation therapy between 14 patients with PAP. Nevertheless, the increased DLCO was significantly correlated with decreased CEA (r = ‐0.579, P = 0.031) and CYFRA 21-1 (r = ‐0.632, P = 0.015). In 10 PAP patients without GM-CSF inhalation therapy, HDL-C and DLCO significantly decreased while NSE and LDH levels increased after six months of follow-up. The decreased DLCO was significantly correlated with increased LDH (r = ‐0.694, P = 0.026). Conclusions Serum CEA, CYFRA21-1, and LDH are valuable serum markers for the evaluation of disease activity of PAP and may predict the response to treatment of PAP.

Highlights

Pulmonary alveolar proteinosis (PAP) is a rare and severe disease in which characterized by the accumulation of lipoproteinaceous material within the alveoli and terminal airways [1]
PAP has been described in three forms clinically: primary PAP that can be autoimmune PAP which is associated with elevated levels of autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF) or hereditary PAP which is due to gene mutations of GM-CSF receptor alpha and beta genes (CSF2RA and CSF2RB, respectively), secondary PAP, and congenital PAP
Levels of lactic dehydrogenase (LDH), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), neutrophil count, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and high-density lipoprotein cholesterol (LDL-C) were significantly distinguished in PAP patients compared with normal subjects

Summary

Objective

Several serum markers were reported to reflect the severity of pulmonary alveolar proteinosis (PAP). We evaluated the correlation between pulmonary function test results and clinical variables. Diffusion capacity for carbon monoxide (DLCO) level was positively correlated with the level of high-density lipoprotein cholesterol (HDL-C) (P < 0:05) in 122 patients of PAP at baseline. The levels of HDL-C and DLCO significantly increased while carcinoembryonic antigen (CEA), CYFRA21-1, neuron-specific enolase (NSE), and lactic dehydrogenase (LDH) levels decreased six months after granulocyte-macrophage colony-stimulating factor (GM-CSF) inhalation therapy between 14 patients with PAP. The increased DLCO was significantly correlated with decreased CEA (r = ‐0:579, P = 0:031) and CYFRA 21-1 (r = ‐0:632, P = 0:015). In 10 PAP patients without GM-CSF inhalation therapy, HDL-C and DLCO significantly decreased while NSE and LDH levels increased after six months of follow-up. The decreased DLCO was significantly correlated with increased LDH (r = ‐0:694, P = 0:026).

Background

Subjects and Methods

Method

Results

Discussion

Conflicts of Interest