Systemic sclerosis & Raynaud's
Performance of serum biomarkers reflective of different pathogenic processes in systemic sclerosis-associated interstitial lung disease
Authors' conclusion
All candidates performed well as diagnostic biomarkers for SSc-ILD.
Study context
- Population
- SSc patients with baseline and follow-up serum samples
- Participants
- 225 patients
- Exposure
- SSc patients with vs without interstitial lung disease (ILD); serum KL-6, SP-D, CCL18, YKL-40 and MMP-7
- Outcome
- Association of serum biomarkers (KL-6, SP-D, CCL18, YKL-40, MMP-7) with presence of SSc-ILD
Methodological detailsbaseline and follow-up serum samples, ELISA, linear mixed models, random forest models, Progressive ILD defined according to the 2022-ATS/ERS/JRS/ALAT guidelines
- Baseline and follow-up serum samples
- ELISA
- Linear mixed models
- Random forest models
- Progressive ILD defined according to the 2022-ATS/ERS/JRS/ALAT guidelines
Main finding
As reported in the abstract
Association of serum levels with presence of SSc-ILD (independent)
- KL-6, MD
- 35.67 (22.44-48.89), P < 0.01 (95% CI)
- SP-D, MD
- 81.13 (28.46-133.79), P < 0.01 (95% CI)
- CCL18, MD
- 17.07 (6.36-27.77), P < 0.01 (95% CI)
- YKL-40, MD
- 22.81 (7.19-38.44), P < 0.01 (95% CI)
- MMP-7, MD
- 2.84 (0.88-4.80), P < 0.01 (95% CI)
Observational data: associations, not effects.
Further findings
Machine-learning model with all candidates classifying patients with or without ILD
- Accuracy
- 85%
Combination of KL-6 and SP-D: presence and previous progression of SSc-ILD
- Presence of SSc-ILD
- 0.77 (0.53-1.00, P' <0.01) (95% CI)
- Previous progression, OR
- 1.28 (1.01-1.61, P' =0.047) (95% CI)
Higher baseline levels and odds of future SSc-ILD progression (independent of conventional risk factors)
- KL-6, OR
- 3.70 (1.52-9.03), P < 0.01 (95% CI)
- SP-D, OR
- 2.00 (1.06-3.78), P = 0.03 (95% CI)
- KL-6 + SP-D combination
- 1.109 (0.665-1.554), P < 0.01 (95% CI)
- Combination showed improved performance compared with KL-6 and SP-D alone
Original publication
Performance of serum biomarkers reflective of different pathogenic processes in systemic sclerosis-associated interstitial lung disease. Rheumatology (Oxford). Published 8 July 2023. doi:10.
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