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(Chest. 2000;118:445-450.)
© 2000 American College of Chest Physicians

Serum KL-6 Concentrations in Dairy Farmers*

Toru Takahashi, MD, PhD; Mitsuru Munakata, MD, PhD; Yoshinori Ohtsuka, MD, PhD; Atsuko Satoh-Kamachi, MD; Rika Sato, MD, PhD; Yukihiko Homma, MD, PhD, FCCP and Yoshikazu Kawakami, MD, PhD, FCCP

* From the First Department of Medicine (Drs. Takahashi, Munakata, Ohtsuka, Satoh-Kamachi, Sato, and Kawakami), School of Medicine, and the Medical Administration Center (Dr. Homma), Hokkaido University, Sapporo, Japan.

Correspondence to: Toru Takahashi, MD, PhD, First Department of Medicine, School of Medicine, Hokkaido University, N-15, W-7, Kitaku, Sapporo 060-8638, Japan

Study objectives: Serum KL-6 (Krebs von den Lungen-6) has been recognized to be a marker for the activity of diffuse interstitial lung diseases. The purpose of the study is to evaluate serum KL-6 measurement as a marker for farmer’s lung disease (FLD).

Design: A cross-sectional survey of a cohort of dairy farmers. Retrospective measurement of KL-6 stored serum samples from those dairy farmers previously screened for FLD.

Setting: University hospital screening project for FLD within a dairy-farming community in Japan.

Participants: Four hundred seventy-two dairy farmers were invited to attend a local clinic.

Measurements and results: We examined serum KL-6 concentrations in 272 farmers. Subjects were classified into three groups: (1) 5 farmers with FLD, (2) 30 farmers with positive serum precipitating antibodies to Saccharopolyspora rectivirgula and/or Thermoactinomyces vulgaris without FLD (Ab+), and (3) 237 farmers without these antibodies (Ab-). Serum KL-6 concentrations in the FLD group were significantly higher than those in the Ab+ and the Ab- groups (1,263 ± 288 [SEM], 328 ± 57, and 207 ± 6 U/mL, respectively, p < 0.001). Serum KL-6 concentrations in those with FLD were significantly higher than KL-6 concentrations from stored screening samples from the same individual when FLD was not diagnosed (1,263 ± 288 and 419 ± 209 U/mL, respectively, p < 0.05). Serum KL-6 concentrations of the Ab+ group were significantly higher than those of the Ab- group (p < 0.001). In the Ab+ group, farmers with high serum KL-6 concentrations had lower permeability coefficients than farmers with normal serum KL-6 concentrations (p < 0.05). These results may suggest that subclinical FLD can be detected in farmers with high KL-6 concentrations and precipitating antibodies.

Conclusion: Serum KL-6 concentration can be a useful marker for assessing the activity of FLD and may be able to be used to detect subclinical disease.

Key Words: farmer’s lung disease • glycoprotein • hypersensitivity pneumonitis • interstitial pneumonia • mucin






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