{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:51:32Z","timestamp":1767898292113,"version":"3.49.0"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP18fk0108043"],"award-info":[{"award-number":["JP18fk0108043"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>The lack of useful biomarkers reflecting the disease state limits the management of <jats:italic>Mycobacterium avium<\/jats:italic> complex lung disease (MAC\u2010LD). We clarified the associations between serum KL\u20106 level, disease progression and treatment response.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Resected lung tissues from MAC\u2010LD patients were immunostained for KL\u20106. We compared serum KL\u20106 levels between MAC\u2010LD and healthy control or bronchiectasis patients without nontuberculous mycobacterial lung disease (NTM\u2010LD). Serum KL\u20106 level was assessed in a prospective observational study at Keio University Hospital between May 2012 and May 2016. We investigated associations between serum KL\u20106 level and disease progression and treatment response in patients untreated for MAC\u2010LD on registration (<jats:italic>n<\/jats:italic> = 187).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The KL\u20106<jats:sup>+<\/jats:sup> alveolar type 2 cell population in the lung and serum KL\u20106 level were significantly higher in MAC\u2010LD patients than in controls. Serum KL\u20106 level in bronchiectasis patients without NTM\u2010LD showed no significant increase. Of the 187 patients who did not receive treatment on registration, 53 experienced disease progression requiring treatment. Multivariable Cox analysis revealed that the serum KL\u20106 level (aHR: 1.18, <jats:italic>P<\/jats:italic> = 0.005), positive acid\u2010fast bacilli smear (aHR: 2.64, <jats:italic>P<\/jats:italic> = 0.001) and cavitary lesions (aHR: 3.01, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) were significantly associated with disease progression. The change in serum KL\u20106 (\u0394KL\u20106) was significantly higher in the disease progression group; it decreased post\u2010treatment, reflecting the negative sputum culture conversion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Serum KL\u20106 level is associated with disease progression and treatment response. Longitudinal assessment combined with AFB smear status and presence of cavitary lesions may aid MAC\u2010LD management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.13886","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T02:45:13Z","timestamp":1593485113000},"page":"112-119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Serum Krebs von den Lungen\u20106 level in the disease progression and treatment of <scp><i>Mycobacterium avium<\/i><\/scp> complex lung disease"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3122-6937","authenticated-orcid":false,"given":"Takanori","family":"Asakura","sequence":"first","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Medicine Keio University School of Medicine  Tokyo Japan"},{"name":"Department of Mycobacteriology, Leprosy Research Center National Institute of Infectious Diseases  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