{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:59:15Z","timestamp":1790089155948,"version":"4.0.1"},"reference-count":41,"publisher":"The Journal of Rheumatology","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Interstitial lung disease (ILD) is involved in polymyositis\/dermatomyositis (PM\/DM), a disease associated with poor prognoses. Chitinase-3-like-1 protein (YKL-40) has pleiotropic biological activities involved in inflammation, cell proliferation, and tissue remodeling; however, the clinical application of YKL-40 remains limited. We investigated the clinical significance of YKL-40 in PM\/DM\u2013ILD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Sixty-nine consecutive patients with PM\/DM\u2013ILD and 34 healthy controls were analyzed. We measured baseline and followup serum YKL-40 using an ELISA, evaluated the association of YKL-40 with clinical variables and survival, and examined YKL-40 expression in lung specimens from patients with PM\/DM\u2013ILD using immunohistochemistry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Serum YKL-40 levels were significantly greater in patients with PM\/DM\u2013ILD compared with healthy controls (p &lt; 0.0001). Serum YKL-40 was correlated with arterial oxygen pressure (r = \u20130.40, p &lt; 0.001) and percent-predicted DLCO (r = \u20130.41, p = 0.01) in patients with PM\/DM\u2013ILD. Multivariate Cox hazard analysis demonstrated that higher serum YKL-40 and lower percent-predicted forced vital capacity were independently associated with a poor prognosis. Immunohistochemistry analysis demonstrated that YKL-40 expression was enhanced in aggregated intraalveolar macrophages and hyperproliferative alveolar epithelial cells in patients with PM\/DM\u2013ILD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>YKL-40 is a promising biomarker for evaluating PM\/DM\u2013ILD activity\/severity and predicting disease prognosis. Insights into YKL-40 might help elucidate the pathogenesis of PM\/DM\u2013ILD.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.170373","type":"journal-article","created":{"date-parts":[[2017,7,16]],"date-time":"2017-07-16T00:10:17Z","timestamp":1500163817000},"page":"1394-1401","source":"Crossref","is-referenced-by-count":43,"title":["Clinical Utility of YKL-40 in Polymyositis\/dermatomyositis-associated Interstitial Lung 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