Relationship between Serum SP-D，KL-6 and sPD-L2 Levels and Disease Severity in Patients with Chronic Obstructive Pulmonary Disease

MAIRIYEMUGULI·Aishan; ABUDUHALIKE·Abudureheman; ZULIPIKAER·Abudureheman; Yun CHEN; Xuemei ZHONG

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Article Navigation > Journal of Kunming Medical University > 2026 > Accepted Manuscript

MAIRIYEMUGULI·Aishan, ABUDUHALIKE·Abudureheman, ZULIPIKAER·Abudureheman, Yun CHEN, Xuemei ZHONG. Relationship between Serum SP-D，KL-6 and sPD-L2 Levels and Disease Severity in Patients with Chronic Obstructive Pulmonary Disease[J]. Journal of Kunming Medical University.

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Relationship between Serum SP-D，KL-6 and sPD-L2 Levels and Disease Severity in Patients with Chronic Obstructive Pulmonary Disease

1.
Department of Respiratory and Critical Care Medicine
2.
Department of Pediatric Bone Tumor，The First People's Hospital of Kashi，Kashi Xinjiang 844000
3.
Xinjiang Clinical Research Center for Infectious Diseases （Tuberculosis），Kashgar Xinjiang 844000，China

Abstract

Abstract

Objective To explore the relationship between serum levels of pulmonary surfactant protein D （SP-D）, Krebs von den Lungen-6 （KL-6）, and soluble programmed death-ligand 2 （sPD-L2） and disease severity in patients with chronic obstructive pulmonary disease （COPD）. Methods A prospective study enrolled 153 COPD patients and 100 healthy controls from the First People's Hospital of Kashgar Region between June 2023 and December 2024. Based on the GOLD criteria, COPD patients were classified into Group A （39 cases）, Group B （53 cases）, and Group E （61 cases）, which were further stratified into low-risk group （Group A） and high-risk group （Group B+E）. Serum levels of SP-D, KL-6, and sPD-L2 were measured. High-resolution computed tomography （HRCT） parameters including percentage of low attenuation area （LAA%）, and bronchial wall thickness of bilateral lungs were obtained. Pulmonary function indices including forced expiratory volume in one second （FEV₁）, FEV₁ as percentage of predicted value （FEV₁%predicted）, and ratio of forced expiratory volume in one second to forced vital capacity （FEV₁/FVC） were assessed. Pearson correlation analysis was used to evaluate associations between variables. Receiver operating characteristic （ROC） curves were constructed to assess the discriminatory efficiency of biomarkers for disease severity. Results Serum levels of SP-D, KL-6, sPD-L2, LAA%, and bronchial wall thickness were significantly higher in the COPD group compared with controls, while pulmonary function indices were significantly decreased （P < 0.05）. With increasing GOLD classification, serum biomarkers and HRCT parameters increased progressively, while pulmonary function decreased （P < 0.05）. Pearson correlation analysis revealed that SP-D, KL-6, and sPD-L2 were negatively correlated with pulmonary function indices and positively correlated with HRCT parameters. ROC curve analysis showed that the combined predictive value of the three biomarkers for COPD severity yielded an AUC of 0.896 （95% CI: 0.836-0.939）, which was significantly superior to any single biomarker alone （Z = 2.909, 2.224, 3.134; all P < 0.05）. Conclusion Serum levels of SP-D, KL-6 and sPD-L2 are associated with disease severity in COPD patients. The combined assessment using these three biomarkers demonstrates superior efficacy in evaluating disease severity in COPD patients.

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References(20)

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