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Plasma level of club‐cell ( CC ‐16) predicts outcome in amyotrophic lateral sclerosis
Author(s) -
ProntoLaborinho A. C.,
Gromicho M.,
Pereira M.,
Pinto S.,
Barros M. do A.,
Swash M.,
Carvalho M.
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12851
Subject(s) - amyotrophic lateral sclerosis , medicine , biomarker , respiratory failure , vital capacity , cardiology , gastroenterology , respiratory system , respiratory distress , ventilation (architecture) , oncology , lung , disease , surgery , diffusing capacity , lung function , biochemistry , mechanical engineering , chemistry , engineering
Objectives The club cell protein ( CC ‐16) is a biomarker associated with respiratory distress and pulmonary inflammation. We evaluated CC ‐16 as a candidate biomarker for respiratory failure in amyotrophic lateral sclerosis ( ALS ). Materials and Methods We studied 81 ALS patients and 30 matched controls. We used an ALS ‐related measure of functional capacity, and tested forced vital capacity ( FVC ) and the amplitude of the diaphragmatic response by phrenic nerve stimulation (PhrenAmpl). Plasma CC ‐16 levels were measured in venous blood. Kaplan‐Meier survival curves were plotted to evaluate risk to non‐invasive ventilation and death in patients with abnormal CC ‐16 levels. Results CC ‐16 levels were significantly raised in ALS patients (10.56 ng/mL ± 6.84 vs 8.34 ng/mL ± 3.10, P = .02), and in 17% of them, CC ‐16 level was above the upper cutoff value (mean + 2.5 SD ). CC ‐16 levels did not correlate with age, onset region, disease duration, functional status, FVC , and PhrenAmpl. In patients with increased CC ‐16 level, the risk of non‐invasive was greater in the following 6 months ( P = .01) and tended to have higher mortality in the following 30 months ( P = .07). Conclusions We propose that increased CC ‐16 levels is a marker of lung inflammatory response that associated with ventilatory insufficiency are related to impending respiratory failure, not fully predicted by conventional respiratory tests. The latter are limited by the moment of testing.