Higher serum CCL17 may be a promising predictor of acute exacerbations in chronic hypersensitivity pneumonitis
نویسندگان
چکیده
BACKGROUND Recent research has suggested that the Th1 and Th2 chemokine/cytokine axis contributes to the development of chronic hypersensitivity pneumonitis (HP). Acute exacerbations (AE) are significant factors in the prognosis of chronic HP. Little is known, however, about these biomarkers in association with AE in chronic HP patients. METHODS Fifty-six patients with chronic HP were evaluated, including 14 patients during episodes of AE. Th1 mediators (C-X-C chemokine ligand [CXCL]10 and interferon [IFN]-γ), Th2 mediators (C-C chemokine ligand [CCL]17, interleukin-4, and interleukin-13), and pro-fibrotic mediator (transforming growth factor [TGF]-β) were measured to evaluate the mediators as predictors of AE. C-C chemokine receptor (CCR)4 (receptor for CCL17)-positive lymphocytes were quantified in lung specimens. RESULTS Serum CCL17 levels at baseline independently predicted the first episode of AE (HR, 72.0; 95% CI, 5.03-1030.23; p = 0.002). AE was significantly more frequent in the higher-CCL17 group (≥285 pg/ml) than in the lower-CCL17 group (<285 pg/ml) (log-rank test, p = 0.0006; 1-year incidence: higher CCL17 vs. lower CCL17, 14.3% vs. 0.0%). Serum CCL17 levels and CCR4-positive cells during episodes of AE were increased from the baseline (p = 0.01 and 0.031). CONCLUSIONS Higher serum concentrations of CCL17 at baseline may be predictive of AE in patients with chronic HP, and CCL17 may contribute to the pathology of AE by inducing the accumulation of CCR4-positive lymphocytes in the lungs.
منابع مشابه
The Relationship of Serum levels of Vascular Endothelial Growth Factor with Disease Severity and the Number of Exacerbations in COPD Patients
Background: Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung disease characterized by progressive and irreversible obstruction of the airways of the lungs. Different studies have emphasized on the role of Vascular Endothelial Growth Factor (VEGF) in COPD patients. The aim of this study was to investigate the relationship of this factor with disease severity and th...
متن کاملEFFEC T OF HEMODI ALYSIS ON TRACE ELEMENTS IN PATIENTS WITH ACUTE AND CHRONIC RENAL FAILURE
Hemodialysis is being implicated in the development of metabolic disturbances, as complications have been observed and the role of trace metals in their development has been questioned. In 78 renal failure patients who underwent hemodialysis, serum levels of zinc and copper were determined before and after first hemodialysis. Acute and chronic renal failure patients were found to have lowe...
متن کاملInhalation challenge in the differential diagnosis of usual interstitial pneumonia.
The authors stress the importance of distinguishing between idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis in the differential diagnosis, especially in view of the fact that immunosuppressant treatment is suitable for patients with hypersensitivity pneumonitis, but is clearly contraindicated in patients with IPF [2]. Furthermore, the authors note that these diagnos...
متن کاملHypersensitivity pneumonitis from ordinary residential exposures.
A previously healthy woman developed hypersensitivity pneumonitis of such severity that she required chronic systemic corticosteroid therapy for symptom control. Detailed investigation of her workplace and home environments revealed fungi in her typical suburban home, to which she had specific serum precipitating antibodies. Efforts to remove mold from the home were unsuccessful in relieving sy...
متن کاملPathology of hypersensitivity pneumonitis.
PURPOSE OF REVIEW Hypersensitity pneumonitis, caused by inhalation of various antigens, is characterized by interstitial mononuclear cell infiltration, nonnecrotizing granulomas, cellular bronchiolitis, and fibrosis. The pathological picture of chronic hypersensitivity pneumonitis is, however, complicated; it is sometimes difficult to differentiate chronic hypersensitivity pneumonitis from idio...
متن کامل