Collagen-V and K-α-1 Tubulin Antibodies as Potential Markers of Unsuspected GERD-Related Lung Damage: Insights from a Cross-Sectional Analysis.

IF 4.6 2区 医学 Q1 RESPIRATORY SYSTEM Lung Pub Date : 2024-12-01 Epub Date: 2024-09-24 DOI:10.1007/s00408-024-00745-8
Andrés R Latorre-Rodríguez, Sumeet K Mittal, Ranjithkumar Ravichandran, Mark Shacker, Andrés Isaza-Restrepo, Sandhya Bansal, Thalachallour Mohankumar, Ross M Bremner
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Abstract

Purpose: Our group has proposed that aspiration of gastric contents leads to exposure of normally sequestered lung self-antigens (SAgs), specifically collagen-V (Col-V) and K-α-1-tubulin (Kα1T), which elicits an immune response characterized by increasing concentrations of self-antibodies (SAbs) anti-Col-V and anti-Kα1T. We sought to establish the point prevalence of abnormally elevated concentrations of SAbs among patients with pathological gastroesophageal reflux disease (GERD) and/or hiatal hernia undergoing antireflux surgery (ARS).

Methods: For this cross-sectional study, we retrieved a plasma aliquot from the Norton Thoracic Institute BioBank from blood samples that were taken preoperatively from patients who underwent ARS between November 2019 and August 2022. Enzyme-linked immunosorbent assays were employed to detect and quantify anti-Col-V and anti-Kα1T.

Results: Samples from 43 patients (females, n = 34 [79.1%]; mean age, 62 ± 12 years; and mean BMI, 30.5 ± 7  kg/m2) were analyzed. Before ARS, 28 (65.1%, CI95: 50.3-80.0%) patients had abnormally elevated concentrations of anti-Col-V and 19 (44.2%, CI95: 28.7-59.7%) had elevated concentrations of circulating anti-Kα1T. Overall, 13 patients (30.2%) had low (i.e., normal) concentrations of both SAbs, 13 (30.2%) were positive only for one, and 17 (39.5%) were positive for both SAbs.

Conclusion: A relative high point prevalence of abnormally elevated circulating SAbs (i.e., anti-Col-V and/or anti-Kα1T) before ARS was found. This result suggests clinically unsuspected pulmonary parenchymal injury secondary to GERD-related aspiration. Further studies are required to confirm this hypothesis and to identify alternative non-invasive early biomarkers of GERD-related lung damage.

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胶原-V 和 K-α-1 管蛋白抗体是胃食管反流病相关肺损伤的潜在标记物:横断面分析的启示
目的:我们的研究小组提出,胃内容物吸入会导致正常封闭的肺自身抗原(SAgs)暴露,特别是胶原-V(Col-V)和 K-α-1-tubulin (Kα1T),从而引起免疫反应,其特点是抗 Col-V 和抗 Kα1T 的自身抗体(SAbs)浓度升高。我们试图确定接受抗反流术(ARS)的病理性胃食管反流病(GERD)和/或食管裂孔疝患者中 SAbs 浓度异常升高的点流行率:在这项横断面研究中,我们从诺顿胸科研究所生物库中提取了血浆等分样本,这些样本来自2019年11月至2022年8月期间接受ARS手术的患者的术前血样。采用酶联免疫吸附试验检测和量化抗Col-V和抗Kα1T:分析了 43 名患者的样本(女性,n = 34 [79.1%];平均年龄为 62 ± 12 岁;平均体重指数为 30.5 ± 7 kg/m2)。ARS 前,28 名患者(65.1%,CI95:50.3-80.0%)的抗 Col-V 浓度异常升高,19 名患者(44.2%,CI95:28.7-59.7%)的循环抗 Kα1T 浓度升高。总体而言,13 名患者(30.2%)两种 SAbs 的浓度均较低(即正常),13 名患者(30.2%)仅一种 SAbs 呈阳性,17 名患者(39.5%)两种 SAbs 均呈阳性:结论:ARS 前循环 SAbs(即抗 Col-V 和/或抗 Kα1T)异常升高的点流行率相对较高。这一结果表明,与胃食管反流相关的吸入继发了临床上未察觉的肺实质损伤。还需要进一步的研究来证实这一假设,并确定胃食管反流相关肺损伤的其他非侵入性早期生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lung
Lung 医学-呼吸系统
CiteScore
9.10
自引率
10.00%
发文量
95
审稿时长
6-12 weeks
期刊介绍: Lung publishes original articles, reviews and editorials on all aspects of the healthy and diseased lungs, of the airways, and of breathing. Epidemiological, clinical, pathophysiological, biochemical, and pharmacological studies fall within the scope of the journal. Case reports, short communications and technical notes can be accepted if they are of particular interest.
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Factors Associated with Corticosteroid Adherence in Sarcoidosis. Percent Predicted vs. Absolute Six-Minute Walk Distance as Predictors of Lung Transplant-Free Survival in Fibrosing Interstitial Lung Diseases. Collagen-V and K-α-1 Tubulin Antibodies as Potential Markers of Unsuspected GERD-Related Lung Damage: Insights from a Cross-Sectional Analysis. IgG Concentrations Distinguish People with Cystic Fibrosis and Mycobacterium abscessus. Impact of Functional Status at the Time of Transplant on Short-Term Pediatric Lung Transplant Outcomes in the USA.
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