Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa5187
E. Leonova, E. Shmelev
Background: Cardiovascular diseases are the most common comorbidities among patients with chronic lung diseases. Arterial stiffness (AS) is one of the most potent prognostic factors of cardiovascular morbidity and mortality. However, there is very little literature describing the factors associated with the increase of AS among patients with chronic hypersensitivity pneumonitis (HP). Aims and Objectives: were to investigate arterial stiffness and determine factors associated with its increase among patients with HP. Methods: We identified 106 patients with chronic HP, who underwent spirometry, plethysmography, diffusing capacity of carbon monoxide (DLCO), pulmonary high resolution computed tomography (HRCT), bronchoscopy and lung biopsy. AS was measured by pulse wave velocity (PWV). BMI, the duration of HP and the exacerbations frequency were evaluated. Results: The increase of arterial stiffness was found in 71 (67%) of patients. Correlation analysis adjusted for age showed a significant correlation between PWV and DLCO, the extent of lung fibrosis (LF) on HRCT (p Conclusions: The increase of arterial stiffness is associated with the extent of lung fibrosis on HRCT, diffusion disturbance, and frequency of exacerbations among patients with chronic hypersensitivity pneumonitis.
{"title":"Factors associated with increased arterial stiffness in patients with chronic hypersensitivity pneumonitis","authors":"E. Leonova, E. Shmelev","doi":"10.1183/13993003.congress-2019.pa5187","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5187","url":null,"abstract":"Background: Cardiovascular diseases are the most common comorbidities among patients with chronic lung diseases. Arterial stiffness (AS) is one of the most potent prognostic factors of cardiovascular morbidity and mortality. However, there is very little literature describing the factors associated with the increase of AS among patients with chronic hypersensitivity pneumonitis (HP). Aims and Objectives: were to investigate arterial stiffness and determine factors associated with its increase among patients with HP. Methods: We identified 106 patients with chronic HP, who underwent spirometry, plethysmography, diffusing capacity of carbon monoxide (DLCO), pulmonary high resolution computed tomography (HRCT), bronchoscopy and lung biopsy. AS was measured by pulse wave velocity (PWV). BMI, the duration of HP and the exacerbations frequency were evaluated. Results: The increase of arterial stiffness was found in 71 (67%) of patients. Correlation analysis adjusted for age showed a significant correlation between PWV and DLCO, the extent of lung fibrosis (LF) on HRCT (p Conclusions: The increase of arterial stiffness is associated with the extent of lung fibrosis on HRCT, diffusion disturbance, and frequency of exacerbations among patients with chronic hypersensitivity pneumonitis.","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124871042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa3601
L. D. Sadeleer, F. Hermans, E. D. Dycker, J. Yserbyt, J. Verschakelen, E. Verbeken, G. Verleden, S. Verleden, W. Wuyts
{"title":"Impact of BAL lymphocytosis and honeycombing presence on corticosteroid treatment effect in Fibrotic Hypersensitivity Pneumonitis","authors":"L. D. Sadeleer, F. Hermans, E. D. Dycker, J. Yserbyt, J. Verschakelen, E. Verbeken, G. Verleden, S. Verleden, W. Wuyts","doi":"10.1183/13993003.congress-2019.oa3601","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa3601","url":null,"abstract":"","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123700327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1361
N. Sakuma, H. Tojima, T. Hiroishi, Takuma Matsumura, Chie Koumura, Masakazu Kouno
Background: There are recent reports that silica exposure is linked with the production of myeloperoxidase-anti-neutrophil cytoplasmic antibodies (MPO-ANCA). Purpose: To investigate the involvement and effects of dust exposure on patients with MPO-ANCA-positive interstitial pneumonia, and to elucidate the clinical differences between exposed and non-exposed groups. Subjects and Methods: The sex, age at the time of the initial diagnosis, occupational history, smoking history, initial symptoms, imaging findings, diagnosis of microscopic polyangiitis, clinical course, and cause of death were investigated in 28 patients with MPO-ANCA-positive interstitial pneumonia that presented at our hospital between 1994 and 2018. Results: Fifteen of 28 patients (54%) had a history of occupational dust exposure. The dust-exposed group (68.3 ± 8.6 years) consists of all men with a history of smoking, the majority of whom initially presented with respiratory symptoms, with 8 patients diagnosed with MPA. Thirteen patients in the non-exposed group (72.7 ±5.7 years) included five men and eight women, seven of whom were smokers. The number of patients complicated with fever and renal dysfunction in terms of initial symptoms were higher in the non-exposed group than that in the exposed group, and nine were diagnosed with MPA. The five-year survival rate was approximately 35% for both groups, and there were no significant differences. Conclusion: Approximately half of the patients with MPO-ANCA-positive interstitial pneumonia at our hospital had a history of occupational dust exposure. Patients in the exposed and non-exposed groups were characterized by different backgrounds and clinical courses.
{"title":"Occupational dust exposure as a risk factor for MPO-ANCA-positive interstitial pneumonia","authors":"N. Sakuma, H. Tojima, T. Hiroishi, Takuma Matsumura, Chie Koumura, Masakazu Kouno","doi":"10.1183/13993003.congress-2019.pa1361","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1361","url":null,"abstract":"Background: There are recent reports that silica exposure is linked with the production of myeloperoxidase-anti-neutrophil cytoplasmic antibodies (MPO-ANCA). Purpose: To investigate the involvement and effects of dust exposure on patients with MPO-ANCA-positive interstitial pneumonia, and to elucidate the clinical differences between exposed and non-exposed groups. Subjects and Methods: The sex, age at the time of the initial diagnosis, occupational history, smoking history, initial symptoms, imaging findings, diagnosis of microscopic polyangiitis, clinical course, and cause of death were investigated in 28 patients with MPO-ANCA-positive interstitial pneumonia that presented at our hospital between 1994 and 2018. Results: Fifteen of 28 patients (54%) had a history of occupational dust exposure. The dust-exposed group (68.3 ± 8.6 years) consists of all men with a history of smoking, the majority of whom initially presented with respiratory symptoms, with 8 patients diagnosed with MPA. Thirteen patients in the non-exposed group (72.7 ±5.7 years) included five men and eight women, seven of whom were smokers. The number of patients complicated with fever and renal dysfunction in terms of initial symptoms were higher in the non-exposed group than that in the exposed group, and nine were diagnosed with MPA. The five-year survival rate was approximately 35% for both groups, and there were no significant differences. Conclusion: Approximately half of the patients with MPO-ANCA-positive interstitial pneumonia at our hospital had a history of occupational dust exposure. Patients in the exposed and non-exposed groups were characterized by different backgrounds and clinical courses.","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127784003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa4734
K. Koshikawa, J. Terada, M. Abe, S. Iwasawa, M. Sakayori, K. Tsushima, K. Tatsumi
{"title":"Evaluation of drug-induced lung injury by ALK inhibitor: a single center retrospective analysis","authors":"K. Koshikawa, J. Terada, M. Abe, S. Iwasawa, M. Sakayori, K. Tsushima, K. Tatsumi","doi":"10.1183/13993003.congress-2019.pa4734","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa4734","url":null,"abstract":"","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130306593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa4739
S. Guerra, M. Conceição, Â. Cunha, J. Correia, J. Vale, C. António, A. Torres
Introduction: Acute exacerbations (AE) are frequent in patients with fibrosing interstitial lung diseases (F-ILD) with usual interstitial pneumonia (UIP) pattern. AE are defined as a significant respiratory deterioration, less than 1-month duration, with new radiological abnormalities and associated with worse outcome. Aims: To study the etiology and outcomes of patients admitted with AE of F-ILD. Methods: Retrospective study of patients admitted with AE of F-ILD from January 2015 to August 2018. F-ILD due to pneumoconiosis and tuberculosis were excluded. Results: 115 admissions were identified, corresponding to 47 patients, median age 77±8 years and 61.7% males. Main diagnoses were F-ILD secondary to chronic hypersensitivity pneumonitis (CHP, 68.7%), connective tissue diseases (CTD, 11.3%), idiopathic pulmonary fibrosis (IPF, 9.6%) and drugs (3.5%). 8 inpatients had other F-ILD with UIP pattern. AE main cause was infection (75.7%). Hospitalization median duration was 9±6 days. 48.7% of cases occurred in Winter. Median time to new admission was 45±145 days. Each patient had a median of 2 admissions, statistically related with previous respiratory failure (RF) (p Conclusion: F-ILD implies high risk of respiratory acute event, mostly by infections. Previous RF were largely present, indicative of advanced disease and probability of more AE. Need for NIV meant poor prognosis. As in international studies, mortality was high among F-ILD due to IPF.
{"title":"Acute exacerbation admissions of fibrosing interstitial lung diseases – 3 years study","authors":"S. Guerra, M. Conceição, Â. Cunha, J. Correia, J. Vale, C. António, A. Torres","doi":"10.1183/13993003.congress-2019.pa4739","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa4739","url":null,"abstract":"Introduction: Acute exacerbations (AE) are frequent in patients with fibrosing interstitial lung diseases (F-ILD) with usual interstitial pneumonia (UIP) pattern. AE are defined as a significant respiratory deterioration, less than 1-month duration, with new radiological abnormalities and associated with worse outcome. Aims: To study the etiology and outcomes of patients admitted with AE of F-ILD. Methods: Retrospective study of patients admitted with AE of F-ILD from January 2015 to August 2018. F-ILD due to pneumoconiosis and tuberculosis were excluded. Results: 115 admissions were identified, corresponding to 47 patients, median age 77±8 years and 61.7% males. Main diagnoses were F-ILD secondary to chronic hypersensitivity pneumonitis (CHP, 68.7%), connective tissue diseases (CTD, 11.3%), idiopathic pulmonary fibrosis (IPF, 9.6%) and drugs (3.5%). 8 inpatients had other F-ILD with UIP pattern. AE main cause was infection (75.7%). Hospitalization median duration was 9±6 days. 48.7% of cases occurred in Winter. Median time to new admission was 45±145 days. Each patient had a median of 2 admissions, statistically related with previous respiratory failure (RF) (p Conclusion: F-ILD implies high risk of respiratory acute event, mostly by infections. Previous RF were largely present, indicative of advanced disease and probability of more AE. Need for NIV meant poor prognosis. As in international studies, mortality was high among F-ILD due to IPF.","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123055856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa5183
Shihwan Chang, M. H. Shin, J. Shin, M. Park
Anti-Jo-1-syndrome is the most common form of antisynthetase syndrome, which often presents with interstitial lung disease (ILD) and polymyositis/dermatomyositis(PM/DM). Little is understood how the presence of PM/DM affects the clinical presentation of ILD patients with anti-Jo-1-antibody (Jo-1-ILD). We aim to characterize Jo-1-ILD by comparing patients with PM/DM (PM/DM-ILD) and without PM/DM (non-PM/DM-ILD). In this retrospective review, 49 Jo-1-ILD patients diagnosed at our institution from January 2005 to June 2018 were included. Clinical, radiologic, and histologic features of 20 PM/DM-ILD and 29 non-PM/DM-ILD patients were compared. PM/DM-ILD patients were younger at ILD diagnosis than non-PM/DM-ILD (51.0 years vs. 64.5 years, p PM/DM-ILD and non-PM/DM-ILD show similar clinical characteristics, except for age at diagnosis, anti-Ro status and medical treatment. The presence of PM/DM does not significantly affect the clinical course of Jo-1-ILD.
{"title":"Clinical characteristics of anti-Jo-1-positive interstitial lung disease","authors":"Shihwan Chang, M. H. Shin, J. Shin, M. Park","doi":"10.1183/13993003.congress-2019.pa5183","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5183","url":null,"abstract":"Anti-Jo-1-syndrome is the most common form of antisynthetase syndrome, which often presents with interstitial lung disease (ILD) and polymyositis/dermatomyositis(PM/DM). Little is understood how the presence of PM/DM affects the clinical presentation of ILD patients with anti-Jo-1-antibody (Jo-1-ILD). We aim to characterize Jo-1-ILD by comparing patients with PM/DM (PM/DM-ILD) and without PM/DM (non-PM/DM-ILD). In this retrospective review, 49 Jo-1-ILD patients diagnosed at our institution from January 2005 to June 2018 were included. Clinical, radiologic, and histologic features of 20 PM/DM-ILD and 29 non-PM/DM-ILD patients were compared. PM/DM-ILD patients were younger at ILD diagnosis than non-PM/DM-ILD (51.0 years vs. 64.5 years, p PM/DM-ILD and non-PM/DM-ILD show similar clinical characteristics, except for age at diagnosis, anti-Ro status and medical treatment. The presence of PM/DM does not significantly affect the clinical course of Jo-1-ILD.","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115460813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa1358
G. Shepelkova, A. Zaytseva, V. Evstifeev, I. Stepanyan, E. Shmelev, V. Yeremeev
{"title":"Micro Array screening of microRNA markers of interstitial lung diseases for differential diagnostics","authors":"G. Shepelkova, A. Zaytseva, V. Evstifeev, I. Stepanyan, E. Shmelev, V. Yeremeev","doi":"10.1183/13993003.congress-2019.pa1358","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa1358","url":null,"abstract":"","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116854779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.pa5188
T. Gursoy, A. Aslan, Z. Onay, T. S. Eyuboglu
{"title":"Childhood Interstitial Lung disease: A Tertiary Single Center Experience","authors":"T. Gursoy, A. Aslan, Z. Onay, T. S. Eyuboglu","doi":"10.1183/13993003.congress-2019.pa5188","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa5188","url":null,"abstract":"","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126548309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.rct1883
C. Denton, Celia J. F. Lin, J. Goldin, G. Kim, M. Kuwana, Y. Allanore, A. Batalov, I. Butrimienė, P. Carreira, M. Matucci-Cerinic, O. Distler, D. Kaliterna, C. Mihai, M. Mogensen, M. Olesińska, J. Pope, G. Riemekasten, T. S. Rodriguez-Reyne, M. Santos, J. Laar, H. Spotswood, J. Siegel, A. Jahreis, D. Furst, D. Khanna
Background: Anti–interleukin-6 receptor antibody TCZ showed clinically relevant lung function preservation (forced vital capacity [FVC]) in SSc patients (pts) in a phase 2 trial. Objective: Investigate TCZ vs placebo (PBO) in SSc in a phase 3 trial. Methods: Pts were randomized 1:1 to double-blind subcutaneous TCZ 162 mg or PBO per week (wk) for 48 wks. Primary endpoint: difference (TCZ vs PBO) in modified Rodnan skin score (mRSS) change from baseline (∆BL). Secondary endpoints: percent-predicted (pp)FVC; time to treatment failure (TTF; time from first study treatment to first occurrence of death, FVC decline >10%, mRSS increase ≥20% and mRSS ≥5, or occurrence of SSc complications); Health Assessment Questionnaire–Disability Index (HAQ-DI); pt/physician global assessment (Pt/PhGA) visual analog scale. Results: Of 106 PBO and 104 TCZ pts, 31% had previous/current interstitial lung disease based on their history. At wk 48, adjusted least-squares mean difference ∆BL mRSS PBO vs TCZ was –1.7 [95% CI: –3.8, 0.3], p=0.098). Cumulative distribution of ∆BL ppFVC (median [IQR] PBO –3.9 [–7.2, 0.6]; TCZ –0.6 [–5.3, 3.9] van Elteren nominal p=0.0015) and difference in mean ∆BL FVC at wk 48 (167 mL [95% CI: 83, 250]) favored TCZ. TTF hazard ratio (95% CI) was 0.6 (0.4, 1.1) numerically favoring TCZ (Cox proportional hazards p=0.082). No clinically meaningful difference was seen in mean (95% CI) difference ∆BL HAQ-DI –0.1 (–0.2, 0.1), PtGA –2.4 (–8.6, 3.7), PhGA –2.5 (–8.7, 3.8). Safety profile was consistent with SSc complications and TCZ treatment. Conclusion: The primary mRSS endpoint was not met. A clinically relevant difference in FVC was seen for TCZ vs PBO, with preservation of lung function.
{"title":"Lung function preservation in a phase 3 trial of tocilizumab (TCZ) in systemic sclerosis (SSc)","authors":"C. Denton, Celia J. F. Lin, J. Goldin, G. Kim, M. Kuwana, Y. Allanore, A. Batalov, I. Butrimienė, P. Carreira, M. Matucci-Cerinic, O. Distler, D. Kaliterna, C. Mihai, M. Mogensen, M. Olesińska, J. Pope, G. Riemekasten, T. S. Rodriguez-Reyne, M. Santos, J. Laar, H. Spotswood, J. Siegel, A. Jahreis, D. Furst, D. Khanna","doi":"10.1183/13993003.congress-2019.rct1883","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.rct1883","url":null,"abstract":"Background: Anti–interleukin-6 receptor antibody TCZ showed clinically relevant lung function preservation (forced vital capacity [FVC]) in SSc patients (pts) in a phase 2 trial. Objective: Investigate TCZ vs placebo (PBO) in SSc in a phase 3 trial. Methods: Pts were randomized 1:1 to double-blind subcutaneous TCZ 162 mg or PBO per week (wk) for 48 wks. Primary endpoint: difference (TCZ vs PBO) in modified Rodnan skin score (mRSS) change from baseline (∆BL). Secondary endpoints: percent-predicted (pp)FVC; time to treatment failure (TTF; time from first study treatment to first occurrence of death, FVC decline >10%, mRSS increase ≥20% and mRSS ≥5, or occurrence of SSc complications); Health Assessment Questionnaire–Disability Index (HAQ-DI); pt/physician global assessment (Pt/PhGA) visual analog scale. Results: Of 106 PBO and 104 TCZ pts, 31% had previous/current interstitial lung disease based on their history. At wk 48, adjusted least-squares mean difference ∆BL mRSS PBO vs TCZ was –1.7 [95% CI: –3.8, 0.3], p=0.098). Cumulative distribution of ∆BL ppFVC (median [IQR] PBO –3.9 [–7.2, 0.6]; TCZ –0.6 [–5.3, 3.9] van Elteren nominal p=0.0015) and difference in mean ∆BL FVC at wk 48 (167 mL [95% CI: 83, 250]) favored TCZ. TTF hazard ratio (95% CI) was 0.6 (0.4, 1.1) numerically favoring TCZ (Cox proportional hazards p=0.082). No clinically meaningful difference was seen in mean (95% CI) difference ∆BL HAQ-DI –0.1 (–0.2, 0.1), PtGA –2.4 (–8.6, 3.7), PhGA –2.5 (–8.7, 3.8). Safety profile was consistent with SSc complications and TCZ treatment. Conclusion: The primary mRSS endpoint was not met. A clinically relevant difference in FVC was seen for TCZ vs PBO, with preservation of lung function.","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"22 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132576001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-28DOI: 10.1183/13993003.congress-2019.oa3600
Masako Watanabe, Y. Horimasu, H. Iwamoto, K. Yamaguchi, S. Sakamoto, T. Masuda, Taku Nakashima, S. Miyamoto, S. Ohshimo, K. Fujitaka, H. Hamada, N. Kohno, N. Hattori
Background: Chronic hypersensitivity pneumonitis (CHP) is characterized by lymphocytic inflammation and progressive fibrosis of the lung caused by a variety of inhaled antigens, and the prognosis of CHP patients is poor with the absence of established diagnosing criteria and effective therapeutic agent. Recently, we have founded that C-C motif chemokine ligand 15 (CCL15) mRNA highly expressed in CHP lung. Method: To investigate the usefulness of CCL15 as a clinical biomarker for CHP, CCL15 protein expression was investigated in lung tissue, serum and bronchoalveolar lavage fluid (BALF). Results: Immunohistochemistry investigations revealed high CCL15 expression in the lungs of CHP patients. Serum CCL15 levels in CHP patients (29.1 ± 2.1 μg/ml) were significantly higher than those in idiopathic pulmonary fibrosis patients (19.7 ± 1.3 μg/ml, p = 0.01) and in healthy subjects (19.5 ± 1.7 μg/ml, p = 0.003). When BALF CCL15 level was divided by BALF albumin level (BALF CCL15/Alb), it was significantly inversely correlated with forced vital capacity (β = -0.47, p = 0.0006), percentage of predicted carbon monoxide diffusion capacity of the lung (β = -0.41, p = 0.0048), and BALF lymphocyte count (β = -0.34, p = 0.01) in CHP patients. Multivariate Cox proportional hazards analysis revealed that high BALF CCL15/Alb and poor prognosis were statistically significantly independently correlated in CHP patients (HR = 1.1, 95% C.I. 1.03–1.18, p = 0.004). Conclusion: The results of the current study suggest that CCL15 may be a useful prognostic biomarker for CHP.
背景:慢性超敏性肺炎(Chronic hypersensitivity pneumonitis, CHP)以吸入多种抗原引起的淋巴细胞性炎症和进行性肺纤维化为特征，缺乏明确的诊断标准和有效的治疗药物，预后较差。最近，我们发现C-C基序趋化因子配体15 (CCL15) mRNA在CHP肺中高表达。方法:观察CCL15蛋白在肺组织、血清和支气管肺泡灌洗液(BALF)中的表达，探讨CCL15作为CHP临床生物标志物的意义。结果:免疫组化检查显示CCL15在CHP患者肺部高表达。CHP患者血清CCL15水平(29.1±2.1 μg/ml)显著高于特发性肺纤维化患者(19.7±1.3 μg/ml, p = 0.01)和健康者(19.5±1.7 μg/ml, p = 0.003)。当BALF CCL15水平除以BALF白蛋白水平(BALF CCL15/Alb)时，其与CHP患者的强迫肺活量(β = -0.47, p = 0.0006)、预测肺一氧化碳扩散能力百分比(β = -0.41, p = 0.0048)和BALF淋巴细胞计数(β = -0.34, p = 0.01)呈显著负相关。多因素Cox比例风险分析显示，CHP患者高BALF CCL15/Alb与预后不良独立相关(HR = 1.1, 95% ci = 1.03 ~ 1.18, p = 0.004)。结论:目前的研究结果表明，CCL15可能是CHP的一个有用的预后生物标志物。
{"title":"Clinical utility of CCL15 as a prognostic biomarker for hypersensitivity pneumonitis","authors":"Masako Watanabe, Y. Horimasu, H. Iwamoto, K. Yamaguchi, S. Sakamoto, T. Masuda, Taku Nakashima, S. Miyamoto, S. Ohshimo, K. Fujitaka, H. Hamada, N. Kohno, N. Hattori","doi":"10.1183/13993003.congress-2019.oa3600","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.oa3600","url":null,"abstract":"Background: Chronic hypersensitivity pneumonitis (CHP) is characterized by lymphocytic inflammation and progressive fibrosis of the lung caused by a variety of inhaled antigens, and the prognosis of CHP patients is poor with the absence of established diagnosing criteria and effective therapeutic agent. Recently, we have founded that C-C motif chemokine ligand 15 (CCL15) mRNA highly expressed in CHP lung. Method: To investigate the usefulness of CCL15 as a clinical biomarker for CHP, CCL15 protein expression was investigated in lung tissue, serum and bronchoalveolar lavage fluid (BALF). Results: Immunohistochemistry investigations revealed high CCL15 expression in the lungs of CHP patients. Serum CCL15 levels in CHP patients (29.1 ± 2.1 μg/ml) were significantly higher than those in idiopathic pulmonary fibrosis patients (19.7 ± 1.3 μg/ml, p = 0.01) and in healthy subjects (19.5 ± 1.7 μg/ml, p = 0.003). When BALF CCL15 level was divided by BALF albumin level (BALF CCL15/Alb), it was significantly inversely correlated with forced vital capacity (β = -0.47, p = 0.0006), percentage of predicted carbon monoxide diffusion capacity of the lung (β = -0.41, p = 0.0048), and BALF lymphocyte count (β = -0.34, p = 0.01) in CHP patients. Multivariate Cox proportional hazards analysis revealed that high BALF CCL15/Alb and poor prognosis were statistically significantly independently correlated in CHP patients (HR = 1.1, 95% C.I. 1.03–1.18, p = 0.004). Conclusion: The results of the current study suggest that CCL15 may be a useful prognostic biomarker for CHP.","PeriodicalId":178396,"journal":{"name":"ILD/DPLD of known origin","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133005509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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