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Immunophenotyping and remodeling process in small airways of idiopathic interstitial pneumonias: functional and prognostic significance.
Clin Respir J. 2008 Oct; 2(4):227-38.CR

Abstract

BACKGROUND AND AIMS

To test whether different degrees of immunologic and fibrotic airway remodeling processes occur in idiopathic interstitial pneumonias (IIPs), with impact on functional tests and survival, we studied the collagen/elastic system and immune cell density in the bronchiolar interstitium of lungs with the major types of IIPs.

MATERIALS AND METHODS

Histochemistry, immunohistochemistry and morphometric analysis were used to evaluate collagen/elastic fibers and immune cells in the bronchiolar interstitium of open lung biopsies of patients with cryptogenic organizing pneumonia [COP/organizing pneumonia (OP) = 10], acute interstitial pneumonia [AIP/diffuse alveolar damage (DAD) = 20], nonspecific interstitial pneumonia (NSIP/NSIP = 20) and idiopathic pulmonary fibrosis/usual interstitial pneumonia (UIP) = 20.

RESULTS

OP lungs presented a significant increase in collagenous/elastic fibers and in the total density of immune cells in the bronchiolar interstitium compared to controls, DAD, NSIP and UIP. We observed a significant increase in CD4, CD8 and CD20 lymphocytes, as well as in neutrophils, macrophages and plasma cells in OP. The increased amount of elastic fibers in the bronchiolar interstitium from OP lungs has a direct association with forced vital capacity (FVC) (r(s) = 0.99, P = 0.03). The most important survival predictor was CD20+ lymphocytes in the bronchiolar interstitium. In decreasing order, patients with UIP [Odds Ratio (OR) = 35.01], high forced expiratory volume in 1 s (FEV(1))/FVC FVC (OR = 7.01), increased CD20+ lymphocytes (OR = 4.44) and collagenous/elastic fiber densities (OR = 2.03 and OR = 1.49, respectively) in the bronchiolar interstitium were those who had the greatest risk of death, followed by those with AIP, NSIP and COP.

CONCLUSION

Different degrees of immunologic and fibroelastotic airway remodeling processes occur in the major types of IIPs with impact on physiological tests and survival.

Authors+Show Affiliations

Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. erparra20003@yahoo.com.brNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20298339

Citation

Parra, E R., et al. "Immunophenotyping and Remodeling Process in Small Airways of Idiopathic Interstitial Pneumonias: Functional and Prognostic Significance." The Clinical Respiratory Journal, vol. 2, no. 4, 2008, pp. 227-38.
Parra ER, Noleto GS, Tinoco LJ, et al. Immunophenotyping and remodeling process in small airways of idiopathic interstitial pneumonias: functional and prognostic significance. Clin Respir J. 2008;2(4):227-38.
Parra, E. R., Noleto, G. S., Tinoco, L. J., & Capelozzi, V. L. (2008). Immunophenotyping and remodeling process in small airways of idiopathic interstitial pneumonias: functional and prognostic significance. The Clinical Respiratory Journal, 2(4), 227-38. https://doi.org/10.1111/j.1752-699X.2008.00077.x
Parra ER, et al. Immunophenotyping and Remodeling Process in Small Airways of Idiopathic Interstitial Pneumonias: Functional and Prognostic Significance. Clin Respir J. 2008;2(4):227-38. PubMed PMID: 20298339.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunophenotyping and remodeling process in small airways of idiopathic interstitial pneumonias: functional and prognostic significance. AU - Parra,E R, AU - Noleto,G S, AU - Tinoco,L J M, AU - Capelozzi,V L, PY - 2010/3/20/entrez PY - 2008/10/1/pubmed PY - 2010/6/17/medline SP - 227 EP - 38 JF - The clinical respiratory journal JO - Clin Respir J VL - 2 IS - 4 N2 - BACKGROUND AND AIMS: To test whether different degrees of immunologic and fibrotic airway remodeling processes occur in idiopathic interstitial pneumonias (IIPs), with impact on functional tests and survival, we studied the collagen/elastic system and immune cell density in the bronchiolar interstitium of lungs with the major types of IIPs. MATERIALS AND METHODS: Histochemistry, immunohistochemistry and morphometric analysis were used to evaluate collagen/elastic fibers and immune cells in the bronchiolar interstitium of open lung biopsies of patients with cryptogenic organizing pneumonia [COP/organizing pneumonia (OP) = 10], acute interstitial pneumonia [AIP/diffuse alveolar damage (DAD) = 20], nonspecific interstitial pneumonia (NSIP/NSIP = 20) and idiopathic pulmonary fibrosis/usual interstitial pneumonia (UIP) = 20. RESULTS: OP lungs presented a significant increase in collagenous/elastic fibers and in the total density of immune cells in the bronchiolar interstitium compared to controls, DAD, NSIP and UIP. We observed a significant increase in CD4, CD8 and CD20 lymphocytes, as well as in neutrophils, macrophages and plasma cells in OP. The increased amount of elastic fibers in the bronchiolar interstitium from OP lungs has a direct association with forced vital capacity (FVC) (r(s) = 0.99, P = 0.03). The most important survival predictor was CD20+ lymphocytes in the bronchiolar interstitium. In decreasing order, patients with UIP [Odds Ratio (OR) = 35.01], high forced expiratory volume in 1 s (FEV(1))/FVC FVC (OR = 7.01), increased CD20+ lymphocytes (OR = 4.44) and collagenous/elastic fiber densities (OR = 2.03 and OR = 1.49, respectively) in the bronchiolar interstitium were those who had the greatest risk of death, followed by those with AIP, NSIP and COP. CONCLUSION: Different degrees of immunologic and fibroelastotic airway remodeling processes occur in the major types of IIPs with impact on physiological tests and survival. SN - 1752-699X UR - https://www.unboundmedicine.com/medline/citation/20298339/Immunophenotyping_and_remodeling_process_in_small_airways_of_idiopathic_interstitial_pneumonias:_functional_and_prognostic_significance_ L2 - https://doi.org/10.1111/j.1752-699X.2008.00077.x DB - PRIME DP - Unbound Medicine ER -