Gu Pan, Luo Benfang, Yi Xianghua, Zhu Hailong, Li Shuai, Yu Xiaoting, Han Fei, Zhang Suxia, Zhu Xuyou, Rui Weiwei, Qiu Weizhe, Fan Desheng
DePartment of Pathology, Tongji HosPital of Tongji University, Shanghai 200065, China.
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Zhonghua Jie He He Hu Xi Za Zhi. 2014 Sep;37(9):664-70.
To investigate the expressions of cytokines in idiopathic pulmonary fibrosis (IPF) and in idiopathic nonspecific interstitial pneumonia (INSIP); To discuss expressions and meanings of bone morphogenetic protein 7 (BMP-7) and transforming growth factor beta (TGF-β) in IPF and IPF.
Selected 47 cases of idiopathic interstitial pneumonia (IIP), which were diagnosed by clinical-radiologic-pathologic (CRP), and classified into two groups which were group IPF (25 IPF) and group INSIP (22 INSIP, including 6 cellular pattern and 16 fibrosing pattern). The normal lung tissues were collected as the control group: The fresh tissues were made to detect more than 114 kinds of cytokines' expressions via Oligo GEArray gene microarray technology. Made a tissue microarray which applied EnVision immunohistochemistry technology to detect the expressions of BMP-7 and TGF-β in both kinds of IIPs. The two groups of patients were followed-up visited around 5 to 8 years and the survival curves were evaluated by Kaplan-Meier method.
According to gene microarray results, these two groups were up-expression in TGF family,IL family and TNF family. Most of BMP members were down-expression, in comparison with the control group, except BMP-5,BMP-8B and BMP-15. As the tissue microarray results demonstrated, compared with normal lung tissues,BMP-7 expressed decreasingly in IPF and INSIP groups (t1 = 27.618, P < 0.001; t2 = -12.404, P < 0.001). The expression of IPF were lower than INSIP (t = 5.387, P < 0.05); In INSIP group, patients of cellular pattern expressed BMP-7 more than fibrosing pattern's (t = -5.341, P < 0.001). There were dramatically increasing expressions of TGF-β in IPF and INSIP, when compared with the control group (t1 = 23.393, P < 0.001; t2 = -13.445, P < 0.001) and it presented negative correlation with BMP-7(group IPF: r = -0.771, P < 0.001; group INSIP: r = -0.729, P < 0.001). (3) Clinical follow-up data showed, the stability(improvement), deterioration and death rates of the group IPF and the group INSIP were, respectively, 0(0%), 2 (8%), 23 (92%) and 15 (68.1%), 3 (13.6%), 4 (18.2%). The results were statistically significant (all P < 0.05). The median survival time of the part with higher BMP-7 expression and the part with relatively lower BMP-7 expression, in the group IPF, were 110.8 and 66.4 months (t = -2.686, P < 0.05); In the group INSIP, were 146.4 and 74.9 months (t = -3.037, P < 0.05).
Cellular cytokines presented different expression profiles in IPF and INSIP patients. Differently with highly activated TGF-β, BMP-7 was inhibited in IIP patients, which would remind the degree of fibrosis and prognosis of IIP. BMP-7 would be expected to be a novel target for IIP pathogenesis and prognostic research.
探讨细胞因子在特发性肺纤维化(IPF)和特发性非特异性间质性肺炎(INSIP)中的表达情况;讨论骨形态发生蛋白7(BMP - 7)和转化生长因子β(TGF - β)在IPF和INSIP中的表达及意义。
选取47例经临床 - 放射 - 病理(CRP)诊断的特发性间质性肺炎(IIP)患者,分为IPF组(25例IPF)和INSIP组(22例INSIP,包括6例细胞型和16例纤维化型)。收集正常肺组织作为对照组:采用Oligo GEArray基因芯片技术检测新鲜组织中114种以上细胞因子的表达。制作组织芯片,应用EnVision免疫组化技术检测两种IIP中BMP - 7和TGF - β的表达。对两组患者进行5至8年的随访,采用Kaplan - Meier法评估生存曲线。
根据基因芯片结果,这两组在TGF家族、IL家族和TNF家族中呈高表达。与对照组相比,除BMP - 5、BMP - 8B和BMP - 15外,大多数BMP成员呈低表达。组织芯片结果显示,与正常肺组织相比,BMP - 7在IPF组和INSIP组中表达降低(t1 = 27.618,P < 0.001;t2 = -12.404,P < 0.001)。IPF组的表达低于INSIP组(t = 5.387,P < 0.05);在INSIP组中,细胞型患者的BMP - 7表达高于纤维化型患者(t = -5.341,P < 0.001)。与对照组相比,IPF组和INSIP组中TGF - β的表达显著增加(t1 = 23.393,P < 0.001;t2 = -13.445,P < 0.001),且与BMP - 7呈负相关(IPF组:r = -0.771,P < 0.001;INSIP组:r = -0.729,P < 0.001)。(3)临床随访数据显示,IPF组和INSIP组的病情稳定(改善)、恶化和死亡率分别为0(0%)、2(8%)、23(92%)和15(68.1%)、3(13.6%)、4(18.2%)。结果具有统计学意义(均P < 0.05)。IPF组中BMP - 7表达较高部分和表达相对较低部分的中位生存时间分别为110.8个月和66.4个月(t = -2.686,P < 0.05);INSIP组中分别为146.4个月和74.9个月(t = -3.037,P < 0.05)。
细胞因子在IPF和INSIP患者中呈现不同的表达谱。与高度活化的TGF - β不同,BMP - 7在IIP患者中受到抑制,这提示了IIP的纤维化程度和预后。BMP - 7有望成为IIP发病机制和预后研究的新靶点。