Lee Jong-Uk, Chang Hun Soo, Lee Hyeon Ju, Jung Chang An, Bae Da Jeong, Song Hyun Ji, Park Jong Sook, Uh Soo-Taek, Kim Young Hoon, Seo Ki-Hyun, Park Choon-Sik
Department of Interdisciplinary Program in Biomedical Science Major, Soonchunhyang Graduate School, Bucheon, Korea.
Genome Research Center and Division of Allergy and Respiratory Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
BMC Pulm Med. 2017 Feb 15;17(1):39. doi: 10.1186/s12890-017-0380-z.
Innate T helper type 2 (Th2) immune responses mediated by interleukin (IL)-33, thymic stromal lymphopoietin (TSLP), and IL-25 have been shown to play an important role in pulmonary fibrosis of animal models; however, their clinical implications remain poorly understood.
TSLP, IL-25, and IL-33 concentrations were measured in bronchoalveolar lavage fluids obtained from normal controls (NCs; n = 40) and from patients with idiopathic pulmonary fibrosis (IPF; n = 100), non-specific interstitial pneumonia (NSIP; n = 22), hypersensitivity pneumonitis (HP; n = 20), and sarcoidosis (n = 19).
The TSLP and IL-33 levels were significantly higher in patients with IPF relative to the NCs (p = 0.01 and p = 0.0001, respectively), NSIP (p = 4.95E - 7 and p = 0.0002, respectively), HP (p = 0.00003 and p = 0.000005, respectively), and sarcoidosis groups (p = 0.003 and p = 0.0001, respectively). However, the IL-25 levels were not significantly different between NC and IPF group (p = 0.432). Receiver operating characteristic curves of the TSLP and IL-33 levels revealed clear differences between the IPF and NC groups (AUC = 0.655 and 0.706, respectively), as well as between the IPF and the other lung disease groups (AUC = 0.786 and 0.781, respectively). Cut-off values of 3.52 pg/μg TSLP and 3.77 pg/μg IL-33 were shown to differentiate between the IPF and NC groups with 99.2 and 94.3% accuracy. Cut-off values of 4.66 pg/μg TSLP and 2.52 pg/μg IL-33 possessed 99.4 and 93.2% accuracy for differentiating among the IPF and other interstitial lung disease groups.
Innate immune responses may be associated with the development of IPF. Furthermore, the IL-33 and TSLP levels in BAL fluids may be useful for differentiating IPF from other chronic interstitial lung diseases.
白细胞介素（IL）-33、胸腺基质淋巴细胞生成素（TSLP）和IL-25介导的先天性2型辅助性T细胞（Th2）免疫反应已被证明在动物模型的肺纤维化中起重要作用；然而，它们的临床意义仍知之甚少。
检测了从正常对照者（NCs；n = 40）以及特发性肺纤维化（IPF；n = 100）、非特异性间质性肺炎（NSIP；n = 22）、过敏性肺炎（HP；n = 20）和结节病（n = 19）患者获取的支气管肺泡灌洗液中TSLP、IL-25和IL-33的浓度。
与NCs相比（分别为p = 0.01和p = 0.0001）、NSIP组（分别为p = 4.95E - 7和p = 0.0002）、HP组（分别为p = 0.00003和p = 0.000005）以及结节病组相比（分别为p = 0.003和p = 0.0001），IPF患者的TSLP和IL-33水平显著更高。然而，NC组和IPF组之间的IL-25水平无显著差异（p = 0.432）。TSLP和IL-33水平的受试者工作特征曲线显示IPF组和NC组之间有明显差异（AUC分别为0.655和0.706），以及IPF组和其他肺部疾病组之间有明显差异（AUC分别为0.786和0.781）。TSLP为3.52 pg/μg和IL-33为3.77 pg/μg的截断值可分别以99.2%和94.3%的准确率区分IPF组和NC组。TSLP为4.66 pg/μg和IL-33为2.52 pg/μg的截断值在区分IPF组和其他间质性肺疾病组时准确率分别为99.4%和93.2%。
先天性免疫反应可能与IPF的发生有关。此外，BAL液中的IL-33和TSLP水平可能有助于将IPF与其他慢性间质性肺疾病区分开来。
