Department of Biostatistics, Faculty of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Respir Res. 2021 Feb 12;22(1):53. doi: 10.1186/s12931-021-01650-x.
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive lung disease. Several risk factors such as smoking, air pollution, inhaled toxins, high body mass index and infectious agents are involved in the pathogenesis of IPF. In the present study, this meta-analysis study investigates the prevalence of viral and bacterial infections in the IPF patients and any possible association between these infections with pathogenesis of IPF.
The authors carried out this systematic literature review from different reliable databases such as PubMed, ISI Web of Science, Scopus and Google Scholar to December 2020.Keywords used were the following "Idiopathic pulmonary fibrosis", "Infection", "Bacterial Infection" and "Viral Infection", alone or combined together with the Boolean operators "OR", "AND" and "NOT" in the Title/Abstract/Keywords field. Pooled proportion and its 95% CI were used to assess the prevalence of viral and bacterial infections in the IPF patients.
In this systematic review and meta-analyses, 32 studies were selected based on the exclusion/inclusion criteria. Geographical distribution of included studies was: eight studies in American people, 8; in European people, 15 in Asians, and one in Africans. The pooled prevalence for viral and bacterial infections w ere 53.72% (95% CI 38.1-69.1%) and 31.21% (95% CI 19.9-43.7%), respectively. The highest and lowest prevalence of viral infections was HSV (77.7% 95% CI 38.48-99.32%), EBV (72.02%, 95% CI 44.65-90.79%) and Influenza A (7.3%, 95% CI 2.66-42.45%), respectively. Whereas the highest and lowest prevalence in bacterial infections were related to Streptococcus sp. (99.49%, 95% CI 96.44-99.9%) and Raoultella (1.2%, 95% CI 0.2-3.08%), respectively.
The results of this review were confirmed that the presence of viral and bacterial infections are the risk factors in the pathogenesis of IPF. In further analyses, which have never been shown in the previous studies, we revealed the geographic variations in the association strengths and emphasized other methodological parameters (e.g., detection method). Also, our study supports the hypothesis that respiratory infection could play a key role in the pathogenesis of IP.
特发性肺纤维化（IPF）是一种慢性进行性肺部疾病。吸烟、空气污染、吸入毒素、高体重指数和感染因子等多种危险因素参与了 IPF 的发病机制。在本研究中，这项荟萃分析研究调查了 IPF 患者中病毒和细菌感染的流行情况，以及这些感染与 IPF 发病机制之间的任何可能关联。
作者从不同的可靠数据库（如 PubMed、ISI Web of Science、Scopus 和 Google Scholar）进行了这项系统的文献回顾，检索时间截至 2020 年 12 月。关键词包括“特发性肺纤维化”、“感染”、“细菌感染”和“病毒感染”，单独或与布尔运算符“OR”、“AND”和“NOT”一起在标题/摘要/关键词字段中使用。使用合并比例及其 95%置信区间来评估 IPF 患者中病毒和细菌感染的流行情况。
在这项系统综述和荟萃分析中，根据排除/纳入标准选择了 32 项研究。纳入研究的地理分布情况为：8 项来自美国人群，8 项来自欧洲人群，15 项来自亚洲人群，1 项来自非洲人群。病毒和细菌感染的合并患病率分别为 53.72%（95%CI 38.1-69.1%）和 31.21%（95%CI 19.9-43.7%）。病毒感染的最高和最低患病率分别为单纯疱疹病毒（77.7%，95%CI 38.48-99.32%）、EB 病毒（72.02%，95%CI 44.65-90.79%）和甲型流感病毒（7.3%，95%CI 2.66-42.45%）。而细菌感染的最高和最低患病率分别与链球菌属（99.49%，95%CI 96.44-99.9%）和罗阿氏菌属（1.2%，95%CI 0.2-3.08%）有关。
本综述的结果证实，病毒和细菌感染的存在是 IPF 发病机制中的危险因素。在进一步的分析中，我们揭示了以前研究中从未显示过的地域差异与关联强度，并强调了其他方法学参数（例如，检测方法）。此外，我们的研究支持这样一种假设，即呼吸道感染可能在 IP 的发病机制中发挥关键作用。
