Nakashima Taku, Omori Keitaro, Namba Masashi, Yamaguchi Kakuhiro, Sakamoto Shinjiro, Horimasu Yasushi, Masuda Takeshi, Miyamoto Shintaro, Iwamoto Hiroshi, Fujitaka Kazunori, Hamada Hironobu, Hattori Noboru
Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Molecular and Internal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Respir Med. 2023 Jun;212:107224. doi: 10.1016/j.rmed.2023.107224. Epub 2023 Mar 31.
The B7 family member B7H3/CD276 was recently reported to be involved in the pathophysiology of idiopathic pulmonary fibrosis (IPF). However, the association of B7H3 with prognosis in patients with fibrosing interstitial lung diseases (ILDs), including IPF, remains unclear. This study was investigated to determine the potential of soluble B7H3 (sB7H3) as a biomarker to predict prognosis in patients with fibrosing ILDs.
Patients with ILDs from various categories who underwent bronchoalveolar lavage (BAL) were included in the study. The relationship between sB7H3 levels in serum or BAL fluid (BALF) and clinical variables at the time of ILD diagnosis was studied retrospectively. All patients who met the fibrosing ILD criteria were followed for 5 years.
We found that coexisting malignancy affected the serum, but not the BALF, sB7H3 levels. There was no significant correlation between serum and BALF levels of sB7H3 in 49 ILD patients without malignancy (11 with sarcoidosis, 5 with drug-induced ILD, 22 with IPF, and 11 with ILD associated with systemic sclerosis). We also found that the BALF levels, but not serum levels, of sB7H3 at the time of ILD diagnosis had independent prognostic potential on 5-year survival in patients with fibrosing ILDs. Of note, patients with a higher level of BALF sB7H3 at diagnosis (≥0.100 ng/mL) showed significantly shorter survival than those with lower levels.
This study suggests that BALF sB7H3 could be a novel prognostic biomarker in a broad range of fibrosing ILD patients.
B7家族成员B7H3/CD276最近被报道参与特发性肺纤维化（IPF）的病理生理过程。然而，B7H3与包括IPF在内的纤维化间质性肺疾病（ILDs）患者预后的关联仍不清楚。本研究旨在确定可溶性B7H3（sB7H3）作为预测纤维化ILDs患者预后生物标志物的潜力。
本研究纳入了接受支气管肺泡灌洗（BAL）的各类ILDs患者。回顾性研究血清或支气管肺泡灌洗液（BALF）中sB7H3水平与ILD诊断时临床变量之间的关系。所有符合纤维化ILD标准的患者均随访5年。
我们发现并存的恶性肿瘤影响血清sB7H3水平，但不影响BALF中的sB7H3水平。在49例无恶性肿瘤的ILD患者（11例结节病、5例药物性ILD、22例IPF和11例与系统性硬化症相关的ILD）中，血清和BALF中sB7H3水平无显著相关性。我们还发现，ILD诊断时BALF中sB7H3水平而非血清水平对纤维化ILDs患者的5年生存率具有独立的预后预测潜力。值得注意的是，诊断时BALF中sB7H3水平较高（≥0.100 ng/mL）的患者生存期明显短于水平较低的患者。
本研究表明，BALF中的sB7H3可能是广泛纤维化ILD患者的一种新型预后生物标志物。
