Okazaki I, Maruyama K, Okuno F, Suzuki H, Aoyagi K, Sera Y
J UOEH. 1983 Dec 1;5(4):461-7. doi: 10.7888/juoeh.5.461.
Early diagnosis of lung fibrosis has been hampered by the lack of a simple, convenient and specific method. Recently Rohde et al. developed an assay method for Type III procollagen peptide. Type III procollagen peptide, an extension peptide released during the biosynthesis of collagen Type III, has been known as a good marker for hepatic fibrosis. Therefore, we applied this assay to the patients with idiopathic pulmonary fibrosis, lung fibrosis in collagen disease and silicosis. And also we measured the serum level of the peptide in the healthy workers being exposed to silica. Normal value of the peptide in adults was 8.3 +/- 2.6 (mean +/- SD; n = 32) ng/ml. The upper value over mean + 2SD, 13.4 ng/ml, was regarded as abnormal value. Six patients with idiopathic pulmonary fibrosis, and lung fibrosis in collagen disease showed a significant increased level of 19.0 +/- 9.6 ng/ml (P less than 0.02). Four of 6 patients had abnormal high values. On the other hand, the patients with silicosis had not so high levels of peptide (12.6 +/- 6.5 ng/ml; n = 24; P less than 0.01), but 25% of the patients showed abnormal values. There were 2 cases among 19 healthy workers being exposed to silica who revealed slight abnormal values, 15.6 and 16.7 ng/ml. These observations suggest that the assay has a prognostic value for lung fibrosis and also is useful for the early detection of active lung fibrosis in the workers, even though Type III procollagen biosynthesis is already low in the late stages of silicosis.
由于缺乏一种简单、便捷且特异的方法，肺纤维化的早期诊断一直受到阻碍。最近，罗德等人开发了一种检测III型前胶原肽的方法。III型前胶原肽是III型胶原生物合成过程中释放的一种延伸肽，一直被认为是肝纤维化的良好标志物。因此，我们将该检测方法应用于特发性肺纤维化、胶原病相关性肺纤维化和矽肺患者。我们还测量了接触二氧化硅的健康工人血清中该肽的水平。成年人该肽的正常值为8.3±2.6（平均值±标准差；n = 32）ng/ml。平均值加2个标准差以上的值，即13.4 ng/ml，被视为异常值。6例特发性肺纤维化和胶原病相关性肺纤维化患者的肽水平显著升高，为19.0±9.6 ng/ml（P＜0.02）。6例患者中有4例的值异常高。另一方面，矽肺患者的肽水平没有那么高（12.6±6.5 ng/ml；n = 24；P＜0.01），但25%的患者显示异常值。在19名接触二氧化硅的健康工人中有2例显示出轻微异常值，分别为15.6和16.7 ng/ml。这些观察结果表明，该检测方法对肺纤维化具有预后价值，并且对于早期检测工人中的活动性肺纤维化也很有用，尽管在矽肺晚期III型前胶原的生物合成已经很低。
