Suga M, Iyonaga K, Ando M
First Department of Internal Medicine, Kumamoto University School of Medicine, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Dec;34 Suppl:175-80.
To clarify role of alveolar macrophages in the pathogenesis of idiopathic interstitial pneumonia (IIP), we studied (1) the localization and expression of monocyte chemoattractant protein-1 (MCP-1) in IIP by immunohistochemistry and in situ hybridization. (2) the role of MCP-1 in macrophage recruitment to be lung, and (3) the clinical usefulness of measuring MCP-1. (1) In IIP, MCP-1 was observed in cuboidal and flattened metaplastic epithelial cells, alveolar macrophages, and vascular endothelial cells. In contrast, no epithelial cells from patients without IIP stained positive for MCP-1, although alveolar macrophages and vascular endothelial cells were labeled. MCP-1 production by epithelial cells in IIP may be caused by the metaplastic nature of the epithelial cells and may be a main cause of the irreversible progression of IIP. (2) MCP-1 levels in bronchoalveolar lavage fluid (BALF) were significantly higher in the IIP, the interstitial pneumonia due to collagen vascular disease (IP-CVD) and sarcoidosis groups than in normal controls. In the IIP group, the MCP-1 level was significantly higher than in any other patient groups. In all three groups of patients, the monocyte chemotactic activity in BALF correlated positively with the MCP-1 levels in BALF, and were neutralized by anti-MCP-1. (3) BALF MCP-1 levels were significantly higher than serum MCP-1 levels in the IIP group, and they were lower in the IP-CVD and non-specific interstitial pneumonia groups. Serum MCP-1 levels reflected the activity of interstitial lung diseases, especially during treatment with corticosteroids. These results indicate (1) that MCP-1 plays a significant role in the recruitment of monocytes into the lung in IIP, (2) that measuring MCP-1 levels both in BALF and in serum may help discriminate IIP from other types of interstitial lung diseases, and (3) that monitoring the serum MCP-1 level may be useful in estimating the activity of interstitial lung diseases.
为阐明肺泡巨噬细胞在特发性间质性肺炎（IIP）发病机制中的作用，我们进行了以下研究：（1）通过免疫组织化学和原位杂交技术，研究单核细胞趋化蛋白-1（MCP-1）在IIP中的定位和表达。（2）MCP-1在巨噬细胞募集至肺过程中的作用，以及（3）检测MCP-1的临床应用价值。（1）在IIP中，MCP-1在立方状和扁平化生上皮细胞、肺泡巨噬细胞及血管内皮细胞中被观察到。相比之下，非IIP患者的上皮细胞中没有MCP-1染色阳性，尽管肺泡巨噬细胞和血管内皮细胞被标记。IIP中上皮细胞产生MCP-1可能是由上皮细胞的化生性质引起的，并且可能是IIP不可逆进展的主要原因。（2）IIP、胶原血管病所致间质性肺炎（IP-CVD）和结节病组支气管肺泡灌洗液（BALF）中的MCP-1水平显著高于正常对照组。在IIP组中，MCP-1水平显著高于其他任何患者组。在所有三组患者中，BALF中的单核细胞趋化活性与BALF中的MCP-1水平呈正相关，并被抗MCP-1中和。（3）IIP组BALF中的MCP-1水平显著高于血清MCP-1水平，而在IP-CVD和非特异性间质性肺炎组中则较低。血清MCP-1水平反映了间质性肺疾病的活动情况，尤其是在使用皮质类固醇治疗期间。这些结果表明：（1）MCP-1在IIP中单核细胞募集至肺的过程中起重要作用；（2）检测BALF和血清中的MCP-1水平可能有助于鉴别IIP与其他类型的间质性肺疾病；（3）监测血清MCP-1水平可能有助于评估间质性肺疾病的活动情况。
