Frette C, Jacob M P, Wei S M, Bertrand J P, Laurent P, Kauffmann F, Pham Q T
Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 169, Villejuif, France.
Thorax. 1997 Dec;52(12):1045-50. doi: 10.1136/thx.52.12.1045.
Clinical and epidemiological studies have given discordant results on the usefulness of the level of circulating elastin peptide (EP), a potential marker of both elastin destruction (a key phenomenon in pulmonary emphysema) and neosynthesis, for assessing structural changes in the lung extracellular matrix. The aim of the present study was to explore the relationship between levels of EP and forced expiratory volume in one second (FEV1) and single breath transfer factor for carbon monoxide (TLCO and KCO) in coal miners.
The study population comprised 227 working coal miners aged 34-50 years consisting of 75 miners heavily exposed to underground coal dust with pulmonary radiographs classified as 0/1 or 1/0 by the International Labour Office classification, 75 exposed miners with radiographs classified as normal (0/0), and 77 miners slightly exposed to coal dust with normal radiographs. The subjects answered a standardised questionnaire and performed spirometric tests and a carbon monoxide (CO) transfer test.
No association was observed between EP levels and % predicted FEV1 (or FEV1/FVC). The level of EP increased significantly with decreased % predicted TLCO (r = -0.20). Miners in the lowest % predicted KCO quintile had higher EP levels than the rest (3.28 (1.37) vs 2.47 (1.16)). A significantly lower EP level was observed in miners with radiographs classified as 1/0 or 0/1, especially in those with round opacities, compared with miners with a normal radiograph, and in current smokers compared with the rest.
The results of this study suggest that the level of EP may reflect some remodelling activity in emphysema and lung fibrosis.
关于循环弹性蛋白肽(EP)水平在评估肺细胞外基质结构变化方面的作用,临床和流行病学研究得出了不一致的结果。EP水平既是弹性蛋白破坏(肺气肿的关键现象)的潜在标志物,也是新合成的潜在标志物。本研究的目的是探讨煤矿工人中EP水平与一秒用力呼气量(FEV1)以及一氧化碳单次呼吸转移因子(TLCO和KCO)之间的关系。
研究人群包括227名年龄在34至50岁的在职煤矿工人,其中75名重度接触地下煤尘的矿工,其肺部X光片根据国际劳工组织分类为0/1或1/0;75名接触煤尘但X光片分类为正常(0/0)的矿工;以及77名轻度接触煤尘且X光片正常的矿工。受试者回答了标准化问卷,并进行了肺功能测试和一氧化碳(CO)转移测试。
未观察到EP水平与预测FEV1百分比(或FEV1/FVC)之间存在关联。随着预测TLCO百分比的降低,EP水平显著升高(r = -0.20)。预测KCO最低五分位数的矿工的EP水平高于其他矿工(3.28(1.37)对2.47(1.16))。与X光片正常的矿工相比,X光片分类为1/0或0/1的矿工,尤其是有圆形阴影的矿工,以及与其他人群相比的当前吸烟者,其EP水平显著较低。
本研究结果表明,EP水平可能反映了肺气肿和肺纤维化中的一些重塑活动。