Peter Paluch

Influence of age on manifestation, VC and TLCO values, and bronchoalveolar lavage cell counts of sarcoidosis and extrinsic allergic alveolitis

Immune response probably changes during human life, being influenced by cumulative exposure to environmental factors and individual genetic background.

Surfactant protein A in chronic extrinsic allergic alveolitis

To the Editors: The chronic form of extrinsic allergic alveolitis (EAA) may have some common features with idiopathic pulmonary fibrosis (IPF). The clinical, radiological and histopathological presentation of both diseases may be similar. Surfactant protein (SP)-A can be detected in serum of patients with IPF and concentrations of SP-A were found to be elevated in these patients [1]. The aim of the present study was to compare serum SP-A concentrations in IPF and chronic EAA patients and detect possible relationships between SP-A levels, bronchoalveolar lavage (BAL) fluid differential cell counts, high-resolution computed tomography (HRCT) patterns and pulmonary function tests in both diseases. 13 patients with chronic EAA and seven patients with IPF were enrolled in the retrospective study after informed consent was obtained. The mean±sd age of IPF patients was 63.7±12.4 yrs and the mean±sd age of the EAA group 60.3±11.3 yrs. Only one IPF patient was a smoker, all others were nonsmokers. All of the enrolled subjects underwent a diagnostic programme including history assessment, physical examination, pulmonary function tests, blood tests including evaluation of SP-A serum concentrations, HRCT of the chest, bronchoscopy with BAL and transbronchial biopsy. HRCT alveolar and interstitial scores were …

EMPIRE Registry, Czech Part: Impact of Demographics, Pulmonary Function and HRCT on Survival and Clinical Course in Idiopathic Pulmonary Fibrosis

Prognostic factors of idiopathic pulmonary fibrosis (IPF) currently recognized include changes in vital capacity and radiologic findings. However, most of the prognostic studies in IPF are based on clinical studies with preselected IPF populations. Therefore, we decided to analyze the factors influencing IPF prognosis based on the real‐practice data from our IPF registry.

SMAD2 mRNA expression is upregulated in fibrosing interstitial lung diseases (ILDs)

ILDs are heterogenous group of diseases with different extent of inflammation and fibrosis. Fibrotic types of ILDs(IPF and NSIP) are associated with the worst prognosis. In pathogenesis of fibroproduction dysregulation of TGFbeta among others probably plays significant role. Methods: 11 patients with hypersensitivity pneumonitis(HP), 15 patients with fibrosing ILDs(IPF and NSIP) and 8 patients with connective tissue diseases (CTD) were enrolled into the prospective study. All patients underwent bronchoscopy with transbronchial biopsy during the diagnostic programme. After isolation of mRNA from lung biopsies, mRNA expression of F2RL1, GPER, IL4R, IL 13, SMAD 2, SMAD 3, TGF beta, TNF alpha, TSLP, VEGFA and YY1 were measured using TLDA cards. CT scans at the time of diagnosis were scored according to Gay S. procedure and alveolar and interstitial score was set. Groups of patients were compared using Cruscal Wallis test and relation between HRCT score and mRNA expression were estimated by Spearman correlation coefficient. Results: RNA expression of SMAD 2 was significantly higher in the group of fibrosing ILDs(median:1.90) comparing to HP(median:0.99, p=0.008) and CTD group(med.:0.98,p=0.02). Differences in other measured expressions between groups didn9t reach statistical significance. Negative correlation has been found between alveolar score and SMAD 2 in all patients (p: 0.016). Conclusion: We have observed upregulated expression of SMAD 2 mRNA in the group of fibrosing ILDs. Moreover the SMAD values negatively correlated with alveolar score. We hypothesise that SMAD 2 might be used as a biomarker of fibroproliferative healing in ILDs.

Can IL-4Ralpha and PAR-2 in bronchoalveolar lavage fluid serve as biomarker of fibroproliferative healing in interstitial lung diseases?

Aims: Prognosis and therapeutic approach to interstitial lung diseases (ILDs) depend on their tendency to fibroproliferative healing. In our previous works we proved a relationship of IL-4 gene polymorphisms and IL-4 receptor alpha (IL-4Ralpha) and proteinase activated receptor (PAR-2) expression in lung tissue in fibrotic idiopathic interstitial pneumonias (fIIPs) and increased values of IL-4Ralpha and PAR-2 in bronchoalveolar lavage fuid (BALF) in chronic hypersensitivity pneumonitits(HP). Thus we aimed to compare the PAR-2 and IL-4Ralpha BALF values in different ILDs to test whether these molecules might serve as biomarkers of fibroproliferative healing. Methods: BALF samples of 46 patients with ILDs (8 sarcoidosis (SARC), 15 HP, 13 fIIPs and 10 ILDs within connective tissue diseases (ILD-CTD)) were investigated by ELISA method to detect PAR-2 and IL-4Ralpha values. The Kruskal-Wallis test with multivariate comparisons was used to compare the PAR-2 and IL-4Ralpha values between the ILDs subgroups. Results: There was no significant difference of BALF IL-4Ralpha values between the ILDs (P=0.2729,NS). For PAR-2 we found significantly lower BALF concentrations in SARC compared to other ILDs (mean values in pg/ml: HP 19.93;fIIPs 26.0;ILD-CTD 27.5;SARC 9.3; P=0.007). In multivariate comparison the PAR-2 values in the HP, fIIPs and ILD-CTD groups differed significantly from SARC and on the contrary SARC differed significantly from all (p Conclusion: We hypothesize that PAR-2 in BALF might be a potential biomarker of fibroproliferative healing and can help in differential diagnosis of ILDs with/without progressive fibroproliferative healing.

Prognostic indicators in extrinsic allergic alveolitis

Abstract Background: Extrinsic allergic alveolitis belongs among the most often diagnosed interstitial lung diseases. However, little data concerning the impact of antigen-type, presentation of disease and treatment, on