TGF-β1在不同类型特发性间质性肺炎患者肺组织中的表达及其意义

目的:探讨TGF-β1在不同类型特发性间质性肺炎患者肺组织中的表达及其意义。方法:选取2010年2月至2013年12月在我院就诊的72例经支气管镜肺活检的不同类型的特发性间质性肺炎患者的组织标本,对其转化生长因子-β1表达程度进行评定。结果:寻常型(普通型)、非特异性、脱屑性、急性等ⅡP、呼吸性细支气管炎并间质性肺疾病以及隐原性机化性肺炎患者肺组织中TGF-β1表达强度评分均显著高于对照组;脱屑性ⅡP和呼吸性细支气管炎并间质性肺疾病患者肺组织中TGF-β1表达强度评分均显著高于其他类型ⅡP患者;非特异性ⅡP、急性ⅡP、淋巴细胞性ⅡP以及隐原性机化性肺炎组患者肺组织中TGF-β1表达强度评分均显著低于寻常型(普通型)ⅡP组;隐原性机化性肺炎、淋巴细胞性ⅡP组患者肺组织中TGF-β1表达强度评分分别为(0.93±0.34)分、(0.82±0.27)分,显著低于急性ⅡP组患者的(1.64±0.05)分。差异均有统计学意义(P0.05)。结论:TGF-β1表达过度可能是ⅡP患者的重要特征,在肺纤维化的过程中发挥着重要作用,但在不同类型ⅡP中的作用机制并不相同。     

SARS患者尸检肺组织的TGF-β检测

为了研究TGF-β1在严重急性呼吸综合征(Severe acute respiratory syndrome, SARS)尸检肺组织中的表达情况及其在患者肺组织损伤中的可能作用,对2例SARS尸检肺组织进行病理学观察;应用免疫组化方法检测TGF-β1在尸检肺组织及对照肺组织中的表达情况,并进行半定量分析. 结果显示病例一尸检肺组织主要病理改变为弥漫性肺泡损伤,透明膜形成及渗出性炎症.病例二尸检肺组织除了上述改变外,还伴有肺泡间质纤维增生和肺泡早期纤维化等机化性肺炎改变.TGF-β1平均灰度值在SARS患者肺组织为103.43±0.62;小叶性肺炎组织为131.47±2.64;正常肺组织中为144.24±0.09.3组比较有显著差别(P值＜0.05).SARS病毒感染后可引起急性肺间质和肺泡渗出性炎症,中后期病例还伴有肺泡间质纤维增生和肺泡早期纤维化;SARS患者肺组织损伤及纤维化与SARS冠状病毒感染后TGF-β1表达增强有关,提示抗TGF-β1治疗在SARS患者肺损伤、纤维化的预防、治疗过程中可能具有一定的临床意义.     

SARS患者尸检肺组织的TGF-β检测

为了研究TGFβ1在严重急性呼吸综合征(Severeacuterespiratorysyndrome,SARS)尸检肺组织中的表达情况及其在患者肺组织损伤中的可能作用,对2例SARS尸检肺组织进行病理学观察;应用免疫组化方法检测TGFβ1在尸检肺组织及对照肺组织中的表达情况,并进行半定量分析。结果显示病例一尸检肺组织主要病理改变为弥漫性肺泡损伤,透明膜形成及渗出性炎症。病例二尸检肺组织除了上述改变外,还伴有肺泡间质纤维增生和肺泡早期纤维化等机化性肺炎改变。TGFβ1平均灰度值在SARS患者肺组织为103.43±0.62;小叶性肺炎组织为131.47±2.64;正常肺组织中为144.24±0.09。3组比较有显著差别(P值<0.05)。SARS病毒感染后可引起急性肺间质和肺泡渗出性炎症,中后期病例还伴有肺泡间质纤维增生和肺泡早期纤维化;SARS患者肺组织损伤及纤维化与SARS冠状病毒感染后TGFβ1表达增强有关,提示抗TGFβ1治疗在SARS患者肺损伤、纤维化的预防、治疗过程中可能具有一定的临床意义。     

乳腺癌组织中转化生长因子-β1和血管内皮生长因子的表达及其与血管生成的关系

目的:研究转化生长因子-β1(transforming growth factor-β1,TGF-β1)和血管内皮生长因子(vascular endothelial cell growth factor,VEGF)在乳腺癌组织中的表达及其与血管生成的关系。方法:选取65例手术切除乳腺癌蜡块标本及其周围正常乳腺组织,分为两组:A组为对照组,检测标本为乳腺癌癌旁正常乳腺组织;B组为实验组,检测标本为乳腺癌组织,采用免疫组织化学染色和形态计量检测TGF-β1和VEGF在乳腺癌组织中的表达。利用CD34相关抗原标记血管内皮细胞,计数微血管密度(intratumoral mier oveseulardensity,MVD),并分析其与TGF-β1和VEGF表达的关系。结果:65例乳腺癌组织中,TGF-β1的阳性表达率为69.23%(45/65),TGF-β1阳性表达者MVD值(25.31±4.05)显著高于TGF-β1阴性表达者(21.23±4.29);VEGF的阳性表达率为78.46%(51/65),VEGF阳性表达者MVD值(26.62±3.41)亦明显显著高于VEGF阴性表达者(18.95±6.52)(均P0.05)。不同病理类型的乳腺癌组织中TGF-β1、VEGF的阳性表达率比较差异无统计学意义(P0.05),但TGF-β1、VEGF的阳性表达与乳腺癌的组织分级、淋巴结转移呈显著正相关(均P0.05),且组织学分级越高、淋巴结转移越多,MVD值越大。结论:TGF-β1与VEGF在乳腺癌组织的表达高于正常乳腺组织,并与乳腺癌肿瘤血管的生成有关,二者有望作为乳腺癌恶性程度、浸润转移等生物学行为的评估指标。     

干细胞对环孢素肾病大鼠肾组织转化生长因子β1的影响

目的观察干细胞治疗技术对环孢素肾病大鼠肾组织转化生长因子β1(TGF-β1)的影响。方法实验大鼠分成3组,每组10只大鼠:C组:正常对照组;H组:模型组;B组:骨髓间充质干细胞治疗组。28 d处死大鼠切取肾脏,免疫组织化学染色、RT-PCR、Western blot测定肾组织TGF-β1、α-平滑肌肌动蛋白(α-SMA)的表达水平。采用单因素方差分析比较各组数据。结果 (1)免疫组织化学染色结果显示:与C组比较,H组、B组TGF-β1(0.899±0.046vs 9.524±1.232,6.437±0.728;P0.01)、α-SMA(2.427±0.188 vs 11.912±2.610,9.232±2.268;P0.01)表达水平均显著升高,差异具有统计学意义。与H组比较,B组大鼠的TGF-β1(9.524±1.232 vs 6.437±0.728;P0.01)、α-SMA(11.912±2.610 vs 9.232±2.268;P0.01)表达水平显著下降,差异具有统计学意义;(2)RT-PCR结果显示:与C组比较,H组、B组TGF-β1(0.119±0.003 vs 0.826±0.004,0.651±0.004;P0.01)、α-SMA(0.370±0.006 vs 0.900±0.007,0.642±0.007;P0.01)m RNA水平均显著升高,差异具有统计学意义(P0.05)。与H组比较,B组大鼠的TGF-β1(0.826±0.004 vs 0.651±0.004;P0.01)、α-SMA(0.900±0.007 vs 0.642±0.007;P0.01)m RNA水平显著下降,差异具有统计学意义;(3)Western blot结果显示:与C组比较,H组、B组TGF-β1(0.218±0.004 vs 0.825±0.003,0.650±0.006;P0.01)、α-SMA(0.263±0.003vs 0.841±0.003,0.615±0.003;P0.01)蛋白水平均显著升高,差异具有统计学意义。与H组比较,B组大鼠的TGF-β1(0.825±0.003 vs 0.650±0.006;P0.01)、α-SMA(0.841±0.003 vs 0.615±0.003;P0.01)蛋白水平显著下降,差异具有统计学意义。结论骨髓间充质干细胞治疗可以下调环孢素肾病大鼠肾组织TGF-β1表达水平,减少α-SMA表达水平,从而改善大鼠肾间质纤维化程度。     

麦门冬汤加减方对特发性肺纤维化小鼠PI3K/AKT/mTOR通路的调控

摘要 目的：探讨麦门冬汤加减方对特发性肺纤维化小鼠转化生长因子-β1(Transforming growth factor-β1,TGF-β1)、平滑肌肌动蛋白(α-smooth muscle actin, α-SMA)、胶原I(Collagen type I, COL1A)表达的影响以及对PI3K/AKT/mTOR通路的调控作用。方法：将120只SPF级ICR小鼠随机分入空白组、模型组、吡菲尼酮组和麦门冬汤加减方组,用博来霉素(5 mg/kg)建立特发性肺纤维化模型,24 h后分别给予相应的药物治疗。吡菲尼酮组和麦门冬汤加减方组小鼠分别灌胃吡菲尼酮和中药麦门冬汤加减方,空白组和模型组小鼠灌胃生理盐水,各组均连续给药3周(21d)后取材。观察指标：各组小鼠的肺系数;肺组织病理变化;肺组织TGF-β1、α-SMA、COL1A的表达量(免疫组化);肺组织中α-SMA、COL1A、p-PI3K、p-AKT、mTOR的蛋白表达量(Western blot);肺组织中TGF-β1、α-SMA、COL1A的mRNA表达量(qPCR)。结果：模型组小鼠的肺系数显著增加,麦门冬汤加减方组肺系数显著降低;模型组小鼠肺组织中有较多炎性细胞浸润,胶原沉积明显,肺泡结构破坏严重,麦门冬汤加减方组小鼠肺组织病理改变较模型组明显减轻,胶原沉积大量减少,肺泡结构逐渐修复;麦门冬汤加减方组较模型组α-SMA、COL1A、TGF-β1的蛋白表达量显著降低(P＜0.01);麦门冬汤加减方组较模型组α-SMA、COL1A、p-PI3K、p-AKT、mTOR的蛋白表达量显著下调(P＜0.01);麦门冬汤加减方组较模型组α-SMA、COL1A、TGF-β1的mRNA表达量显著降低(P＜0.01)。结论：麦门冬汤加减方能有效改善博来霉素诱导的特发性肺纤维化,降低α-SMA、COL1A、TGF-β1的表达,可能是通过调控PI3K/AKT/mTOR信号通路,抑制上皮间充质转化,减少细胞外基质沉积而发挥作用。     

TGF-β2和TGFβRⅡ在外阴鳞癌中的表达及意义

目的:探讨外阴鳞癌(VSCC)中转化生长因子-β2(TGF-β2)和转化生长因子受体βRⅡ(TGFβRⅡ)蛋白的表达及其临床病理意义。方法:收集30例外阴鳞癌及10例外阴整形时切下的外阴正常皮肤组织。所有组织来自2012年1月至2015年10月在我院妇科行手术治疗的患者。采用免疫组化方法检测TGF-β2及TGFβRⅡ蛋白的表达。结果:外阴鳞癌组织中TGF-β2的阳性表达率显著高于正常外阴组织(90%vs 20%),差异有统计学意义(P0.05),TGF-β2的表达与肿瘤分化程度、FIGO分期无关(P0.05),但与淋巴结是否转移显著相关(P0.05)。外阴鳞癌组织中TGFβRⅡ的阳性表达低于正常外阴组织(13.33%vs 70%),差异有统计学意义(P0.05),TGFβRⅡ的表达与肿瘤分化程度、FIGO分期和淋巴结是否转移均无显著相关性(P0.05)。结论:TGF-β2的表达上调与外阴鳞癌的发生及其淋巴结转移有关,可能是VSCC的治疗靶点。TGFβRⅡ的表达下调可能参与了外阴鳞癌的发生。     

前列腺癌nm23H1mRNA、TGF-β1mRNA表达及其与肿瘤转移、生存率的相关性研究

应用原位杂交法检测42例前列腺癌组织nm23H1mRNA、TGF-β1mRNA表达,并以CD31抗体为标记,经EnVision~(TM)免疫组织化学及Leica-Qwin计算机图像分析,用Weidner最高血管密度计数法,计数阳性MVD,研究前列腺癌组织nm23H1mRNA、TGF-β1mRNA和CD31的表达与前列腺癌中的新生血管的生成、肿瘤血道转移和调查患者术后的生存率关系。前列腺癌nm23H1mRNA阳性表达66．67%(28例),nm23H1mRNA阳性表达与前列腺癌骨转移、TNM分期、MVD呈负相关(P＜0．05)：TGF-β1mRNA阳性表达78．75%(33例),其与前列腺癌骨转移、TNM分期、MVD呈正相关(P＜0．05),与癌周组织的nm23H1mRNA和TGF-β1mRNA阳性表达比较,具有显著性差异(P＜0．01或P＜0．05)。前列腺癌组织的MVD(78．51±10．29/mm~2)显著高于癌周组织(34．19±9．27/mm~2),两者比较具有显著性差异(P＜0．05)。在根治术后5年内死亡的42．86%(18例)患者中MVD(92．41±15．42/ mm~2),高于5年内生存的患者(62．79±13．58/mm~2),两组间有显著性差异(P＜0．05);在不同的肿瘤病理学分级中,nm23H1mRNA在前列腺癌未、低分化型中阳性表达率高,高、中分化型中阳性表达率低,两组间有显著性差异(P＜0．05)。当nm23H1mRNA阳性表达率高时,肿瘤骨转移率低,生存率高,故认为nm23H1基因具有抑制前列腺癌发生和转移作用。当TGF-β1mRNA阳性表达率高时,肿瘤骨转移率高,生存率低。故认为TGF-β1基因具有促进前列腺癌发生和转移作用。前列腺癌组织中的MVD与肿瘤骨转移密切相关,前列腺癌组织MVD的显著增高,提示肿瘤组织有新血管的生成。TGF-β1促进了肿瘤诱导的血管新生,在前列腺癌的骨转移中起重要作用。     

乳腺癌组织中转化生长因子-beta1 和血管内皮生长因子的表达 及其与血管生成的关系

目的:研究转化生长因子-β1(transforming growth factor-β1,TGF-β1)和血管内皮生长因子(vascular endothelial cell growth factor,VEGF)在乳腺癌组织中的表达及其与血管生成的关系。方法:选取65例手术切除乳腺癌蜡块标本及其周围正常乳腺组织,分为两组:A组为对照组,检测标本为乳腺癌癌旁正常乳腺组织;B组为实验组,检测标本为乳腺癌组织,采用免疫组织化学染色和形态计量检测TGF-β1和VEGF在乳腺癌组织中的表达。利用CD34相关抗原标记血管内皮细胞,计数微血管密度(intratumoral mier oveseulardensity,MVD),并分析其与TGF-β1和VEGF表达的关系。结果:65例乳腺癌组织中,TGF-β1的阳性表达率为69.23%(45/65),TGF-β1阳性表达者MVD值(25.31±4.05)显著高于TGF-β1阴性表达者(21.23±4.29);VEGF的阳性表达率为78.46%(51/65),VEGF阳性表达者MVD值(26.62±3.41)亦明显显著高于VEGF阴性表达者(18.95±6.52)(均P<0.05)。不同病理类型的乳腺癌组织中TGF-β1、VEGF的阳性表达率比较差异无统计学意义(P>0.05),但TGF-β1、VEGF的阳性表达与乳腺癌的组织分级、淋巴结转移呈显著正相关(均P<0.05),且组织学分级越高、淋巴结转移越多,MVD值越大。结论:TGF-β1与VEGF在乳腺癌组织的表达高于正常乳腺组织,并与乳腺癌肿瘤血管的生成有关,二者有望作为乳腺癌恶性程度、浸润转移等生物学行为的评估指标。     

非小细胞肺癌组织血管生成相关因子表达及临床病理分析

目的探讨血管内皮生长因子(VEGF)及其受体(Flt-1)、转化生长因子β1(TGF-β1)在非小细胞肺癌(non-smallcelllungcancer,NSCLC)组织血管形成中的意义及与肿瘤临床、生物学行为的关系。方法免疫组化染色观察VEGF、血管内皮生长因子受体-1(Flt-1)、TGF-β1在NSCLC组织中的表达,以CD34免疫组化染色来显示NSCLC组织中微血管生成情况和进行微血管密度判断。结果NSCLC组织中癌细胞不同程度地表达VEGF、血管内皮生长因子受体因子、TGF-β1,而对照组肺组织基本不表达(P<0·05);VEGF、Flt-1、TGF-β1阳性表达的NSCLC组织内微血管计数明显高于VEGF、Flt-1、TGF-β1表达阴性的NSCLC组织(P<0·05);NSCLC组织中VEGF、Flt-1、TGF-β1的阳性表达率和表达强度均与肿瘤淋巴结转移密切相关;随年龄增长,VEGF及其受体Flt-1的阳性表达率有所降低(P<0·05)。结论VEGF、Flt-1、TGF-β1的表达与NSCLC组织内肿瘤血管生成和淋巴结转移有密切关系,VEGF、Flt-1的表达与患者的年龄有一定关系。     

Active remodeling in idiopathic interstitial pneumonias: evaluation of collagen types XII and XIV.

Fibril-associated collagens with interrupted triple helices (FACITs) XII and XIV act as fibril organizers and assist in the maintenance of uniform fibril size. We investigated the spatial expression patterns of collagens XII and XIV in cryptogenic organizing pneumonia (COP)/organizing pneumonia (OP) and in idiopathic pulmonary fibrosis (IPF)/usual interstitial pneumonia (UIP) and compared them to normal human lung. Study subjects included 10 patients with COP/OP, 10 patients with IPF/UIP, and 8 control subjects. Immunostaining for collagens XII and XIV was carried out in paraffin-embedded human lung tissue sections. Picrosirius red histochemical staining for collagen I expression and electron microcopy to evaluate fibril diameter were also performed. In normal lung, collagens XII and XIV were expressed in perivascular and subpleural connective tissue. In COP/OP, both collagens showed intense staining in perivascular connective tissue, thickened alveolar septae, and subpleural areas. In IPF/UIP, XII and XIV were expressed in perivascular connective tissue, in areas of established fibrosis, and in areas of subpleural thickening. Only collagen XII was expressed in granulation tissue plugs in COP/OP and in fibroblastic foci in IPF/UIP. Collagen type I was overexpressed in fibrotic areas. Electron micrographs revealed obvious fibril diameter alteration and fusion in the same areas. FACITs XII and XIV are expressed in normal and fibrotic lung. Unlike collagen XIV, collagen XII was expressed in granulation tissue plugs in COP/OP and in fibroblast foci in IPF/UIP. This may suggest a possible distinct role for both collagens in the modulation of the extracellular matrix during the onset of fibrotic process.     

TLR9 is expressed in idiopathic interstitial pneumonia and its activation promotes in vitro myofibroblast differentiation

Infectious diseases can be cofactors in idiopathic interstitial pneumonias (IIP) pathogenesis; recent data suggests that toll-like receptors 9 (TLR9) ligands contribute to experimental chronic tissue remodeling. Real-time TAQMAN and immunohistochemical analysis of IIP normal surgical lung biopsies (SLBs), primary fibroblast lines grown from both IIP and normal SLBs indicate that TLR9 is prominently and differentially expressed in a disease-specific manner. TLR9 expression was increased in biopsies from patients with IIP compared with normal lung biopsies and its expression is localized to areas of marked interstitial fibrosis. TLR9 in fibroblasts appeared to be increased by profibrotic Th2 cytokines (IL-4 and IL-13) and this was true in fibroblasts cultured from the most severe form of IIP, idiopathic pulmonary fibrosis (IPF) SLBs, in non-specific interstitial pneumonia fibroblast lines, and in normal fibroblasts. Finally, confocal microscopy studies have shown that TLR9 activation by its synthetic agonist CpG-ODN significantly increased the expression of alpha smooth muscle actin, the main marker of myofibroblast differentiation. These data indicate that TLR9 expression may drive the abnormal tissue healing response in severe forms of IIP and its activation can have a key role in myofibroblast differentiation promoting the progression of disease during the terminal phase of IPF. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.     

Fibrosing alveolitis

Fibrosing alveolitis is a disease of unknown cause mainly involving the gas-exchanging portions of the lungs. It may occur in isolation and be called cryptogenic or idiopathic, in which case the clinical manifestations are mainly respiratory, or it may be associated with other disorders, such as rheumatoid arthritis. The histopathologic abnormalities of the pulmonary tissue are identical in either instance. Other names used for the disease have included usual interstitial pneumonia, desquamative interstitial pneumonia and the Hamman-Rich syndrome; these terms may describe different stages of the same pathologic process. Many authors in North America and those in the United Kingdom favour the term fibrosing alveolitis when describing chronic interstitial pneumonias. There may be accompanying nonspecific Immunologic abnormalities, which may denote that fibrosing alveolitis is part of the wide spectrum of diseases known as connective tissue disorders. Recently immune complexes have been found in the lung parenchyma; they probably result in the granulocyte destruction and reticuloendothelial proliferation seen in the acute phase of the disease.There are no specific diagnostic tests for the disease apart from lung biopsy, which can be performed at the time of thoracotomy or transbronchially, with the use of a flexible fibreoptic bronchoscope. Lavaged cells from the alveoli have also been obtained via the bronchoscope; in persons with fibrosing alveolitis a high proportion of these cells are neutrophils, and after corticosteroid treatment the proportion decreases. The progress of the disease can be followed by examination of these washings as well as by lung scanning with gallium-67 citrate. Newer methods of treatment using combinations of corticosteroids and immunosuppressant drugs are being evaluated and are initially proving to be successful.     

Selective Induction of Endothelial L-selectin Ligand Human Lung Inflammation

During inflammation, leukocyte emigration from the circulation can be directed by the endothelium, in part by the inducible endothelial adhesion ligand for L-selectin. In this study, endothelial L-selectin ligand expression was localized by immuno-histochemistry in human lung in several different types of lung inflammation and in systemic inflammation. Endothelial L-selectin ligand was not seen in normal lung or in acute pneumonia involving neutrophil accumulation. However, the endothelial ligand was seen in most cases of chronic interstitial pneumonia with mononuclear cell accumulation (a mean of 5.9% of microvessels positive). Regarding granulomatous conditions, in sarcoidosis the endothelial ligand was not identified, but in tuberculous infection some expression was seen in a minority of cases (mean 3.3% of microvessels positive). In contrast, consistent, typically extensive ligand induction (mean 33.4% of microvessels positive) was present in bronchiectatic lung showing prominent lymphocytic accumulation and venules with thickened (high) endothelium, the latter being normally characteristic of lymphoid tissue in which L-selectin ligand is known to be constitutively expressed. Lung from subjects with systemic infection was negative for endothelial expression of the ligand. These studies show how in a defined extralymphoid tissue induction of endothelial L-selectin ligand depended not only on the presence or absence of an inflammatory state, but also on the nature of the inflammation.     

Pulmonary protostrongyliasis in a mountain hare from Italy

An adult male mountain hare (Lepus timidus), shot during the hunting season on the slopes of Mt. Civetta (eastern Alps, Veneto, northeastern Italy), was eviscerated and diffuse nodular lesions of verminous pneumonia were observed. Adult helminths were collected and male specimens were identified as Protostrongylus pulmonalis. Histologically, a non-purulent interstitial pneumonia and a desquamative bronchiolitis and alveolitis, along with thickening of alveolar septa, were apparent in the nodules. In several enlarged alveoli, a large number of eggs and larvae of nematodes were found. This is the first recorded case of protostrongyliasis in mountain hares from Italy and from an alpine population.     

Down-regulation of the inhibitor of growth family member 4 (ING4) in different forms of pulmonary fibrosis

Background

Recent evidence has underscored the role of hypoxia and angiogenesis in the pathogenesis of idiopathic fibrotic lung disease. Inhibitor of growth family member 4 (ING4) has recently attracted much attention as a tumor suppressor gene, due to its ability to inhibit cancer cell proliferation, migration and angiogenesis. The aim of our study was to investigate the role of ING4 in the pathogenesis of pulmonary fibrosis both in the bleomycin (BLM)-model and in two different types of human pulmonary fibrosis, including idiopathic pulmonary fibrosis (IPF) and cryptogenic organizing pneumonia (COP).

Methods

Experimental model of pulmonary fibrosis was induced by a single tail vein injection of bleomycin in 6- to 8-wk-old C57BL/6mice. Tissue microarrays coupled with qRT-PCR and immunohistochemistry were applied in whole lung samples and paraffin-embedded tissue sections of 30 patients with IPF, 20 with COP and 20 control subjects.

Results

A gradual decline of ING4 expression in both mRNA and protein levels was reported in the BLM-model. ING4 was also found down-regulated in IPF patients compared to COP and control subjects. Immunolocalization analyses revealed increased expression in areas of normal epithelium and in alveolar epithelium surrounding Masson bodies, in COP lung, whereas showed no expression within areas of active fibrosis within IPF and COP lung. In addition, ING4 expression levels were negatively correlated with pulmonary function parameters in IPF patients.

Conclusion

Our data suggest a potential role for ING4 in lung fibrogenesis. ING4 down-regulation may facilitate aberrant vascular remodelling and fibroblast proliferation and migration leading to progressive disease.     

Interstitial Lung Disease in Coppersmiths in High Serum Copper Levels

Coppersmith is a worker who uses copper most commonly for the production of kitchen appliances in Turkey. This is an ancient occupation practiced for centuries in Turkey. Our objective was to investigate the prevalence of parenchymal lung diseases among coppersmiths in Kahramanmaras city in Turkey. Thirty coppersmiths were included to the study, and they all signed an informed consent. Demographics, spirometric test results and high-resolution computed tomography (HRCT) scans, and blood samples were obtained. Laboratory analysis of the serum samples showed that serum copper levels of the subjects were 0.93 ± 0.14 mg/L. Serum copper level in control group was found as 0.70 ± 0.14 mg/L, and it was significantly different between the two groups (p < 0.05). Of 30 coppersmiths, 17 HRCT findings are abnormal and seen with diffuse parenchymal interstitial lung disease pattern—ten (58.8%) respiratory bronchiolitis interstitial lung disease, five (29.4%) nonspecific interstitial pneumonia, and two (11.8%) usual interstitial pneumonia. The most prevalent HRCT pattern was micronodular pattern in workers. This is the first field study reporting the radiologic findings of coppersmiths and effect of the occupation on lung diseases.     

A plasminogen activator inhibitor-1 promoter polymorphism and idiopathic interstitial pneumonia

The normal fibrinolytic activity within the alveolar space is suppressed in fibrotic lung diseases in part because of increased levels of plasminogen activator inhibitor-1 (PAI-1). Studies with animals have shown that inhibition of the plasminogen system by PAI-1 increases the generation of pulmonary fibrosis. To determine if a similar relationship occurs in human fibrotic lung diseases, we took advantage of a polymorphism (4G/5G) that occurs in the promoter region of the human PAI-1 gene and influences the expression of PAI-1. We hypothesized that the 4G/4G genotype, because of its association with higher levels of PAI-1, would occur in patients with idiopathic interstitial pneumonia more frequently than in a control population. PAI-1 promoter genotype was determined in 88 well-characterized patients with idiopathic interstitial pneumonia consisting of 62 patients with usual interstitial pneumonia and 26 with nonspecific interstitial pneumonia. DNA was extracted from paraffin-embedded biopsy tissue and the genotype identified by polymerase chain reaction and restriction endonuclease digestion. We found that the distribution of PAI-1 genotypes in the idiopathic interstitial pneumonia population was similar to that of a large control population. However, subgroup analysis showed that patients with nonspecific interstitial pneumonia were more likely than the control population to have the promoter genotype (4G/4G) that is associated with higher levels of PAI-1. A similar pattern in PAI-1 polymorphism was not seen in the usual interstitial pneumonia subgroup. The results of this study support the conclusion that PAl-1 expression influences the development of nonspecific interstitial pneumonia in a similar manner to what occurs in animal models of pulmonary fibrosis. Patients with usual interstitial pneumonia did not show the same relationship with PAl-1 genotype.     

Reversed Halo Sign: Presents in Different Pulmonary Diseases

Objective

To observe the incidence of reversed halo sign in different pulmonary diseases and the pathological correspondence of reversed halo sign.

Methods

Retrospectively studied the high resolution computer tomography scans of all the patients who were admitted in our department with abnormal pulmonary imaging, from 1st of January 2011 to 31st of December 2013, and all the cases with reversed halo sign on the high resolution computer tomography were collected. Clinical data such as pathological findings and confirmed diagnosis of the patients with reversed halo sign on the high resolution computer tomography scan were collected and summarized.

Results

Of 1546 abnormal High resolution computer tomography scans 108 had a reverse halo sign present, including 108 cases were observed with reversed halo sign in the high resolution computer tomography, including 40 cases of pulmonary tuberculosis, 43 cases of cryptogenic organizing pneumonia, 16 cases of lung cancer, 7 cases of sarcoidosis, and 1 case of pulmonary cryptococcosis, 1 case of granulomatosis with polyangiitis. Reversed halo sign had a higher incidence in granulomatous diseases (16.28%) compared with non-granulomatous diseases (9.97%).

Conclusions

Reversed halo sign is relatively non specific; it can be observed in different lung diseases, and different phases of diseases; reversed halo sign is more commonly found in granulomatous diseases compared with non-granulomatous diseases, and is most commonly observed in pulmonary tuberculosis among the granulomatous diseases, and in cryptogenic organizing pneumonia among the non-granulomatous diseases.