Higher serum CCL17 may be a promising predictor of acute exacerbations in chronic hypersensitivity pneumonitis |
| |
Authors: | Yasunari Miyazaki Koji Unoura Tomoya Tateishi Takumi Akashi Tamiko Takemura Makoto Tomita Naohiko Inase Yasuyuki Yoshizawa |
| |
Institution: | 1.Departments of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan;2.Departments of Pathology, Tokyo Medical and Dental University, Tokyo, Japan;3.Department of Pathology, Japanese Red Cross Medical Center, Tokyo, Japan;4.Clinical Research Center, Tokyo Medical and Dental University, Tokyo, Japan |
| |
Abstract: | BackgroundRecent research has suggested that the Th1 and Th2 chemokine/cytokine axis contributes to the development of chronic hypersensitivity pneumonitis (HP). Acute exacerbations (AE) are significant factors in the prognosis of chronic HP. Little is known, however, about these biomarkers in association with AE in chronic HP patients.MethodsFifty-six patients with chronic HP were evaluated, including 14 patients during episodes of AE. Th1 mediators (C-X-C chemokine ligand CXCL]10 and interferon IFN]-γ), Th2 mediators (C-C chemokine ligand CCL]17, interleukin-4, and interleukin-13), and pro-fibrotic mediator (transforming growth factor TGF]-β) were measured to evaluate the mediators as predictors of AE. C-C chemokine receptor (CCR)4 (receptor for CCL17)-positive lymphocytes were quantified in lung specimens.ResultsSerum CCL17 levels at baseline independently predicted the first episode of AE (HR, 72.0; 95% CI, 5.03-1030.23; p = 0.002). AE was significantly more frequent in the higher-CCL17 group (≥285 pg/ml) than in the lower-CCL17 group (<285 pg/ml) (log-rank test, p = 0.0006; 1-year incidence: higher CCL17 vs. lower CCL17, 14.3% vs. 0.0%). Serum CCL17 levels and CCR4-positive cells during episodes of AE were increased from the baseline (p = 0.01 and 0.031).ConclusionsHigher serum concentrations of CCL17 at baseline may be predictive of AE in patients with chronic HP, and CCL17 may contribute to the pathology of AE by inducing the accumulation of CCR4-positive lymphocytes in the lungs. |
| |
Keywords: | Chronic hypersensitivity pneumonitis Acute exacerbations CCL17/thymus- and activation-regulated chemokine C-C chemokine receptor 4 |
|
|