BAL and serum multiplex lipid profiling in idiopathic pulmonary fibrosis and fibrotic hypersensitivity pneumonitis
BAL and serum multiplex lipid profiling in idiopathic pulmonary fibrosis and fibrotic hypersensitivity pneumonitis
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DOI：
10.1016/j.lfs.2020.117995
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发表时间：
2020-09-01
期刊：
影响因子：
6.1
通讯作者：
Bargagi, Elena
中科院分区：
文献类型：
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作者：
d'Alessandro, Miriana;Bergantini, Laura;Bargagi, Elena
背景：IPF和纤维性HP(FHP)的鉴别诊断可能具有挑战性：这两种ILDS有许多共同的特征，但需要不同的治疗方法。本研究用一种新的方法分析了Hp和IPF患者BAL和血清中不同的脂质介质谱。材料和方法：76例患者纳入本研究。中位年龄(IQR)为67岁(51-74岁)；男性占63%，FHP患者30例，IPF患者46例。初诊时采集血清和BAL样本。结果：IPF患者血清载脂蛋白A1水平显著高于FHP患者(p=0.314)，HP患者血清CCL2和ApoC3水平明显低于IPF患者(p=0.013和p=0.041)。IPF患者的载脂蛋白A1、脂蛋白、载脂蛋白C3和载脂蛋白水平均显著低于FHP患者(p<；0.0001，p<；0.0001，p=0.007和p=0.023)。在Logistic回归分析中，以IPF为因变量。以血清载脂蛋白A1、CCl2和载脂蛋白C3水平为自变量，模型性能的ROC曲线分析显示AUC93%(p<；0.0001)；另一方面，ApoA1、脂肪素、ApoC3和APN的BAL浓度显示AUC81%(p<；0.0001)。前者是炎症后细胞调节的ILD，后者更多地与组织重塑和修复有关。
Background: Differential diagnosis between IPF and fibrotic HP (fHP) can be challenging: these two ILDs share many common features but call for different therapeutic approaches. In the present study, differential lipid mediator profiles were analysed by a new method in BAL and serum from HP and IPF patients.Materials and methods: 76 patients were enrolled retrospectively in the study. Median age (IQR) was 67 years (51-74); 63% were males, 30 had fHP and 46 had IPF. Serum and BAL samples were collected at initial diagnosis. For quantification of serum and BAL lipid mediators was used bead-based multiplex LEGENDPlex" analysis (Biolegend).Results: Serum Apo Al levels were significantly higher in IPF than fHP patients (p = 0.314); indeed, serum levels of CCL2 and Apo C3 were lower in HP than in IPF patients (p = 0.013 and p = 0.041, respectively). BAL concentrations of Apo Al, adipsin, Apo C3 and APN were significantly lower in IPF than in fHP patients (p < 0.0001, p < 0.0001, p = 0.007 and p = 0.023, respectively). In the logistic regression, IPF was tested as dependent variable. Serum levels of Apo Al, CCL2 and Apo C3 were tested as independent variables and ROC curve analysis of model performance showed AUC 93% (p < 0.0001); on the other hand, BAL concentrations of Apo Al, adipsin, Apo C3 and APN showed AUC 81% (p < 0.0001).Discussion: Lipid biomarkers evaluated in BAL in our study confirm the hypothesis that fHP and IPF have different lung fibrosis phenotypes. The former is a post-inflammatory cell-regulated ILD and the second is more related to tissue remodeling and repair.