Polymyxin-B hemoperfusion for acute exacerbation of idiopathic pulmonary fibrosis: serum IL-7 as a prognostic marker.
Polymyxin-B hemoperfusion for acute exacerbation of idiopathic pulmonary fibrosis: serum IL-7 as a prognostic marker.
复制标题
多粘菌素-B 血液灌流治疗特发性肺纤维化急性加重：血清 IL-7 作为预后标志物。
DOI：
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Seiji Hayashi
中科院分区：
文献类型：
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作者：
K. Tachibana;Yoshikazu Inoue;A. Nishiyama;C. Sugimoto;A. Matsumuro;M. Hirose;Masanori Kitaichi;M. Akira;T. Arai;Seiji Hayashi
背景
特发性肺纤维化（IPF）的急性加重（AE）预后极差。多粘菌素B固定纤维柱（PMX-DHP）直接血液灌流已被用于改善急性呼吸窘迫综合征的氧合。本研究旨在回顾性确定影响PMX-DHP治疗IPF AE预后的预测因素。
方法
我们研究了接受PMX-DHP联合高剂量皮质类固醇治疗的IPF AE患者。在PMX-DHP治疗前后采集的储存血清分析了27种细胞因子和趋化因子。
结果
研究了19例IPF AE患者。诊断AE后的中位生存时间为22天。AE诊断后30天、60天和90天的生存率分别为47.4%、31.6%和26.3%。在PMX-DHP治疗后第30天的存活者（“存活者”）中白介素（IL）-7（一种抗纤维化细胞因子）的血清水平在治疗后显著增加，相比之下，在治疗后第30天的非存活者（“非存活者”）的血清水平没有显示出显著变化。血清IL-1 β、干扰素-γ和趋化因子配体（CCL）2水平在“存活者”中没有显著改变，但在“非存活者”中显著改变。多变量考克斯比例风险分析显示，PMX-DHP治疗后IL-7水平升高和无插管治疗（有创正压通气除外）是显著更好的预后因素。
结论
结果表明，血清IL-7可能是接受PMX-DHP治疗的IPF AE患者的有用预后因素，可能反映了潜在的抗纤维化机制。
BACKGROUND
Acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) has an extremely poor prognosis. Direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) has been used to improve oxygenation for acute respiratory distress syndrome. The study aim was to retrospectively determine the predictive factors affecting the prognosis of AE of IPF treated with PMX-DHP.
METHODS
We studied patients suffering from AE of IPF, treated with PMX-DHP combined with high-dose corticosteroid therapy. Stored serum taken before and after PMX-DHP therapy was analyzed for 27 cytokines and chemokines.
RESULTS
Nineteen patients with AE of IPF were studied. The median survival time after diagnosis of AE was 22 days. Survival rates after diagnosis of AE were 47.4% at 30 days, 31.6% at 60 days, and 26.3% at 90 days. Serum levels of Interleukin (IL)-7, an anti-fibrotic cytokine, in survivors at day 30 following PMX-DHP therapy ('Survivors') significantly increased after the treatment, compared to serum levels of non-survivors at day 30 after the therapy ('Nonsurvivors'), which did not demonstrate a significant change. Serum levels of IL-1beta, interferon-y and chemokine ligand (CCL) 2 levels were not significantly altered in 'Survivors', but were significantly changed in 'Nonsurvivors.' Multivariate Cox proportional-hazards analysis showed that an increase in IL-7 levels after PMX-DHP therapy and treatment without intubation (other than invasive positive-pressure ventilation) were significantly better prognostic factors.
CONCLUSION
The results suggest that serum IL-7 may be a useful prognostic factor for patients with AE of IPF treated with PMX-DHP, possibly reflecting underlying anti-fibrotic mechanisms.
影响因子：
9.6
作者：
Kinder, Brent W.;Brown, Kevin K.;King, Talmadge E., Jr.
通讯作者：
King, Talmadge E., Jr.
影响因子：
1.7
作者：
GURUJEYALAKSHMI, G;GIRI, SN
通讯作者：
GIRI, SN