Higher serum CCL17 may be a promising predictor of acute exacerbations in chronic hypersensitivity pneumonitis.
Higher serum CCL17 may be a promising predictor of acute exacerbations in chronic hypersensitivity pneumonitis.
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DOI：
10.1186/1465-9921-14-57
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发表时间：
2013-05-25
影响因子：
5.8
通讯作者：
Yoshizawa Y
中科院分区：
文献类型：
--
作者：
Miyazaki Y;Unoura K;Tateishi T;Akashi T;Takemura T;Tomita M;Inase N;Yoshizawa Y
最近的研究表明Th1和Th2趋化因子/细胞因子轴在慢性过敏性肺炎(HP)的发生发展中起作用。急性加重期是影响慢性幽门螺杆菌预后的重要因素。然而，对于这些与慢性幽门螺杆菌患者的AE相关的生物标志物知之甚少。对56例慢性幽门螺杆菌患者进行了评估，其中14例为急性发作期患者。检测Th1介质(C-X-C趋化因子配体10和干扰素-γ)、Th2介质(C-C趋化因子配体17、IL-4和IL-13)和促纤维化介质(转化生长因子-β)作为AE的预测因子。对肺组织中C-C趋化因子受体(CCR)4(CCL17受体)阳性淋巴细胞进行定量。基线时血清CCL17水平独立预测首发AE(HR，72.0；95%CI，5.03-1030.23；p = 0.002)。高CCL17组(≥285Pg/ml)的AE发生率显著高于低CCL17组(<；285Pg/ml)(对数检验，p = 0.0006；1年发病率：高CCL17组与低CCL17组，14.3%比0.0%)。在AE发作期间，血清CCL17水平和CCR4阳性细胞较基线水平升高(p = 0.01和0.031)。慢性幽门螺杆菌患者血清CCL17浓度升高可能预示着AE的发生，CCL17可能通过诱导肺内CCR4阳性淋巴细胞的聚集而参与AE的病理过程。
Recent 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. Fifty-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. Serum 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). Higher 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.
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