Periostin as a predictor of prognosis in chronic bird-related hypersensitivity pneumonitis
Periostin as a predictor of prognosis in chronic bird-related hypersensitivity pneumonitis
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DOI：
10.1016/j.alit.2019.02.007
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发表时间：
2019-07-01
影响因子：
6.8
通讯作者：
Inase, Naohiko
中科院分区：
文献类型：
--
作者：
Nukui, Yoshihisa;Miyazaki, Yasunari;Inase, Naohiko
背景：骨膜蛋白是Th 2免疫应答和纤维化发生的既定生物标志物。最近的研究表明，骨膜蛋白在特发性间质性肺炎的发病机制中起重要作用。为了阐明骨膜蛋白和慢性鸟相关性过敏性肺炎（HP）的发病机制之间的关系，并揭示血清骨膜蛋白水平在诊断和管理慢性鸟相关性HP.Methods的有用性：我们测定了63例慢性鸟相关性HP患者，13例特发性肺纤维化患者和113名健康志愿者的血清骨膜蛋白。我们调查了血清periostin和临床参数之间的关系，并评估了基线血清periostin是否可以预测预后.Results：血清periostin是显着高于慢性鸟相关HP患者相比，健康志愿者。在慢性鸟源性HP中，血清骨膜蛋白与血清KL-6水平、支气管肺泡灌洗液中CD 4/CD 8比值、HRCT纤维化评分呈显著正相关，与肺一氧化碳弥散量呈显著负相关。血清骨膜蛋白水平超过92.5 ng/mL和89.5 ng/mL的慢性鸟相关HP患者的预后显著更差，急性加重的频率显著更高。较高的血清periostin（92.5 ng/mL或更高;二元反应血清periostin）是一个独立的预后因素在多变量analysis.Conclusions：血清periostin可能反映肺纤维化的程度，并发挥重要作用，在慢性鸟类相关HP的发病机制。血清骨膜蛋白水平升高可能是慢性鸟类相关HP患者预后的预测因子。Copyright（C）2019，日本变态反应学会制作和主办：Elsevier B. V.
Background: Periostin is an established biomarker of Th2 immune response and fibrogenesis. Recent research has indicated that periostin plays an important role in the pathogenesis of idiopathic interstitial pneumonias. To clarify the relationship between periostin and pathogenesis in chronic bird-related hypersensitivity pneumonitis (HP) and to reveal the usefulness of serum periostin levels in diagnosing and managing chronic bird-related HP.Methods: We measured serum periostin in 63 patients with chronic bird-related HP, 13 patients with idiopathic pulmonary fibrosis, and 113 healthy volunteers. We investigated the relationship between serum periostin and clinical parameters, and evaluated if the baseline serum periostin could predict the prognosis.Results: Serum periostin was significantly higher in patients with chronic bird-related HP compared to the healthy volunteers. In chronic bird-related HP, serum periostin had significant positive correlations with serum KL-6 levels, the CD4/CD8 ratio in bronchoalveolar lavage fluid, and fibrosis score on HRCT, and a significant negative correlation with the diffusing capacity of the lungs for carbon monoxide. Chronic bird-related HP patients with serum periostin levels exceeding >= 92.5 ng/mL and >= 89.5 ng/mL had a significantly worse prognosis and significantly higher frequency of acute exacerbation, respectively. Higher serum periostin (92.5 ng/mL or higher; binary response for serum periostin) was an independent prognostic factor in multivariate analysis.Conclusions: Serum periostin may reflect the extent of lung fibrosis and play an important role in pathogenesis of chronic bird-related HP. Elevated serum periostin could be a predictor of prognosis in patients with chronic bird-related HP. Copyright (C) 2019, Japanese Society of Allergology. Production and hosting by Elsevier B.V.