Serum heat shock protein 47 levels in patients with drug-induced lung disease.
Serum heat shock protein 47 levels in patients with drug-induced lung disease.
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DOI：
10.1186/1465-9921-14-133
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发表时间：
2013-11-20
影响因子：
5.8
通讯作者：
Kohno S
中科院分区：
文献类型：
--
作者：
Kakugawa T;Yokota S;Ishimatsu Y;Hayashi T;Nakashima S;Hara S;Sakamoto N;Matsuoka Y;Kubota H;Mine M;Mukae H;Nagata K;Kohno S
热休克蛋白（HSP）47是一种胶原特异性分子伴侣，是各种类型胶原分子成熟所必需的。我们最近报道了特发性肺纤维化（IPF）急性加重期患者血清HSP 47水平明显高于稳定期IPF患者，提示血清HSP 47水平与间质性肺炎活动相关。本研究的目的是评估药物性肺疾病（DILD）患者血清HSP 47水平。47例DILD患者的高分辨率CT胸部扫描结果分为四种主要模式之一：机化性肺炎（OP）（n = 4），非特异性间质性肺炎（NSIP）（n = 24），过敏性肺炎（HP）（n = 11）和弥漫性肺泡损伤（DAD）（n = 8）。检测血清HSP 47、KL-6、SP-A和SP-D水平。DAD组PaO 2/FiO 2（P/F）比值显著低于其他各组，而肺泡-动脉氧分压差（A-aDO 2）显著高于其他各组。DAD患者在不同亚组中结局最差。DAD组血清HSP 47水平显著高于其他各组。受试者工作特征曲线显示，HSP 47在区分DAD组与其他组方面上级KL-6、SP-A和SP-D。HSP 47的最高诊断准确度的临界值为1711.5 pg/mL。其敏感性、特异性和诊断准确性分别为87.5%、97.4%和95.7%。需要糖皮质激素治疗的患者血清HSP 47水平显著高于未使用糖皮质激素治疗的患者。血清HSP 47水平也与各种呼吸参数显著相关。本研究表明，血清HSP 47水平升高的DILD患者与DAD模式中有最坏的结果在不同的亚组，这与P/F比和A-a DO 2。
Heat shock protein (HSP) 47 is a collagen-specific molecular chaperone that is required for molecular maturation of various types of collagens. We recently reported that HSP47 serum levels were markedly higher in patients with acute exacerbations of idiopathic pulmonary fibrosis (IPF) when compared with patients with stable IPF, suggesting that serum HSP47 levels correlate with interstitial pneumonia activity. The aim of this study was to evaluate serum HSP47 levels in patients with drug-induced lung disease (DILD). Findings from high-resolution computed tomographic chest scans of 47 patients with DILD were classified into one of four predominant patterns: organizing pneumonia (OP) (n = 4), nonspecific interstitial pneumonia (NSIP) (n = 24), hypersensitivity pneumonitis (HP) (n = 11), and diffuse alveolar damage (DAD) (n = 8). Serum levels of HSP47, Krebs von den Lungen-6 (KL-6), surfactant protein (SP)-A, and SP-D were measured in these patients. The PaO2/fraction of inspired oxygen (FiO2) (P/F) ratios were significantly lower and the alveolar-arterial difference of oxygen (A-a DO2) was significantly higher in the DAD group than in the other groups. Patients with DAD had the worst outcomes among the different subgroups. Patients in the DAD group had significantly higher serum HSP47 levels than those in other groups. Receiver operating characteristic curves revealed that HSP47 was superior to KL-6, SP-A, and SP-D for discriminating between the DAD group and the other groups. The cut-off level for HSP47 that resulted in the highest diagnostic accuracy was 1711.5 pg/mL. The sensitivity, specificity, and diagnostic accuracy were 87.5%, 97.4%, and 95.7%, respectively. Serum levels of HSP47 in the group of patients requiring glucocorticoids were significantly higher than those in patients who experienced clinical improvement without glucocorticoid administration. Serum HSP47 levels also significantly correlated with various respiratory parameters. This study demonstrated that serum HSP47 levels were elevated in patients with DILD with a DAD pattern who had the worst outcomes among the different subgroups, and that this was correlated with P/F ratio and A-a DO2.
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影响因子：
5
作者：
Obuchowski, NA;Zepp, RC
通讯作者：
Zepp, RC
DOI：
10.1164/rccm.2106157
发表时间：
2002-06-01
影响因子：
24.7
作者：
Ichikado, K;Suga, M;Ando, M
通讯作者：
Ando, M
DOI：
10.1152/ajplung.00305.2002
发表时间：
2003-10-01
影响因子：
4.9
作者：
Ishii, H;Mukae, H;Kohno, S
通讯作者：
Kohno, S
影响因子：
3.5
作者：
Kakugawa, Tomoyuki;Mukae, Hiroshi;Kohno, Shigeru
通讯作者：
Kohno, Shigeru
影响因子：
24.3
作者：
Kakugawa, T;Mukae, H;Kohno, S
通讯作者：
Kohno, S