title: Procollagen-III in serum, plasminogen activation and fibronectin in bronchoalveolar lavage fluid during and following irradiation of human lung.
abstract: In the search for predictors of late radiation-induced lung injury we studied procollagen type III peptide concentration (P-III-P) in serum as well as fibronectin and plasminogen activation in bronchoalveolar lavage (BAL) fluid during and following irradiation of human lung. The patients received either high-dose hemithorax irradiation for pleural mesothelioma (11 patients) or high-dose irradiation with individually shaped fields for non-small cell lung cancer (12 patients). The severity of radiation fibrosis was assessed clinically from CT scans 6 months and 12 months after treatment. Four scores were used: severe, moderate, mild, or normal. Radiological lung injury varied from "severe" (9 patients) to near absence of injury-"normal" (6 patients). Serum levels of P-III-P, when measured weekly during the 5-week period of radiotherapy or at several time-points after treatment, did not show consistent changes, nor did the levels correlate with the score for radiation fibrosis as assessed by CT scanning. Changes in fibronectin levels or in markers of plasminogen activation in BAL fluid did not correlate with the development of late lung injury. The levels of BAL fluid plasmin and plasminogen activator as assessed zymographically, but not the free net enzyme values, showed a tendency to be elevated in patients with severe radiation-induced lung injury, suggesting a possible role for inhibitors of the plasminogen activation cascade in the process of radiation-induced lung injury.
authors.affiliation: Department of Pulmonary Medicine, Helsinki University Central Hospital, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Maasilta
authors.forename: E M
authors.initials: EM
authors.lastname: Salonen
authors.forename: A
authors.initials: A
authors.lastname: Vaheri
authors.forename: L
authors.initials: L
authors.lastname: Kivisaari
authors.forename: L R
authors.initials: LR
authors.lastname: Holsti
authors.forename: K
authors.initials: K
authors.lastname: Mattson
mesh_terms: D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy; D005353:Fibronectins / Q000032:analysis*; D006801:Humans; D008168:Lung / Q000528:radiation effects; D008175:Lung Neoplasms / Q000532:radiotherapy; D008654:Mesothelioma / Q000532:radiotherapy; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D010960:Plasminogen Activators / Q000032:analysis*; D010997:Pleural Neoplasms / Q000532:radiotherapy; D011347:Procollagen / Q000097:blood*; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D013899:Thoracic Neoplasms / Q000532:radiotherapy*
chemical_list: D005353:Fibronectins; D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide; D010960:Plasminogen Activators