Role of carbohydrate antigens sialyl Lewis (a) (CA19-9) in bronchoalveolar lavage in patients with pulmonary fibrosis.
BACKGROUND
It has been reported that carbohydrate antigen sialyl Lewis (a) (CA19-9) levels are elevated in serum as well as in bronchoalveolar lavage fluid (BALF) of patients with pulmonary fibrosis. However, the biological significance of CA19-9 is unclear.


OBJECTIVE
The purpose of the present study was to evaluate correlations between CA19-9 levels in BALF and several biochemical as well as clinical parameters in patients with pulmonary fibrosis. In addition, biological functions of CA19-9 were also examined.


METHODS
We studied 24 patients with a diagnosis of pulmonary fibrosis: 16 with idiopathic pulmonary fibrosis (IPF) and 8 with pulmonary fibrosis associated with a collagen vascular disorder (PF-CVD). In BALF, carbohydrate antigens sialyl Lewis (a) (CA19-9), elastase: alpha(1)-proteinase inhibitor complex (E-PI), hepatocyte growth factor (HGF), LDH, IgG, IgA, albumin, and cell differentiation were measured. We also evaluated the effects of CA19-9 on neutrophil functions.


RESULTS
CA19-9/albumin levels in BALF significantly correlated with HGF/albumin, elastase/albumin, LDH/albumin, total number of alveolar macrophages, and total number of neutrophils. Purified CA19-9 had a chemotactic activity for neutrophils. In addition, neutrophil chemotactic activity to C5a, fMLP, and interleukin 8 was significantly stimulated after incubation with purified CA19-9. Furthermore, CA19-9 increased the expression of CD15s on neutrophils.


CONCLUSIONS
Our data demonstrated (i) CA19-9 in BALF correlated with other markers of inflammation in pulmonary fibrosis, and (ii) CA19-9 can modify neutrophil functions. These results suggest that CA19-9 may play a role in the process of lung injury in patients with pulmonary fibrosis.
Obayashi
Y
Y
First Department of Internal Medicine, Kagawa Medical University, Kita-gun, Japan.
Fujita
J
J
Nishiyama
T
T
Yoshinouchi
T
T
Kamei
T
T
Yamadori
I
I
Hojo
S
S
Ohtsuki
Y
Y
Hirashima
M
M
Takahara
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry* / Q000166:cytology / Q000276:immunology; D018395:CA-19-9 Antigen / Q000378:metabolism* / Q000494:pharmacology; D002454:Cell Differentiation; D002634:Chemotaxis, Leukocyte / Q000187:drug effects / Q000276:immunology; D003095:Collagen Diseases / Q000150:complications / Q000503:physiopathology*; D015936:Complement C5a / Q000494:pharmacology; D004305:Dose-Response Relationship, Drug; D005260:Female; D017228:Hepatocyte Growth Factor / Q000378:metabolism; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism; D007074:Immunoglobulin G / Q000378:metabolism; D016209:Interleukin-8 / Q000494:pharmacology; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D019272:Leukocyte Elastase / Q000378:metabolism; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000503:physiopathology; D008213:Lymphocyte Activation / Q000187:drug effects; D016676:Macrophages, Alveolar / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009240:N-Formylmethionine Leucyl-Phenylalanine / Q000494:pharmacology; D009504:Neutrophils / Q000166:cytology / Q000187:drug effects / Q000276:immunology / Q000378:metabolism; D011658:Pulmonary Fibrosis / Q000150:complications / Q000503:physiopathology*; D012709:Serum Albumin / Q000378:metabolism; D000515:alpha 1-Antitrypsin / Q000378:metabolism
D018395:CA-19-9 Antigen; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D016209:Interleukin-8; D012709:Serum Albumin; D000515:alpha 1-Antitrypsin; C037741:alpha 1-antitrypsin-leukocyte elastase complex; D009240:N-Formylmethionine Leucyl-Phenylalanine; D017228:Hepatocyte Growth Factor; D015936:Complement C5a; D007770:L-Lactate Dehydrogenase; D019272:Leukocyte Elastase