Parathyroid hormone-related protein in epithelial lining fluid in humans negatively correlates with the severity of lung injury.
OBJECTIVE
To determine the concentration of parathyroid hormone-related protein (PTHrP; an autocrine/paracrine regulator of type-2 alveolar epithelial cells proliferation and apoptosis) in the epithelial lining fluid (ELF) from patients without pulmonary disease and from patients with acute lung injury (ALI), and to evaluate whether PTHrP concentrations correlated with the intensity of lung injury.


METHODS
Prospective study.


METHODS
An adult trauma/surgical ICU in an urban teaching hospital.


METHODS
A total of 20 patients with ALI receiving mechanical ventilation (patients), and 10 patients without pulmonary disease not receiving mechanical ventilation (control subjects).


METHODS
None.


RESULTS
PTHrP was detected in all BAL fluids, and ELF PTHrP concentrations (median; 25% to 75% percentiles) tended to be higher in patients (52.2 nmol/mL; 20.8 to 65.6 nmol/mL) than in control subjects (25.4 nmol/mL; 20.5 to 35.4 nmol/mL; p = 0.18). In patients, ELF PTHrP concentration correlated positively with the PaO(2)/fraction of inspired oxygen ratio (r = 0.53; p = 0.005), and negatively with lung injury score (r = - 0.44; p = 0.02), radiologic score (r = - 0.40; p = 0.04), and BAL albumin concentration (r = - 0.42; p = 0.02).


CONCLUSIONS
PTHrP is present in biologically significant concentrations in the alveolar milieu in humans. In patients with ALI, the PTHrP concentration correlates negatively with the degree of lung injury.
Stern
Jean-Baptiste
JB
INSERM U408, Hôpital Lariboisière (Assistance Publique - Hôpitaux de Paris), Paris, France.
Bernard
Oana
O
Paugam
Catherine
C
Silve
Caroline
C
Mantz
Jean
J
Aubier
Michel
M
Crestani
Bruno
B
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D004848:Epithelium; D005260:Female; D006801:Humans; D008168:Lung / Q000378:metabolism; D055370:Lung Injury; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000032:analysis*; D044162:Parathyroid Hormone-Related Protein; D011446:Prospective Studies; D011506:Proteins / Q000032:analysis*; D011650:Pulmonary Alveoli / Q000166:cytology / Q000473:pathology*
C470121:PTHLH protein, human; D010281:Parathyroid Hormone; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins