BAL cytokine profile in different interstitial lung diseases: a focus on systemic sclerosis.
OBJECTIVE
Fibrosing alveolitis develops in up to 80% of systemic sclerosis patients (SSc) but progression to end stage fibrosis occurs in about 15% of cases. Mechanisms leading to the process remain mostly unknown. We compared cytokine profiles of broncho-alveolar lavage fluids (BAL-f) from patients with SSc associated interstitial lung disease (SSc-ILD) (n. 34), idiopathic pulmonary fibrosis (IPF) (n. 13), stage II sarcoidosis (n. 14) and 9 controls.


METHODS
Interleukin (IL) 8, monocyte chemoattractant protein 1 (MCP-1), gamma-interferon (IFN-gamma), IL12, IL18 and IL10 and transforming growth factor-beta (TGF-beta) were assessed by ELISA in concentrated BAL-f.


RESULTS
Levels of IL8 and MCP-1 were significantly elevated in SSc-ILD and in IPF as compared with controls (Mann Whitney test p < 0.05), while MCP-1 values were significantly lower in SSc-ILD than in IPF. A significant correlation between neutrophils and IL8 levels (p = 0.047), as well as between eosinophils and MCP-1 levels (p = 0.004) was also observed. IFN-gamma levels were slightly higher than normal only in sarcoidosis (p = 0.06), whereas IL12 levels increased both in sarcoidosis and SSc-ILD (p < 0.05). No differences were found in IL18 and TGF-beta levels. Finally, IL10 levels were higher in SSc-ILD and sarcoidosis than in controls and IPF (p < 0.05).


CONCLUSIONS
BAL-f cytokine profile differentiates ILD associated with SSc from IPF. The lower expression of MCP-1 and the higher expression of the anti-fibrotic IL12 and the anti-inflammatory IL10, observed both in sarcoidosis and in SSc-ILD, could account for the better prognosis of these ILDs. Further longitudinal studies are required to confirm whether a different cytokine phenotype may be considered predictive of clinical outcome in SSc-ILD.
Department of Haematological, Pneumological and Cardiovascular Sciences, Section of Pneumology, University of Pavia and IRCCS, Policlinico San Matteo, Pavia, Italy. federica_meloni@libero.it
Federica
F
Meloni
Roberto
R
Caporali
Alessia
A
Marone Bianco
Enrica
E
Paschetto
Monica
M
Morosini
Anna Maria
AM
Fietta
Vitulo
V
Patrizio
Francesca
F
Bobbio-Pallavicini
Ernesto
E
Pozzi
Carlomaurizio
C
Montecucco
D000328:Adult; D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry / Q000276:immunology*; D016207:Cytokines / Q000032:analysis* / Q000276:immunology; D005260:Female; D006801:Humans; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011658:Pulmonary Fibrosis / Q000175:diagnosis / Q000276:immunology*; D017565:Sarcoidosis, Pulmonary / Q000175:diagnosis / Q000276:immunology*; D012595:Scleroderma, Systemic / Q000150:complications / Q000175:diagnosis / Q000276:immunology*
D016207:Cytokines