HSP47 in lung fibroblasts is a predictor of survival in fibrotic nonspecific interstitial pneumonia.
BACKGROUND
The histopathologic pattern is currently the most important prognostic marker for idiopathic interstitial pneumonia (IIP). However, more highly sensitive markers are now required. Heat shock protein (HSP) 47, a collagen-specific molecular chaperone, is involved in the processing and/or secretion of procollagens, and it has been demonstrated that HSP47 expression is significantly higher in the lung specimens of idiopathic UIP than in UIP associated with collagen vascular diseases (CVD). However, its expression in nonspecific interstitial pneumonia (NSIP), the other common pathological pattern of IIP, has not been well investigated. Therefore, the association between lung fibroblast HSP47 expression and prognosis in fibrotic NSIP was evaluated.


METHODS
Surgical lung biopsy specimens of 63 patients [idiopathic fibrotic NSIP=19, fibrotic NSIP associated with CVD=9, idiopathic UIP=26, and UIP associated with CVD=9] were reviewed, and a score for lung fibroblast HSP47 expression was assigned. These patients' clinical features and survival were also analyzed.


RESULTS
There was no significant difference in HSP47 expression between idiopathic fibrotic NSIP and fibrotic NSIP associated with CVD. The idiopathic fibrotic NSIP patients with higher HSP47 expression levels in their lung specimens had a poorer prognosis than patients with lower HSP47 expression levels.


CONCLUSIONS
The present results suggest that lung fibroblast HSP47 expression may be a useful new prognostic marker for idiopathic fibrotic nonspecific interstitial pneumonia.
Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
Misato
M
Amenomori
Hiroshi
H
Mukae
Noriho
N
Sakamoto
Tomoyuki
T
Kakugawa
Tomayoshi
T
Hayashi
Atsuko
A
Hara
Shintaro
S
Hara
Hanako
H
Fujita
Hiroshi
H
Ishimoto
Yuji
Y
Ishimatsu
Takeshi
T
Nagayasu
Shigeru
S
Kohno
D000368:Aged; D005260:Female; D005347:Fibroblasts / Q000473:pathology*; D050958:HSP47 Heat-Shock Proteins / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000235:genetics / Q000401:mortality / Q000473:pathology*; D015996:Survival Rate
D050958:HSP47 Heat-Shock Proteins