title: Pulmonary inflammation in asbestos-exposed subjects with borderline parenchymal changes on HRCT.
abstract: Many asbestos-exposed subjects have minor parenchymal changes on high resolution computed tomography (HRCT) that do not fulfil the diagnostic criteria for pulmonary fibrosis and asbestosis. We investigated if these borderline parenchymal changes in asbestos-exposed subjects are related to pulmonary inflammatory activity. Exhaled nitric oxide was measured, exhaled breath condensate collected and HRCT scanned in 104 subjects with moderate to high occupational asbestos exposure. Forty-one healthy unexposed subjects served as a comparison group. After excluding other pulmonary diseases, 35 asbestos-exposed subjects had normal parenchymal findings and 31 subjects had borderline parenchymal changes on HRCT. Lung function was poorer in the latter group, but there was no difference in the degree of asbestos exposure between these groups. As compared with the unexposed comparison group, asbestos-exposed subjects with borderline parenchymal changes had increased alveolar NO concentration (3.0 + or - 0.2 vs. 2.3 + or - 0.1 ppb, p = 0.008) and increased levels of leukotriene B(4) (12.2 + or - 1.1 vs. 3.3 + or - 0.8 pg/ml, p < 0.001) and 8-isoprostane (9.4 + or - 0.7 vs. 7.3 + or - 0.6 pg/ml, p = 0.021) in breath condensate. Asbestos-exposed subjects with normal parenchymal findings had only increased breath condensate levels of leukotriene B(4) (11.4 + or - 0.9, p < 0.001). Borderline parenchymal changes on HRCT in asbestos-exposed subjects are associated with increased markers of pulmonary inflammation. Such borderline parenchymal changes are likely a mild or early form of the same pathological process that leads to asbestosis.
authors.affiliation: The Immunopharmacology Research Group, Medical School, University of Tampere, Finland. lauri.lehtimaki@uta.fi
authors.forename: Lauri
authors.initials: L
authors.lastname: Lehtimäki
authors.forename: Panu
authors.initials: P
authors.lastname: Oksa
authors.forename: Ritva
authors.initials: R
authors.lastname: Järvenpää
authors.forename: Tuula
authors.initials: T
authors.lastname: Vierikko
authors.forename: Riina
authors.initials: R
authors.lastname: Nieminen
authors.forename: Hannu
authors.initials: H
authors.lastname: Kankaanranta
authors.forename: Jukka
authors.initials: J
authors.lastname: Uitti
authors.forename: Eeva
authors.initials: E
authors.lastname: Moilanen
mesh_terms: D001194:Asbestos / Q000633:toxicity*; D001195:Asbestosis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D001944:Breath Tests; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000378:metabolism*; D009784:Occupational Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging*; D012129:Respiratory Function Tests; D014057:Tomography, X-Ray Computed
chemical_list: D015415:Biomarkers; D001194:Asbestos; D009569:Nitric Oxide