title: Effect of breast cancer adjuvant therapies on potential biomarkers of pulmonary inflammation.
abstract: BACKGROUND
  The aim of this study was to investigate the effect of breast cancer adjuvant therapies on the levels of circulating surfactant protein-D (SP-D), C-Reactive protein (CRP) and soluble receptor for advanced glycation end-products (sRAGE), as potential biomarkers of subclinical pulmonary inflammation.
  
  
  METHODS
  The soluble molecules were serially determined in 38 patients, prior to the initiation of radiation therapy (RT) and during adjuvant treatment, using immunoassays.
  
  
  RESULTS
  Significantly higher levels of all three biomarkers were observed in patients prior to the initiation of RT compared to healthy controls (CRP: p<0.001, SP-D: p<0.05, sRAGE: p<0.05). SP-D levels exhibited a gradual increase after RT and during follow-up (p<0.005). Patients treated with a combination of RT and hormonal therapy presented a significant, but less pronounced, increase in SP-D and a significant decrease in CRP compared to those who did not receive hormonal therapy (p=0.0428 and p=0.0116, respectively). Patients treated with a combination of RT and trastuzumab presented a significant increase in SP-D levels (p=0.0310).
  
  
  CONCLUSIONS
  The average rate of change in the levels of circulating SP-D and CRP during postoperative irradiation and adjuvant hormonal therapy suggests that the combined therapeutic regiment may potentially exert important anti-inflammatory effects on the lung. On the contrary, combined administration of RT and trastuzumab is likely to induce or provoke pulmonary inflammation.
authors.affiliation: Department of Radiotherapeutics, St. Savvas Hospital, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Piperis
authors.forename: Xeni
authors.initials: X
authors.lastname: Provatopoulou
authors.forename: Alexandros
authors.initials: A
authors.lastname: Sagkriotis
authors.forename: Eleni
authors.initials: E
authors.lastname: Kalogera
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Ampatzoglou
authors.forename: George C
authors.initials: GC
authors.lastname: Zografos
authors.forename: Eleni
authors.initials: E
authors.lastname: Athanasiou
authors.forename: Antonia
authors.initials: A
authors.lastname: Gounaris
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood*; D001943:Breast Neoplasms / Q000628:therapy*; D002097:C-Reactive Protein / Q000032:analysis; D059248:Chemoradiotherapy / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008875:Middle Aged; D011014:Pneumonia / Q000097:blood* / Q000209:etiology; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood; D000068878:Trastuzumab
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D015415:Biomarkers; D037663:Pulmonary Surfactant-Associated Protein D; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; D002097:C-Reactive Protein; D000068878:Trastuzumab