title: Multiplex protein profiling of bronchoalveolar lavage in idiopathic pulmonary fibrosis and hypersensitivity pneumonitis.
abstract: BACKGROUND
  Idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis (HP) are diffuse parenchymal lung diseases characterized by a mixture of inflammation and fibrosis, leading to lung destruction and finally death.
  
  
  OBJECTIVE
  The aim of this study was to compare different pathophysiological mechanisms, such as angiogenesis, coagulation, fibrosis, tissue repair, inflammation, epithelial damage, oxidative stress, and matrix remodeling, in both disorders using bronchoalveolar lavage (BAL).
  
  
  METHODS
  at diagnosis, patients underwent bronchoscopy with BAL and were divided into three groups: Control (n = 10), HP (n = 11), and IPF (n = 11), based on multidisciplinary approach (clinical examination, radiology, and histology): Multiplex searchlight technology was used to analyze 25 proteins representative for different pathophysiological processes: Eotaxin, basic fibroblast growth factor (FGFb), fibronectin, hepatocyte growth factor (HGF), interleukine (IL)-8, IL-12p40, IL-17, IL-23, monocyte chemotactic protein (MCP-1), macrophage-derived chemokine (MDC), myeloperoxidase (MPO), matrix metalloproteinase (MMP)-8, MMP-9, active plasminogen activating inhibitor 1 (PAI-1), pulmonary activation regulated chemokine (PARC), placental growth factor (PlGF), protein-C, receptor for advanced glycation end products (RAGE), regulated on activation normal T cells expressed and secreted (RANTES), surfactant protein-C (SP-C), transforming growth factor-β1 (TGF-β1), tissue inhibitor of metalloproteinase-1 (TIMP-1), tissue factor, thymic stromal lymphopoietin (TSLP), and vascular endothelial growth factor (VEGF).
  
  
  RESULTS
  All patients suffered from decreased pulmonary function and abnormal BAL cell differential compared with control. Protein levels were increased in both IPF and HP for MMP-8 (P = 0.022), MMP-9 (P = 0.0020), MCP-1 (P = 0.0006), MDC (P = 0.0048), IL-8 (P = 0.013), MPO (P = 0.019), and protein-C (P = 0.0087), whereas VEGF was decreased (P = 0.0003) compared with control. HGF was upregulated in HP (P = 0.0089) and active PAI-1 was upregulated (P = 0.019) in IPF compared with control. Differences in expression between IPF and HP were observed for IL-12p40 (P = 0.0093) and TGF-β1 (P = 0.0045).
  
  
  CONCLUSIONS
  Using BAL, we demonstrated not only expected similarities but also important differences in both disorders, many related to the innate immunity. These findings provide new clues for further research in both disorders.
authors: Department of Pathophysiology, Katholieke Universiteit Leuven and University Hospital Gasthuisberg, Leuven, Belgium.
authors: Stijn
authors: S
authors: Willems
authors: Willems
authors: W
authors: Stijn
authors: Stijn E
authors: SE
authors: Verleden
authors: Bart M
authors: BM
authors: Vanaudenaerde
authors: Marijke
authors: M
authors: Wynants
authors: Wynants
authors: W
authors: Marijke
authors: Christophe
authors: C
authors: Dooms
authors: Dooms
authors: D
authors: Christophe
authors: Jonas
authors: J
authors: Yserbyt
authors: Yserbyt
authors: Y
authors: Jonas
authors: Jana
authors: J
authors: Somers
authors: Somers
authors: S
authors: Jana
authors: Eric K
authors: EK
authors: Verbeken
authors: Geert M
authors: GM
authors: Verleden
authors: Wim A
authors: WA
authors: Wuyts
keywords: Bronchoalveolar lavage; enzyme-linked immunosorbent assay; hypersensitivity pneumonitis; idiopathic pulmonary fibrosis; interstitial lung disease