title: Biomarkers from bronchoalveolar lavage fluid in systemic sclerosis patients with interstitial lung disease relate to severity of lung fibrosis.
abstract: OBJECTIVE
  Decision on treatment of systemic sclerosis (SSc) related interstitial lung disease (ILD) largely relies on the findings on high resolution computed tomography (HRCT) and there is a need for improvement in assessment of the fibrotic activity. The objectives of this study were to study biomarkers in bronchoalveolar lavage fluid (BALF) from SSc patients with ILD and to relate the findings to the severity and activity of lung fibrosis.
  
  
  METHODS
  Fifteen patients with early SSc and 12 healthy controls were subjected to BAL. Cell counts and analyses of CXCL5, CXCL8 and S100A8/A9 were performed in BALF and serum. COMP and KL-6 were measured in serum. HRCT of lungs was quantified for ground glass opacities (GGO), reticulation and traction bronchiectases.
  
  
  RESULTS
  BALF concentrations of CXCL8 (p < 0.001), CXCL5 (p = 0.002) and S100A8/A9 (p = 0.016) were higher in patients than controls. Serum KL-6 (p < 0.001) was increased in SSc patients and correlated with BALF concentration of eosinophils (rS = 0.57, p = 0.027). Patients with more widespread GGO on HRCT were characterised in BALF by a higher eosinophil count (p = 0.002) and in serum by higher KL-6 (p = 0.008). Patients with more fibrosis were characterised in BALF by higher eosinophil count (p = 0.014), higher CXCL8 (p = 0.005) and S100A8A/A9 (p = 0.014) concentration and in serum by a higher serum COMP (p = 0.023).
  
  
  CONCLUSIONS
  In SSc related ILD, biomarkers from BALF and serum correlate to findings on HRCT suggesting usefulness as markers of presence and extent of lung fibrosis.
authors: Department of Clinical Sciences, Section of Rheumatology, Lund University, Skåne University Hospital, S-221 85 Lund, Sweden. roger.hesselstrand@med.lu.se
authors: Roger
authors: R
authors: Hesselstrand
authors: Marie
authors: M
authors: Wildt
authors: Gracijela
authors: G
authors: Bozovic
authors: Annika
authors: A
authors: Andersson-Sjöland
authors: Kristofer
authors: K
authors: Andréasson
authors: Agneta
authors: A
authors: Scheja
authors: Gunilla
authors: G
authors: Westergren-Thorsson
authors: Leif
authors: L
authors: Bjermer
authors: Dirk M
authors: DM
authors: Wuttge
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D040501:Calgranulin A / Q000032:analysis; D064236:Cartilage Oligomeric Matrix Protein / Q000097:blood; D016022:Case-Control Studies; D054365:Chemokine CXCL5 / Q000032:analysis; D004804:Eosinophils / Q000473:pathology; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000032:analysis; D007958:Leukocyte Count; D008137:Longitudinal Studies; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000097:blood; D011658:Pulmonary Fibrosis / Q000175:diagnosis / Q000209:etiology*; D012595:Scleroderma, Systemic / Q000150:complications*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D015415:Biomarkers; D040501:Calgranulin A; D064236:Cartilage Oligomeric Matrix Protein; D054365:Chemokine CXCL5; D016209:Interleukin-8; D018396:Mucin-1; C486263:CXCL5 protein, human; C508606:CXCL8 protein, human; C060192:MUC1 protein, human; C577553:TSP5 protein, human