title: Transforming growth factor-beta 1 in humidifier disinfectant-associated children's interstitial lung disease.
abstract: BACKGROUND
  Humidifier disinfectant-associated children's interstitial lung disease has an unpredictable clinical course with a high morbidity and mortality.
  
  
  OBJECTIVE
  To evaluate the differences in clinical findings between survivors and non-survivors of humidifier disinfectant-associated children's interstitial lung disease. To evaluate dynamic changes in serum cytokines related to inflammation and fibrosis in lung injury, and to determine whether these changes are predictive of survival in this disease.
  
  
  METHODS
  We evaluated 17 children with humidifier disinfectant-associated children's interstitial lung disease, from whom serum samples were obtained weekly during hospitalization. The severity of chest tomographic and lung pathologic findings was scored. Levels of several cytokines were measured in the serial serum samples.
  
  
  RESULTS
  Seven of the 17 children were survivors. Compared to survivors, non-survivors had greater ground-glass attenuation on follow-up chest tomography, higher admission neutrophil counts, and more macrophages on pathologic findings. Transforming growth factor-beta 1 persisted at an elevated level (1,000-1,500 pg/ml) in survivors, whereas it decreased abruptly in non-survivors. At the time of this decrease, non-survivors had clinical worsening of their respiratory failure. Transforming growth factor-beta 1 was positively correlated with PaO2 /FiO2 (r = 0.481, P < 0.0001).
  
  
  CONCLUSIONS
  Non-survivors exhibited more inflammatory clinical findings than survivors. Transforming growth factor-beta 1 remained elevated in survivors, suggesting that it affected the clinical course of humidifier disinfectant-associated children's interstitial lung disease. The prognosis of this lung disease may depend more on controlling excessive inflammation and repairing damaged lung than on fibrosis, and transforming growth factor-beta 1 may play a key role in this process.
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Brain Korea 21 PLUS project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Yoon Hee
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Brain Korea 21 PLUS project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Brain Korea 21 PLUS project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Kyung Eun
authors.initials: KE
authors.lastname: Lee
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Mi-Jung
authors.initials: MJ
authors.lastname: Lee
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Kyum
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Se Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyo Sup
authors.initials: HS
authors.lastname: Shim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Chang Young
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Myung-Joon
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Brain Korea 21 PLUS project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Myung Hyun
authors.initials: MH
authors.lastname: Sohn
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Institute of Allergy, Yonsei University College of Medicine, Seoul, Republic of Korea, 120-752.|Brain Korea 21 PLUS project for Medical Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Kyu-Earn
authors.initials: KE
authors.lastname: Kim
mesh_terms: D015815:Cell Adhesion Molecules / Q000276:immunology; D018932:Chemokine CCL2 / Q000276:immunology; D018946:Chemokine CCL5 / Q000276:immunology; D002675:Child, Preschool; D004202:Disinfectants / Q000009:adverse effects*; D005260:Female; D005355:Fibrosis; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000276:immunology; D006801:Humans; D000068998:Humidifiers; D007223:Infant; D007249:Inflammation; D018793:Interleukin-13 / Q000276:immunology; D016209:Interleukin-8 / Q000276:immunology; D008168:Lung / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000139:chemically induced / Q000276:immunology* / Q000401:mortality; D055370:Lung Injury / Q000139:chemically induced / Q000276:immunology* / Q000401:mortality; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000276:immunology; D011379:Prognosis; D014057:Tomography, X-Ray Computed; D053773:Transforming Growth Factor beta1 / Q000276:immunology*; D042461:Vascular Endothelial Growth Factor A / Q000276:immunology
chemical_list: C111835:CCL2 protein, human; C508606:CXCL8 protein, human; D015815:Cell Adhesion Molecules; D018932:Chemokine CCL2; D018946:Chemokine CCL5; D004202:Disinfectants; D018793:Interleukin-13; D016209:Interleukin-8; C512835:POSTN protein, human; C508960:TGFB1 protein, human; D053773:Transforming Growth Factor beta1; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
keywords: child; interstitial; lung disease; prognosis; transforming growth factor beta1; wound healing