Cytokine modulation in patients with idiopathic pulmonary fibrosis undergoing treatment with steroids, immunosuppressants, and IFN-γ 1b.
Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease of unknown etiology and pathogenic mechanisms. From an etiopathogenic point of view, alveolar macrophages play a key role in accumulation of fibroblasts and deposition of collagen and extracellular matrix by releasing specific cytokines and inflammatory mediators. IPF seems to be also associated with circulating fibrocytes, which might be involved with an abnormal pulmonary vascular repair and remodeling. Based on its hypothesized pathologic mechanisms, anti-inflammatory, anti-fibrotic and immunosuppressive therapies are often used. For these reasons, Interferon-g (IFN-g) has been used to exploit its activity on macrophages and fibroblasts. The aim of this study was to investigate the response to corticosteroids and/or IFN-g 1b treatments based on pulmonary function tests and on inflammatory cytokine patterns of expression on bronchoalveolar lavage (BAL), at baseline and during and after the therapies. Unlike previous studies, we analyzed a period of therapy longer than 1 year. Our results demonstrated the effectiveness of IFN-γ in a group of IPF patients in whom the treatment was prolonged for over a year. These data suggest a positive role of IFN-γ; treatment in patients in the initial stage of the disease.
SS Annunziata University Hospital, Unit of Pneumology, Chieti, Italy.
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S
Marinari
Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
V
V
De Iuliis
Department of Medical, Oral and Biotechnological Sciences, University of Chieti.
V
V
Dadorante
SS Annunziata University Hospital, Unit of Pneumology, Chieti, Italy.
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S
Colella
Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
A
A
Marino
Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
A
A
Nunziata
Department of Biotechnological and Applied Clinical Sciences, University of LAquila, Italy.
V
V
Flati
Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
M
M
Caruso
Department of Medical, Oral and Biotechnological Sciences, University of Chieti.
A
A
Pennelli
AIMAR (Interdisciplinary Association for the study of Respiratory Diseases), Arona (NO), Italy.
F
F
De Benedetto
Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
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S
Matera
Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
S
S
Capodifoglio
Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
S
S
Martinotti
Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
S
S
Caputi
Department of Medical, Oral and Biotechnological Sciences, University of Chieti, Italy.
E
E
Toniato
D000111:Acetylcysteine / Q000627:therapeutic use*; D048868:Adaptor Proteins, Signal Transducing / Q000235:genetics / Q000276:immunology; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001379:Azathioprine / Q000627:therapeutic use*; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology; D004334:Drug Administration Schedule; D005260:Female; D005347:Fibroblasts / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D005786:Gene Expression Regulation; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology / Q000473:pathology; D007371:Interferon-gamma / Q000627:therapeutic use*; D007375:Interleukin-1 / Q000235:genetics / Q000276:immunology; D018664:Interleukin-12 / Q000235:genetics / Q000276:immunology; D015850:Interleukin-6 / Q000235:genetics / Q000276:immunology; D008168:Lung / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D016676:Macrophages, Alveolar / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D012129:Respiratory Function Tests; D016896:Treatment Outcome
D048868:Adaptor Proteins, Signal Transducing; D000893:Anti-Inflammatory Agents; C508600:IL6 protein, human; D007375:Interleukin-1; D015850:Interleukin-6; C493277:MAPKAP1 protein, human; D011994:Recombinant Proteins; D018664:Interleukin-12; C554125:interferon gamma-1b; D007371:Interferon-gamma; D001379:Azathioprine; D000111:Acetylcysteine; D008775:Methylprednisolone