Clinical utility of inflammatory biomarkers as a prognostic tool in patients with silicosis

• Grant number: 24/06212-4
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: September 01, 2024
• End date: February 28, 2027
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Ubiratan de Paula Santos
• Grantee: Lavinia Clara Del Roio
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil

Abstract

Introduction: Silica is the most abundant mineral in the Earth's crust and its use is wide and diverse. Despite its ancient use, exposure to silica dust is persistent and a risk factor for several diseases, the most prevalent and with the highest morbidity and mortality being silicosis, the most prevalent pneumoconiosis in Brazil and worldwide. Silicosis is an irreversible and progressive disease, even after exposure has stopped. To date, there is no curative treatment, except for lung transplantation. Despite existing studies on the presence of biomarkers and their association with the risk of silicosis and its severity, the findings, especially associated with changes in lung function and disease progression, still need to be clarified. Identifying inflammatory markers associated with greater functional loss and clinical worsening can help early detect patients at risk of developing more severe forms of the disease. Main objective: To evaluate the clinical usefulness of inflammatory biomarkers in the blood to estimate the progression of silicosis, identified through worsening of symptoms, weight loss, accelerated decline in lung function, and worse performance at exercise. Methods: 120 patients diagnosed with silicosis followed at the Environmental and Occupational Lung Diseases outpatient clinic of the Pulmonology Division of InCor-HCFMUSP will be included. Patients will undergo an assessment at three different times, with a distance of eight months between each assessment, consisting of clinical, sociodemographic, and occupational assessment, assessment of symptoms using questionnaires validated for Brazil (mMRC, CAT, St George), test complete lung function test, chest tomography, 6-minute walk test, cardiopulmonary exercise test, anthropometric records and analysis of systemic inflammatory markers in blood samples. The data will be analyzed to evaluate the relationship between disease progression and blood markers, the 6-minute walk test, and changes in the chest tomography.