Immunophenotyping and remodeling process in small airways of idiopathic interstitial pneumonias: functional and prognostic significance

Autor(es)

Parra, E. R. ^[1] ; Noleto, G. S. ^[1] ; Tinoco, L. J. M. ^[1] ; Capelozzi, V. L. ^[1]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Dept Pathol, Fac Med, BR-01246903 Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: CLINICAL RESPIRATORY JOURNAL; v. 2, n. 4, p. 227-238, OCT 2008.
• Citações Web of Science: 5

Resumo

Background and Aims: To test whether different degrees of immunologic and fibrotic airway remodeling processes occur in idiopathic interstitial pneumonias (IIPs), with impact on functional tests and survival, we studied the collagen/elastic system and immune cell density in the bronchiolar interstitium of lungs with the major types of IIPs. Materials and Methods: Histochemistry, immunohistochemistry and morphometric analysis were used to evaluate collagen/elastic fibers and immune cells in the bronchiolar interstitium of open lung biopsies of patients with cryptogenic organizing pneumonia {[}COP/organizing pneumonia (OP) = 10], acute interstitial pneumonia {[}AIP/diffuse alveolar damage (DAD) = 20], nonspecific interstitial pneumonia (NSIP/NSIP = 20) and idiopathic pulmonary fibrosis/usual interstitial pneumonia (UIP) = 20. Results: OP lungs presented a significant increase in collagenous/elastic fibers and in the total density of immune cells in the bronchiolar interstitium compared to controls, DAD, NSIP and UIP. We observed a significant increase in CD4, CD8 and CD20 lymphocytes, as well as in neutrophils, macrophages and plasma cells in OP. The increased amount of elastic fibers in the bronchiolar interstitium from OP lungs has a direct association with forced vital capacity (FVC) (r(s) = 0.99, P = 0.03). The most important survival predictor was CD20+ lymphocytes in the bronchiolar interstitium. In decreasing order, patients with UIP {[}Odds Ratio (OR) = 35.01], high forced expiratory volume in 1 s (FEV1)/FVC FVC (OR = 7.01), increased CD20+ lymphocytes (OR = 4.44) and collagenous/elastic fiber densities (OR = 2.03 and OR = 1.49, respectively) in the bronchiolar interstitium were those who had the greatest risk of death, followed by those with AIP, NSIP and COP. Conclusion: Different degrees of immunologic and fibroelastotic airway remodeling processes occur in the major types of IIPs with impact on physiological tests and survival. (AU)

• Processo FAPESP: 06/54978-8 - Estudo da participacao do colageno tipo v na fibrose pulmonar idiopatica e outras doencas do colageno.
• Beneficiário: Edwin Roger Parra Cuentas
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 06/51400-5 - Mapeamento das celulas inflamatorias nas vias aereas em formas agudas,subagudas e cronicas das pneumonias intersticiais idiopaticas e seu impacto nas provas de funcao pulmonar.
• Beneficiário: Luisa Juliatto Molina Tinoco
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica
• Processo FAPESP: 06/51260-9 - Estudo morfométrico de remodelamento da matriz extracelular nas vias aéreas em formas agudas, subagudas e crônicas das pneumonias intersticiais idiopáticas
• Beneficiário: Gustavo Sousa Noleto
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica