lewis-x-antigen and Lung-Diseases--Interstitial

The pathological diagnosis of interstitial lung diseases (ILD) by surgical lung biopsy is important for clinical decision making. There is a need, however, to use serum markers for differentiating usual interstitial pneumonia (UIP) from other ILD. Surfactant protein (SP)-A, SP-D, KL-6, sialyl SSEA-1 (SLX), and sialyl Lewis(a) (CA19-9) are useful markers for the diagnosis and evaluation of activity of ILD. We have investigated the usefulness of these proteins as markers of UIP.. Serum and bronchoalveolar lavage (BAL) fluid levels of the above five markers were measured in 57 patients with various forms of ILD (19 with UIP, 12 with non-specific interstitial pneumonia (NSIP), eight with bronchiolitis obliterans organising pneumonia (BOOP), and 10 with sarcoidosis), eight patients with the control disease (diffuse panbronchiolitis (DPB)), and nine healthy volunteers.. Serum levels of SP-A, SP-D, and KL-6 in patients with UIP and NSIP were significantly higher than in healthy volunteers. In particular, the serum levels of SP-A in patients with UIP were significantly higher than in patients with NSIP (p<0.0001, mean difference -58.3 ng/ml, 95% confidence interval -81.6 to -35.0), and BAL fluid levels of SP-D in patients with UIP were significantly lower than in patients with NSIP (p=0.01, mean difference 322.4 ng/ml, 95% confidence interval 79.3 to 565.5).. Serum SP-A levels may be clinically useful as a biomarker to differentiate between UIP and NSIP.

Topics: Adult; Aged; Antigens; Antigens, Neoplasm; Biomarkers; Bronchoalveolar Lavage Fluid; CA-19-9 Antigen; Cell Count; Female; Glycoproteins; Humans; Lewis X Antigen; Lung Diseases, Interstitial; Male; Middle Aged; Mucin-1; Mucins; Pulmonary Surfactant-Associated Protein A; Pulmonary Surfactant-Associated Protein B

Serum SLX levels were measured in 29 patients with idiopathic interstitial pneumonia (IIP) to evaluate its clinical significance. Serum SLX had positive correlations with the BALF neutrophil ratio but not with the severity or the disease activity in patients with IIP, and bronchoalveolar lavage fluid (BALF) SLX had positive correlations with the BALF neutrophil count. Epithelial lining fluid (ELF) SLX levels showed positive correlations with serum SLX, but were much higher. These results suggest that increases of serum SLX may reflect increases of SLX in the lung tissues. Thus, we speculate that increases of the serum SLX level may represent increases of the BALF neutrophil count. Patients with higher SLX showed poor therapeutic responses and poor prognoses in comparison with those with normal SLX for the reason that serum SLX level represents BALF neutrophil level.

Topics: Aged; Bronchoalveolar Lavage Fluid; Chemotaxis, Leukocyte; Female; Humans; Lewis X Antigen; Lung Diseases, Interstitial; Male; Middle Aged; Neutrophils

Pulmonary fibrosis begins with alveolitis, which progresses to destruction of lung tissue and excess collagen deposition. This process could be the result of DNA damage and a form of apoptosis. Therefore, we hypothesized that Fas ligand (FasL), which induces apoptosis in cells expressing Fas antigen (Fas), is associated with pulmonary fibrosis. We examined frozen lung tissues from seven patients with idiopathic pulmonary fibrosis (IPF), and bronchoalveolar lavage fluid (BALF) cells from 19 patients with IPF and from 17 patients with interstitial pneumonia associated with collagen vascular diseases (CVD-IP). We used five frozen lungs with normal lung parenchyma and BALF cells from 10 patients with solitary pulmonary nodule as controls. Reverse transcription-polymerase chain reaction (RT-PCR) showed that FasL messenger RNA (mRNA) was expressed in BALF cells from all patients with IPF and from 15 of 16 patients with CVD-IP. FasL mRNA was not detected in BALF cells except in one of 10 controls. RT in situ PCR detected FasL mRNA in inflammatory cells in BALF from patients with IPF. Immunohistochemistry detected FasL protein in infiltrating lymphocytes and granulocytes in all of seven frozen lung tissues of IPF, but in none of five control lung tissues. Additionally, the expression of Fas appeared to be upregulated in bronchiolar and alveolar epithelial cells in IPF compared with normal lung parenchyma by immunohistochemistry. We conclude that Fas and FasL were upregulated in fibrosing lung diseases and may associate with DNA damage or apoptosis of bronchiolar and alveolar epithelial cells in this disorder.

Topics: Adult; Aged; Aged, 80 and over; Apoptosis; Bronchoalveolar Lavage Fluid; CD4 Antigens; CD8 Antigens; Collagen; Cryopreservation; Fas Ligand Protein; fas Receptor; Female; Humans; Immunohistochemistry; Lewis X Antigen; Lung Diseases, Interstitial; Male; Membrane Glycoproteins; Middle Aged; Pulmonary Fibrosis; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger

We compared diagnostic values of three serum carbohydrate antigens, KL-6, CA19-9 and SLX to discriminate interstitial pneumonia (IP) from alveolar pneumonia and healthy volunteers. Subjects consisted of 13 patients with idiopathic pulmonary fibrosis and 10 associated with collagen vascular diseases, 12 patients with sarcoidosis and 70 controls (52 healthy volunteers and 18 patients with alveolar pneumonia). Cut-off values were determined at the level at which the diagnostic accuracy became the highest for each marker, 449 U/mL for KL-6, 26 U/mL for CA19-9 and 41 U/mL for SLX. The sensitivity, the specificity and the diagnostic accuracy were 74.3% (26/35), 98.6% (69/70) and 90.5% (95/105) in KL-6, 42.9% (15/35), 94.3% (66/70) and 77.1% (81/105) in CA19-9, and 20.0% (7/35) and 95.7% (67/70) and 70.5% (74/105) in SLX, respectively. Receiver operating characteristic curves revealed that KL-6 was far superior to both CA19-9 and SLX. These results suggest that KL-6 is the best marker for interstitial pneumonia among these carbohydrate antigens.

Topics: Adult; Aged; Antigens; Antigens, Neoplasm; Biomarkers; CA-19-9 Antigen; Female; Gangliosides; Glycoproteins; Humans; Lewis Blood Group Antigens; Lewis X Antigen; Lung Diseases, Interstitial; Male; Middle Aged; Mucin-1; Mucins; Oligosaccharides; ROC Curve; Sensitivity and Specificity; Sialyl Lewis X Antigen