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Transforming growth factor-beta 1 in humidifier disinfectant-associated children's interstitial lung disease

 Yoon Hee Kim  ;  Kyung Won Kim  ;  Kyung Eun Lee  ;  Mi-Jung Lee  ;  Sang Kyum Kim  ;  Se Hoon Kim  ;  Hyo Sup Shim  ;  Chang Young Lee  ;  Myung-Joon Kim  ;  Myung Hyun Sohn  ;  Kyu-Earn Kim 
 Pediatric Pulmonology, Vol.51(2) : 173-182, 2016 
Journal Title
 Pediatric Pulmonology 
Issue Date
Cell Adhesion Molecules/immunology ; Chemokine CCL2/immunology ; Chemokine CCL5/immunology ; Child, Preschool ; Disinfectants/adverse effects* ; Female ; Fibrosis ; Granulocyte-Macrophage Colony-Stimulating Factor/immunology ; Humans ; Humidifiers* ; Infant ; Inflammation ; Interleukin-13/immunology ; Interleukin-8/immunology ; Lung/diagnostic imaging ; Lung/immunology* ; Lung/pathology ; Lung Diseases, Interstitial/chemically induced ; Lung Diseases, Interstitial/immunology* ; Lung Diseases, Interstitial/mortality ; Lung Injury/chemically induced ; Lung Injury/immunology* ; Lung Injury/mortality ; Male ; Matrix Metalloproteinase 9/immunology ; Prognosis ; Tomography, X-Ray Computed ; Transforming Growth Factor beta1/immunology* ; Vascular Endothelial Growth Factor A/immunology
child ; interstitial ; lung disease ; prognosis ; transforming growth factor beta1 ; wound healing
BACKGROUND: Humidifier disinfectant-associated children's interstitial lung disease has an unpredictable clinical course with a high morbidity and mortality. OBJECTIVES: 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.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
김경원(Kim, Kyung Won) ORCID logo https://orcid.org/0000-0003-4529-6135
김규언(Kim, Kyu Earn)
김명준(Kim, Myung Joon) ORCID logo https://orcid.org/0000-0002-4608-0275
김상겸(Kim, Sang Kyum) ORCID logo https://orcid.org/0000-0003-0768-9923
김세훈(Kim, Se Hoon) ORCID logo https://orcid.org/0000-0001-7516-7372
김윤희(Kim, Yoon Hee) ORCID logo https://orcid.org/0000-0002-2149-8501
손명현(Sohn, Myung Hyun) ORCID logo https://orcid.org/0000-0002-2478-487X
심효섭(Shim, Hyo Sup) ORCID logo https://orcid.org/0000-0002-5718-3624
이미정(Lee, Mi-Jung) ORCID logo https://orcid.org/0000-0003-3244-9171
이창영(Lee, Chang Young)
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