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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
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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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Won(김경원) ORCID logo https://orcid.org/0000-0003-4529-6135
Kim, Kyu Earn(김규언)
Kim, Myung Joon(김명준) ORCID logo https://orcid.org/0000-0002-4608-0275
Kim, Sang Kyum(김상겸) ORCID logo https://orcid.org/0000-0003-0768-9923
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Yoon Hee(김윤희) ORCID logo https://orcid.org/0000-0002-2149-8501
Sohn, Myung Hyun(손명현) ORCID logo https://orcid.org/0000-0002-2478-487X
Shim, Hyo Sup(심효섭) ORCID logo https://orcid.org/0000-0002-5718-3624
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
Lee, Chang Young(이창영)
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