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Prognostic factors for idiopathic pulmonary fibrosis: clinical, physiologic, pathologic, and molecular aspects

Authors
 S.H. Lee  ;  H.S. Shim  ;  S.H. Cho  ;  S.Y. Kim  ;  S.K. Lee  ;  J.Y. Son  ;  J.Y. Jung  ;  E.Y. Kim  ;  , J.E. Lim  ;  K.J. Lee  ;  B.H. Park  ;  Y.A. Kang  ;  Y.S. Kim  ;  S.K. Kim  ;  J. Chang  ;  M.S. Park 
Citation
 SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES, Vol.28(2) : 102-112, 2011 
Journal Title
 SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 
ISSN
 1124-0490 
Issue Date
2011
MeSH
Aged ; Biomarkers/analysis ; Biopsy ; C-Reactive Protein/analysis ; Codon ; Female ; Fibroblasts/pathology ; Forced Expiratory Volume ; Humans ; Idiopathic Pulmonary Fibrosis/diagnosis* ; Idiopathic Pulmonary Fibrosis/genetics ; Idiopathic Pulmonary Fibrosis/metabolism ; Idiopathic Pulmonary Fibrosis/mortality ; Idiopathic Pulmonary Fibrosis/pathology ; Idiopathic Pulmonary Fibrosis/physiopathology ; Immunohistochemistry ; Kaplan-Meier Estimate ; Lung*/chemistry ; Lung*/pathology ; Lung*/physiopathology ; Male ; Middle Aged ; Phosphorylation ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Prognosis ; Proportional Hazards Models ; Protein-Serine-Threonine Kinases/analysis ; Receptors, Transforming Growth Factor beta/analysis ; Republic of Korea ; Risk Assessment ; Risk Factors ; Smad2 Protein/analysis ; Smad3 Protein/analysis ; Smoking/adverse effects ; Transforming Growth Factor beta1/analysis ; Transforming Growth Factor beta1/genetics ; Vital Capacity
Keywords
idiopathic pulmonary fibrosis ; C-reactive protein ; Smad ; TGF-β ; survival ; prognosis ; risk factor
Abstract
BACKGROUND: Previous studies identified clinical and physiologic factors of idiopathic pulmonary fibrosis (IPF) that are related to an increased risk of mortality. But there are few studies about histologic and molecular approach. OBJECTIVE: We investigated whether the C-reactive protein (CRP), fibroblastic foci, phosphorylated Smad2/3 (p-Smad2/3), tumor growth factor-beta (TGF-beta), TGF-beta receptor II (TbetaRII), and the polymorphism of the TGF-beta1 codon 10 are associated with the progression of IPF patients. DESIGN: Eighty-six IPF patients who underwent surgical lung biopsies were examined. For each patient, clinical and physiologic parameters were investigated, and we performed immunohistochemical staining for p-Smad2/3 and TbetaRII, and genotyping of the TGF-beta1 codon 10 polymorphism. RESULTS: Age at diagnosis, gender, symptom duration, and smoking status did not show a significant association. However, the amount of smoking (p = 0.002), severe reduction in the percentages of predicted forced vital capacity (p = 0.013) and diffusion lung capacity of carbon monoxide (p = 0.023), CRP (p = 0.009) at diagnosis, and fibroblastic foci (p = 0.026) were associated with a poor prognosis. Cellularity, fibrosis, expression level of p-Smad2/3 and TbetaRII, and genotype of the TGF-beta1 codon 10 polymorphism did not have a statistically significant association with the prognosis. CONCLUSION: This study confirmed the amount of smoking, abrupt decrease in follow-up pulmonary function parameters, fibroblastic foci, and increased levels of CRP concentration at diagnosis were significantly associated with poor survival. Larger studies are required to confirm all prognostic factors including CRP.
Full Text
http://www.sarcoidosis.it/data/2011/2_2011.html
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Kim, Se Kyu(김세규)
Kim, Song Yee(김송이) ORCID logo https://orcid.org/0000-0001-8627-486X
Kim, Young Sam(김영삼) ORCID logo https://orcid.org/0000-0001-9656-8482
Kim, Eun Young(김은영) ORCID logo https://orcid.org/0000-0002-3281-5744
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
Park, Byung Hoon(박병훈)
Son, Ji Young(손지영)
Shim, Hyo Sup(심효섭) ORCID logo https://orcid.org/0000-0002-5718-3624
Lee, Kyung Jong(이경종)
Lee, Sang Kook(이상국)
Lee, Sang Hoon(이상훈) ORCID logo https://orcid.org/0000-0002-7706-5318
Lim, Ju Eun(임주은)
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Jung, Ji Ye(정지예) ORCID logo https://orcid.org/0000-0003-1589-4142
Cho, Sang Ho(조상호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/95374
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