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Kawano-Dourado L, Molina-Molina M, Sellares J, Enghelmayer JI. The Relevance of REMAP-ILD for Ibero-American Countries: A Randomized Embedded Multifactorial Adaptive Platform (REMAP) Trial in the Field of Interstitial Lung Diseases (ILDs). Arch Bronconeumol 2024; 60:463-465. [PMID: 38816284 DOI: 10.1016/j.arbres.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 05/11/2024] [Accepted: 05/13/2024] [Indexed: 06/01/2024]
Affiliation(s)
- Leticia Kawano-Dourado
- Hcor Research Institute, Hcor Hospital, Sao Paulo, Brazil; Pulmonary Division, Heart Institute (InCor), University of Sao Paulo, Sao Paulo, Brazil; MAGIC Evidence Ecosystem Foundation, Oslo, Norway.
| | - Maria Molina-Molina
- ILD Unit, Respiratory Department, University Hospital of Bellvitge, IDIBELL, Hospitalet de Llobregat, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER), Spain
| | - Jacobo Sellares
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBER), Spain; Servei de Pneumologia, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Facultat de Medicina, Universitat de Vic (UVIC), Vic, Spain
| | - Juan I Enghelmayer
- Hospital de Clínicas, Universidad de Buenos Aires, Argentina; Fundación FUNEF, Buenos Aires, Argentina
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Zhang Q, Zhang B, Yang F, Hu Y, Fan R, Wang M, Chen S. Forsythoside A regulates pulmonary fibrosis by inhibiting endothelial-to-mesenchymal transition and lung fibroblast proliferation via the PTPRB signaling. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 130:155715. [PMID: 38788399 DOI: 10.1016/j.phymed.2024.155715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/27/2024] [Accepted: 05/04/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Pulmonary fibrosis (PF) is an end-stage change in many interstitial lung diseases, whereas no proven effective anti-pulmonary fibrotic treatments. Forsythoside A (FA) derived from Forsythia suspensa (Thunb.) Vahl, has been found to possess lung-protective effect. However, studies on its anti-pulmonary fibrosis effect are limited and its mechanism of action remains unknown. PURPOSE This study aimed to explore the underlying mechanism of FA on PF. METHODS Male C57BL/6 mice were randomized into normal (CON), model (BLM), pirfenidone (PFD), low- and high-dose FA (FA-L, FA-H, respectively). Except for the CON group, which was injected with the same dose of saline, the model of PF was established by intratracheal instillation of BLM, during which the survival rate and body weight changes of the mice were measured. The lung histopathology was evaluated by Hematoxylin-eosin, Sirius red, and Masson staining. Transcriptome analysis was performed to screen for the differential genes associated with the role of FA in PF. Differential genes in normal and pulmonary fibrosis patients with the GSE2052 dataset were analyzed in the GEO database. The levels of CTGF, α-SMA, MMP-8 in lung and TNF-α in bronchoalveolar lavage fluid (BALF) were detected by ELISA. The levels of HYP in lungs were detected by digestion. The mRNA and protein levels of MMP-7, E-cadherin, CD31, α-SMA, TGF-β1, IL-6, β-catenin, ZO-1, PTPRB, E-cadherin, and vimentin in lungs were detected by RT-qPCR and Western blot. The expression of CD31, α-SMA, TGF-β1 and ZO-1 were detected by immunofluorescence. TGF-β1-stimulated HFL1 cells and human umbilical vein endothelial cells (HUVECs) were used in an attempt to explore the possible role of protein tyrosine phosphatase receptor type B (PTPRB) involved in FA-induced improvement of PF. RESULTS The results showed that FA could improve the survival rate and body weight of PF mice. FA could alleviate the symptoms of alveolar wall thickening, inflammatory cell infiltration, blue collagen fiber deposition, collagen fiber type Ⅰ and type Ⅲ in mice with PF. In addition, FA could reduce the levels of HYP, CTGF, α-SMA, TGF-β1, TNF-α, β-catenin and MMP8, and regulate the expression levels of CD31, ZO-1, PTPRB and E-cadherin in lung of mice with PF, inhibiting endothelial-to-mesenchymal transition (EndMT) and fibroblasts proliferation. In the GSE2052 dataset, the expression level of PTPRB is reduced in lung tissue from PF patients, and results from transcriptome sequencing indicate that PTPRB expression is also reduced in PF mice. In addition, the effect of FA on TGF-β1-induced HFL1 or HUVECs cells could be attenuated by the inhibitor of PTPRB, suggesting that the effect of FA on PF is related to PTPRB. CONCLUSION This study demonstrated that FA could ameliorate PF by inhibiting lung fibroblast proliferation and EndMT, and that PTPRB might be a target of FA to ameliorate PF, which provided evidence to support FA as a candidate phytochemical for PF.
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Affiliation(s)
- Qinqin Zhang
- Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China; Henan Key Laboratory of Chinese Medicine Resources and Chemistry, Zhengzhou 450046, Henan, China
| | - Beibei Zhang
- Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China; Henan Key Laboratory of Chinese Medicine Resources and Chemistry, Zhengzhou 450046, Henan, China; Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China
| | - Fan Yang
- Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China; Henan Key Laboratory of Chinese Medicine Resources and Chemistry, Zhengzhou 450046, Henan, China
| | - Yingbo Hu
- Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China
| | - Ruyi Fan
- Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China
| | - Mengya Wang
- Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China
| | - Suiqing Chen
- Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China; Henan Key Laboratory of Chinese Medicine Resources and Chemistry, Zhengzhou 450046, Henan, China; Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan and Education Ministry of P.R., Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China; Henan University of Chinese Medicine, Collaborative Innovation Center of Research and Development on the Whole Industry Chain of Yu-Yao, Henan, China.
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Romero Ortiz AD, Jiménez-Rodríguez BM, López-Ramírez C, López-Bauzá Á, Pérez-Morales M, Delgado-Torralbo JA, Villalba Moral C, Alcazar-Navarrete B. Antifibrotic treatment adherence, efficacy and outcomes for patients with idiopathic pulmonary fibrosis in Spain: a real-world evidence study. BMJ Open Respir Res 2024; 11:e001687. [PMID: 38663886 PMCID: PMC11043774 DOI: 10.1136/bmjresp-2023-001687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/05/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a rare disorder associated with increased mortality and morbidity. There are currently two drugs approved for IPF but their safety and efficacy profile in real-world settings in Spain is not well understood. METHODS An observational, multicentre, prospective study was carried out among patients with IPF who started treatment with pirfenidone or nintedanib from 2015 to 2021. Data regarding clinical characteristics, drug adherence, safety profiles and clinical outcomes between these two drugs were collected. RESULTS 232 patients were included in the analysis. There were no meaningful differences between both groups at baseline. Patients who started pirfenidone showed a decreased risk for treatment withdrawal compared with those starting nintedanib (HR 0.65 (95% CI 0.46 to 0.94; p=0.002)). Time to first adverse event and all-cause mortality was similar between study groups. Risk factors for withdrawal were female sex, diarrhoea and photosensitivity. CONCLUSIONS in this real-world study, both pirfenidone and nintedanib showed similar efficacy profiles. Pirfenidone was associated with less treatment discontinuations due to side effects.
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Affiliation(s)
| | | | | | | | - María Pérez-Morales
- Respiratory Department, Hospital Universitario Costa del Sol, Marbella, Spain
| | | | | | - Bernardino Alcazar-Navarrete
- Respiratory Department, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Medicine Department, Universidad de Granada, Granada, Spain
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Osuna-Gómez R, Mulet M, Barril S, Cantó E, Millan-Billi P, Pardessus A, de la Rosa-Carrillo D, Castillo D, Vidal S. Levels of Lysozyme and SLPI in Bronchoalveolar Lavage: Exploring Their Role in Interstitial Lung Disease. Int J Mol Sci 2024; 25:4297. [PMID: 38673881 PMCID: PMC11050299 DOI: 10.3390/ijms25084297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/08/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Interstitial lung diseases (ILDs) are characterized by inflammation or fibrosis of the pulmonary parenchyma. Despite the involvement of immune cells and soluble mediators in pulmonary fibrosis, the influence of antimicrobial peptides (AMPs) remains underexplored. These effector molecules display a range of activities, which include immunomodulation and wound repair. Here, we investigate the role of AMPs in the development of fibrosis in ILD. We compare the concentration of different AMPs and different cytokines in 46 fibrotic (F-ILD) and 17 non-fibrotic (NF-ILD) patients by ELISA and using peripheral blood mononuclear cells from in vitro stimulation in the presence of lysozyme or secretory leukocyte protease inhibitor (SLPI) from 10 healthy donors. We observed that bronchoalveolar lavage (BAL) levels of AMPs were decreased in F-ILD patients (lysozyme: p < 0.001; SLPI: p < 0.001; LL-37: p < 0.001; lactoferrin: p = 0.47) and were negatively correlated with levels of TGF-β (lysozyme: p = 0.02; SLPI: p < 0.001) and IL-17 (lysozyme: p < 0.001; SLPI: p < 0.001). We observed that lysozyme increased the percentage of CD86+ macrophages (p < 0.001) and the production of TNF-α (p < 0.001). We showed that lysozyme and SLPI were associated with clinical parameters (lysozyme: p < 0.001; SLPI: p < 0.001) and disease progression (lysozyme: p < 0.001; SLPI: p = 0.01). These results suggest that AMPs may play an important role in the anti-fibrotic response, regulating the effect of pro-fibrotic cytokines. In addition, levels of lysozyme in BAL may be a potential biomarker to predict the progression in F-ILD patients.
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Affiliation(s)
- Rubén Osuna-Gómez
- Inflammatory Diseases, Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain; (R.O.-G.); (M.M.); (E.C.)
| | - Maria Mulet
- Inflammatory Diseases, Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain; (R.O.-G.); (M.M.); (E.C.)
| | - Silvia Barril
- Respiratory Department, Institut de Recerca Biomèdica de Lleida (IRBLleida), Hospital Universitari Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, Universitat de Lleida (UdL), 25198 Lleida, Spain;
- Department of Respiratory, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (P.M.-B.); (A.P.); (D.d.l.R.-C.); (D.C.)
| | - Elisabet Cantó
- Inflammatory Diseases, Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain; (R.O.-G.); (M.M.); (E.C.)
| | - Paloma Millan-Billi
- Department of Respiratory, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (P.M.-B.); (A.P.); (D.d.l.R.-C.); (D.C.)
- Department of Respiratory, Hospital Universitario Germans Trias i Pujol, 08916 Barcelona, Spain
| | - Ana Pardessus
- Department of Respiratory, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (P.M.-B.); (A.P.); (D.d.l.R.-C.); (D.C.)
| | - David de la Rosa-Carrillo
- Department of Respiratory, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (P.M.-B.); (A.P.); (D.d.l.R.-C.); (D.C.)
| | - Diego Castillo
- Department of Respiratory, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain; (P.M.-B.); (A.P.); (D.d.l.R.-C.); (D.C.)
| | - Silvia Vidal
- Inflammatory Diseases, Institut de Recerca Sant Pau (IR Sant Pau), 08041 Barcelona, Spain; (R.O.-G.); (M.M.); (E.C.)
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Ba C, Jiang C, Wang H, Shi X, Jin J, Fang Q. Prognostic value of serum oncomarkers for patients hospitalized with acute exacerbation of interstitial lung disease. Ther Adv Respir Dis 2024; 18:17534666241250332. [PMID: 38757948 PMCID: PMC11102678 DOI: 10.1177/17534666241250332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 04/11/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Different types of inflammatory processes and fibrosis have been implicated in the pathogenesis of interstitial lung disease (ILD), a heterogeneous, diffuse, parenchymal lung disease. Acute exacerbation (AE) of ILD is characterized by significant respiratory deterioration and is associated with high mortality rates. Several serum oncomarkers have been used to determine the prognosis of ILD; however, the prognostic value of serum oncomarker levels in patients with AE-ILD remains unclear. OBJECTIVE To evaluate the prognostic value of serum oncomarker levels in patients with AE-ILD and its main subtypes. DESIGN Retrospective study. METHODS The serum levels of 8 oncomarkers in 281 patients hospitalized with AE-ILD at our institution between 2017 and 2022 were retrospectively reviewed. The baseline characteristics and serum oncomarker levels were compared between the survival and non-survival groups of AE-ILD and its main subtypes. Multivariate logistic regression analysis was performed to identify independent prognosis-related markers, and the best prognostic predictor was analyzed using receiver operating characteristic curve (ROC) analysis. RESULT Idiopathic pulmonary fibrosis (IPF; n = 65), idiopathic nonspecific interstitial pneumonia (iNSIP; n = 26), and connective tissue disease-associated interstitial lung disease (CTD-ILD; n = 161) were the three main subtypes of ILD. The in-hospital mortality rate among patients with AE-ILD was 21%. The serum oncomarker levels of most patients with AE-ILD and its main subtypes in the non-survival group were higher than those in the survival group. Multivariate analysis revealed that ferritin and cytokeratin 19 fragments (CYFRA21-1) were independent prognostic risk factors for patients hospitalized with AE-ILD or AE-CTD-ILD. CYFRA21-1 was identified as an independent prognostic risk factor for patients hospitalized with AE-IPF or AE-iNSIP. CONCLUSION CYFRA21-1 may be a viable biomarker for predicting the prognosis of patients with AE-ILD, regardless of the underlying subtype of ILD. Ferritin has a prognostic value in patients with AE-ILD or AE-CTD-ILD.
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Affiliation(s)
- Cuirong Ba
- Department of Respiratory Medicine, Beijing Ditan Hospital, Capital Medical University, China
| | - Chunguo Jiang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Huijuan Wang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xuhua Shi
- Department of Immunology and Rheumatology, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jiawei Jin
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- The Clinical Research Center, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital Jingxi Branch, Capital Medical University, Beijing, China
| | - Qiuhong Fang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chaoyang Hospital, Capital Medical University, No. 8, Gongren Tiyuchang South Road, Chaoyang District, Beijing 100020, China
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Zhong B, Luo S. Identifying the link between serum VEGF and KL-6 concentrations: a correlation analysis for idiopathic pulmonary fibrosis interstitial lung disease progression. Front Med (Lausanne) 2023; 10:1282757. [PMID: 38105892 PMCID: PMC10722179 DOI: 10.3389/fmed.2023.1282757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023] Open
Abstract
Background Idiopathic pulmonary fibrosis interstitial lung disease (IPF-ILD) is a progressive lung disease characterized by excessive collagen deposition and fibrotic changes in the lungs. Identifying reliable serum markers that correlate with disease progression is crucial for diagnosis and prognosis. Objective This study aimed to explore the association between serum markers KL-6 and VEGF and IPF-ILD. Specifically, it assessed their correlation with PaO2, a measure of pulmonary gas function, to provide diagnostic and prognostic indicators. Methods Patients with IPF-ILD were included, and their serum levels of KL-6 and VEGF were measured. Correlations with fibrotic damage and PaO2 were analyzed using statistical methods. Results The analysis confirmed a positive correlation between the serum marker KL-6 and the degree of fibrotic damage in IPF-ILD. On the other hand, the serum marker VEGF was found to promote disease progression. In terms of correlation with PaO2, both KL-6 and VEGF demonstrated high sensitivity and specificity. Specifically, the correlation between KL-6 and PaO2 suggests that it can be used as a reliable indicator to assess the status of pulmonary oxygenation function in patients with ILD. The correlation between VEGF and PaO2 helps to understand its role in the progression of IPF-ILD and provides an important basis for predicting patient prognosis. Conclusion This study confirmed the correlation between KL-6 and VEGF with IPF-ILD and their association with PaO2. KL-6 and VEGF demonstrated high specificity and sensitivity in diagnosing, monitoring, and predicting prognosis in IPF-ILD. These findings contribute to our understanding of the disease and have clinical implications for diagnosis and prognostication.
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Affiliation(s)
| | - Shuixiang Luo
- Department of Respiratory Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
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Hernandez-Gonzalez F, Mendoza N, Casas-Recasens S, Cruz T, Albacar N, López-Saiz G, Alsina-Restoy X, Rojas M, Agusti A, Sellarés J, Faner R. Peripheral Immune Cell Profiling Reveals Distinct Immune Hallmarks in Progressive Pulmonary Fibrosis. Arch Bronconeumol 2023; 59:681-684. [PMID: 37468400 DOI: 10.1016/j.arbres.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/21/2023]
Affiliation(s)
- Fernanda Hernandez-Gonzalez
- Department of Pulmonary Medicine, Respiratory Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Nuria Mendoza
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain; University of Barcelona, Biomedicine Department, Immunology Unit, Barcelona, Spain
| | - Sandra Casas-Recasens
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - Tamara Cruz
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - Nuria Albacar
- Department of Pulmonary Medicine, Respiratory Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gemma López-Saiz
- Department of Pulmonary Medicine, Respiratory Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Xavier Alsina-Restoy
- Department of Pulmonary Medicine, Respiratory Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Mauricio Rojas
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Alvar Agusti
- Department of Pulmonary Medicine, Respiratory Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - Jacobo Sellarés
- Department of Pulmonary Medicine, Respiratory Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - Rosa Faner
- Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain; University of Barcelona, Biomedicine Department, Immunology Unit, Barcelona, Spain.
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Lassan S, Tesar T, Tisonova J, Lassanova M. Pharmacological approaches to pulmonary fibrosis following COVID-19. Front Pharmacol 2023; 14:1143158. [PMID: 37397477 PMCID: PMC10308083 DOI: 10.3389/fphar.2023.1143158] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
Background: In the past few years, COVID-19 became the leading cause of morbidity and mortality worldwide. Although the World Health Organization has declared an end to COVID-19 as a public health emergency, it can be expected, that the emerging new cases at the top of previous ones will result in an increasing number of patients with post-COVID-19 sequelae. Despite the fact that the majority of patients recover, severe acute lung tissue injury can in susceptible individuals progress to interstitial pulmonary involvement. Our goal is to provide an overview of various aspects associated with the Post-COVID-19 pulmonary fibrosis with a focus on its potential pharmacological treatment options. Areas covered: We discuss epidemiology, underlying pathobiological mechanisms, and possible risk and predictive factors that were found to be associated with the development of fibrotic lung tissue remodelling. Several pharmacotherapeutic approaches are currently being applied and include anti-fibrotic drugs, prolonged use or pulses of systemic corticosteroids and non-steroidal anti-inflammatory and immunosuppressive drugs. In addition, several repurposed or novel compounds are being investigated. Fortunately, clinical trials focused on pharmacological treatment regimens for post-COVID-19 pulmonary fibrosis have been either designed, completed or are already in progress. However, the results are contrasting so far. High quality randomised clinical trials are urgently needed with respect to the heterogeneity of disease behaviour, patient characteristics and treatable traits. Conclusion: The Post-COVID-19 pulmonary fibrosis contributes to the burden of chronic respiratory consequences among survivors. Currently available pharmacotherapeutic approaches mostly comprise repurposed drugs with a proven efficacy and safety profile, namely, corticosteroids, immunosuppressants and antifibrotics. The role of nintedanib and pirfenidone is promising in this area. However, we still need to verify conditions under which the potential to prevent, slow or stop progression of lung damage will be fulfilled.
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Affiliation(s)
- Stefan Lassan
- Department of Pneumology, Phthisiology and Functional Diagnostics, Slovak Medical University and Bratislava University Hospital, Bratislava, Slovakia
| | - Tomas Tesar
- Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University, Bratislava, Slovakia
| | - Jana Tisonova
- Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Monika Lassanova
- Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
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Osuna-Gómez R, Barril S, Mulet M, Zamora Atenza C, Millan-Billi P, Pardessus A, Brough DE, Sabzevari H, Semnani RT, Castillo D, Vidal S. The immunoregulatory role of IL-35 in patients with interstitial lung disease. Immunology 2023; 168:610-621. [PMID: 36273280 DOI: 10.1111/imm.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/20/2022] [Indexed: 11/29/2022] Open
Abstract
Pulmonary fibrosis involves various types of immune cells and soluble mediators, including TGF-β and IL-35, a recently identified heterodimeric cytokine that belongs to the IL-12 cytokine family. However, the effect of regulatory IL-35 may play an important role in fibrotic diseases. The aim of this paper is to explore the immunoregulatory role of IL-35 in the development of fibrosis in interstitial lung disease (ILD). To gain a better understanding of this issue, the concentrations of IL-35 and different profibrotic cytokines in fibrotic (F-ILD) and non-fibrotic (NF-ILD) patients by ELISA were compared to that of intracellular IL-35 and IL-17 on CD4+ T cells stimulated in the presence of BAL or with different ratios of recombinant IL-35 (rIL-35) and TGF-β (rTGF-β), which were evaluated by flow cytometry. We observed that BAL concentration of IL-35 was lower in F patients (p < 0.001) and was negatively correlated with concentrations of TGF-β (p < 0.001) and IL-17 (p < 0.001). In supplemented cell cultures, BAL from NF but not F patients enhanced the percentage of IL-35 + CD4+ T (p < 0.001) cells and decreased the percentage of IL-17 + CD4+ T cells (p < 0.001). The percentage of IL-35 + CD4+ T cells correlated positively with BAL concentration of IL-35 (p = 0.02), but correlated negatively with BAL concentrations of IL-17 (p = 0.007) and TGF-β (p = 0.01). After adjusting the concentrations of recombinant cytokines to establish a TGF-β: IL-35 ratio of 1:4, an enhanced percentage of IL-35 + CD4+ T cells (p < 0.001) but a decreased percentage of IL-17 + CD4+ T cells (p < 0.001) was observed. After adding recombinant IL-35 to the BAL from F patients until a 1:4 ratio of TGF-β: IL-35 was reached, a significantly increased percentage of IL-35 + CD4+ T cells (p < 0.001) and a decreased percentage of IL-17 + CD4+ T cells (p = 0.003) was found. These results suggest that IL-35 may induce an anti-fibrotic response, regulating the effect of TGF-β and the inflammatory response on CD4+ T cells. In addition, the TGF-β: IL-35 ratio in BAL has been shown to be a potential biomarker to predict the outcome of F patients with ILD.
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Affiliation(s)
- Rubén Osuna-Gómez
- Inflammatory Diseases, Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Silvia Barril
- Respiratory Department, Institut de Recerca Biomèdica de Lleida (IRBLleida), Hospital Universitari Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, Universitat de Lleida (UdL), Lleida, Spain
- Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Maria Mulet
- Inflammatory Diseases, Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Carlos Zamora Atenza
- Inflammatory Diseases, Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Paloma Millan-Billi
- Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Respiratory Department, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - Ana Pardessus
- Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | | | | | - Diego Castillo
- Inflammatory Diseases, Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
- Respiratory Department, Institut de Recerca Biomèdica de Lleida (IRBLleida), Hospital Universitari Arnau de Vilanova-Santa María, Translational Research in Respiratory Medicine, Universitat de Lleida (UdL), Lleida, Spain
- Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Silvia Vidal
- Inflammatory Diseases, Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
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Highlights for the Clinical Practice in Idiopathic Pulmonary Fibrosis and Progressive Pulmonary Fibrosis: From the ATS/ERS/ALAT/JRS 2022 Guideline. Arch Bronconeumol 2023; 59:73-75. [PMID: 36319518 DOI: 10.1016/j.arbres.2022.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 02/07/2023]
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11
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Alsina-Restoy X, Torres-Castro R, Caballería E, Sisó-Comabella M, Romano-Andrioni B, Pérez-Rodas N, Noboa-Sevilla B, Francesqui J, Hernandez-Gonzalez F, Sellarés J. Is Carob Flour Helpful in Reducing Diarrhoea Associated With Nintedanib? Arch Bronconeumol 2023; 59:341-343. [PMID: 36658079 DOI: 10.1016/j.arbres.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/14/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Xavier Alsina-Restoy
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Rodrigo Torres-Castro
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Estrella Caballería
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Marina Sisó-Comabella
- Servei Endocrinologia i Nutrició, Institut Clínic Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, Spain
| | - Bárbara Romano-Andrioni
- Servei Endocrinologia i Nutrició, Institut Clínic Malalties Digestives i Metabòliques, Hospital Clínic, Barcelona, Spain
| | - Nancy Pérez-Rodas
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Belén Noboa-Sevilla
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain
| | - Joel Francesqui
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Fernanda Hernandez-Gonzalez
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain
| | - Jacobo Sellarés
- Servei de Pneumologia, Institut Clínic Respiratori, Hospital Clinic de Barcelona, Universitat de Barcelona, 08036 Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), 08036 Barcelona, Spain; Center for Biomedical Network Research in Respiratory Diseases (CIBERES), Spain; Facultat de Medicina, Universitat de Vic (UVIC), Vic, Spain.
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12
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Castro HM, Maritano Furcada J, Enghelmayer JI. Relative Versus Absolute Decline in Forced Vital Capacity in Progressive Pulmonary Fibrosis. Arch Bronconeumol 2022; 58:843-844. [DOI: 10.1016/j.arbres.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 11/15/2022]
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