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Beltramo G, Thabut G, Peron N, Nicaise P, Cazes A, Debray MP, Joannes A, Castier Y, Mailleux AA, Frija J, Pradère P, Justet A, Borie R, Dombret MC, Taille C, Aubier M, Crestani B. Anti-parietal cell autoimmunity is associated with an accelerated decline of lung function in IPF patients. Respir Med 2018; 135:15-21. [PMID: 29414448 DOI: 10.1016/j.rmed.2017.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 11/26/2017] [Accepted: 12/26/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND Autoantibodies against lung epithelial antigens are often detected in patients with Idiopathic Pulmonary Fibrosis (IPF). Anti-Parietal Cell Antibodies (APCA) target the H+/K+ATPase (proton pump). APCA prevalence and lung H+/K+ATPase expression was never studied in IPF patients. METHODS We retrospectively collected clinical, lung function and imaging data from APCA positive patients (APCA+IPF) and compared them with APCA negative IPF patients matched on the date of diagnostic assessment. H+/K+ATPase expression was assessed with immunohistochemistry and PCR. RESULTS Among 138 IPF patients diagnosed between 2007 and 2014 and tested for APCA, 19 (13.7%) APCA+ patients were identified. APCA+IPF patients were 16 men and 3 women, mean age 71 years. The median titer of APCA was 1:160. A pernicious anemia was present in 5 patients and preceded the fibrosis in 3 cases. With a mean follow up of 31 months, 2 patients had an exacerbation and 7 patients died. As compared with 19 APCA- IPF patients, APCA+IPF patients had a less severe disease with better DLCO (57% vs 43% predicted), preserved PaO2 (85 ± 8 mmHg vs 74 ± 11 mmHg), a lower rate of honeycombing on HRCT (58% vs 89%), but they experienced an accelerated decline of FVC (difference 61.4 ml/year; p = .0002). The H+/K+ATPase was strongly expressed by hyperplastic alveolar epithelial cells in the fibrotic lung. CONCLUSION Anti-parietal cell autoimmunity is detected in some IPF patients and is associated with an accelerated decline of lung function. Anti-parietal cell autoimmunity may promote lung fibrosis progression.
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Affiliation(s)
- Guillaume Beltramo
- Assistance Publique-Hôpitaux de Paris, DHU FIRE (Fibrosis, Inflammation and Remodeling), Hôpital Bichat, Service de Pneumologie A, 75018 Paris, France
| | - Gabriel Thabut
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Service de Pneumologie et Transplantation, 75018 Paris, France; INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France
| | - Nicolas Peron
- Assistance Publique-Hôpitaux de Paris, DHU FIRE (Fibrosis, Inflammation and Remodeling), Hôpital Bichat, Service de Pneumologie A, 75018 Paris, France
| | - Pascale Nicaise
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Département d'Hématologie et Immunologie UF Autoimmunité et Hypersensibilités, 75018 Paris, France
| | - Aurélie Cazes
- INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Département d'Anatomie Pathologique, 75018 Paris, France
| | - Marie-Pierre Debray
- Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Service de Radiologie, Paris, France
| | - Audrey Joannes
- INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France
| | - Yves Castier
- INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Service de Chirurgie Vasculaire et Thoracique 75018 Paris, France
| | - Arnaud A Mailleux
- INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France
| | - Justine Frija
- Université Paris Diderot, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Bichat, Service d'Explorations Fonctionnelles Multidisciplinaires, 75018 Paris, France
| | - Pauline Pradère
- Assistance Publique-Hôpitaux de Paris, DHU FIRE (Fibrosis, Inflammation and Remodeling), Hôpital Bichat, Service de Pneumologie A, 75018 Paris, France
| | - Aurélien Justet
- Assistance Publique-Hôpitaux de Paris, DHU FIRE (Fibrosis, Inflammation and Remodeling), Hôpital Bichat, Service de Pneumologie A, 75018 Paris, France; INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France
| | - Raphaël Borie
- Assistance Publique-Hôpitaux de Paris, DHU FIRE (Fibrosis, Inflammation and Remodeling), Hôpital Bichat, Service de Pneumologie A, 75018 Paris, France; INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France
| | - Marie-Christine Dombret
- Assistance Publique-Hôpitaux de Paris, DHU FIRE (Fibrosis, Inflammation and Remodeling), Hôpital Bichat, Service de Pneumologie A, 75018 Paris, France; INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France
| | - Camille Taille
- Assistance Publique-Hôpitaux de Paris, DHU FIRE (Fibrosis, Inflammation and Remodeling), Hôpital Bichat, Service de Pneumologie A, 75018 Paris, France; INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France
| | - Michel Aubier
- Assistance Publique-Hôpitaux de Paris, DHU FIRE (Fibrosis, Inflammation and Remodeling), Hôpital Bichat, Service de Pneumologie A, 75018 Paris, France; INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France
| | - Bruno Crestani
- Assistance Publique-Hôpitaux de Paris, DHU FIRE (Fibrosis, Inflammation and Remodeling), Hôpital Bichat, Service de Pneumologie A, 75018 Paris, France; INSERM UMR 1152, Labex Inflamex, Paris, France; Université Paris Diderot, Paris, France.
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