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Jacquerie P, André B, De Seny D, Henket M, Giltay L, Ernst M, Louis R, Malaise M, Ribbens C, Guiot J. Reproducibility of pulmonary function tests in patients with systemic sclerosis. Sci Rep 2023; 13:18960. [PMID: 37923803 PMCID: PMC10624913 DOI: 10.1038/s41598-023-45881-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 10/25/2023] [Indexed: 11/06/2023] Open
Abstract
Systemic sclerosis (SSc) is a rare autoimmune disease in which interstitial lung disease (ILD) is the leading cause of morbidity and mortality. Clinical management of the lung disease is mainly based on pulmonary function testing (PFT) and their changes over time. Little is known about the reproducibility of PFT testing in SSc patients. The aim of this study was to assess the test-retest reliability and reproducibility of PFTs in SSc patients with or without ILD over 30 days in order determine the potential physiologic variation over the time. We performed prospective observational study of SSc patients. The FVC, FEV1/FVC ratio, DLCO and KCO parameters were assessed in this population at four different timepoints; T0 (time 0) and H3 (T0 + 3 h) defined test-retest reliability, D15 (T0 + 15 days) and D30 (T0 + 30 days) for reproducibility. A mixed linear model was used to test the effect of time (and therefore reproducibility) on patients and we looked for an interaction. We included 25 SSc patients divided in two groups, 14 with ILD and 11 non-ILD. Interactions between time and group were not significant and were not reported. Time and group did not significantly influence the different measures of the PFT: FVC [p values time and group effect respectively (0.33; 0.34)], FEV1/FVC ratio (0.093; 0.056) and DLCO (0.99; 0.13) in the ILD and non ILD group (Table S2). The analyse with interactions between time and group were not significant and are not reported. We also used a Bland Altman test to assess reproducibility for FVC (L) and DLCO (mMKpa/min/L), Figs. 1 and 2 respectively. The measurements were therefore reproducible over time and in each group. PFT parameters are reproducible over time in a clinically stable population of SSc (no significant effect of the time T0, H3, D15 and D30) and there is no significant distinction between patients with ILD and no ILD. These respiratory functional data can further underline their use in clinical practice.
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Affiliation(s)
- P Jacquerie
- Rheumatology Department, CHU LiègeULiège, Domaine Universitaire Sart Tilman, B35, 4020, Liège, Belgium.
| | - B André
- Rheumatology Department, CHU LiègeULiège, Domaine Universitaire Sart Tilman, B35, 4020, Liège, Belgium
| | - D De Seny
- Pneumology Department, CHU Liège, GIGA Research, ULiège, Domaine Universitaire Sart Tilman, Liège, Belgium
| | - M Henket
- Pneumology Department, CHU Liège, GIGA Research, ULiège, Domaine Universitaire Sart Tilman, Liège, Belgium
| | - L Giltay
- Pneumology Department, CHU Liège, GIGA Research, ULiège, Domaine Universitaire Sart Tilman, Liège, Belgium
| | - M Ernst
- Biostatistics and Research Method Center (B-STAT), ULiège, Domaine Universitaire Sart Tilman, Liège, Belgium
| | - R Louis
- Pneumology Department, CHU Liège, GIGA Research, ULiège, Domaine Universitaire Sart Tilman, Liège, Belgium
| | - M Malaise
- Rheumatology Department, CHU LiègeULiège, Domaine Universitaire Sart Tilman, B35, 4020, Liège, Belgium
| | - C Ribbens
- Rheumatology Department, CHU LiègeULiège, Domaine Universitaire Sart Tilman, B35, 4020, Liège, Belgium
| | - J Guiot
- Pneumology Department, CHU Liège, GIGA Research, ULiège, Domaine Universitaire Sart Tilman, Liège, Belgium
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Guiot J, Henket M, Ernst M, Seidel L, Winandy M, Denis A, Frix AN, Gester F, Thys M, Giltay L, Garah O, Njock MS, Canivet P, Meunier P, Corhay JL, Regnier C, Malaise O, Malaise M, Louis R. Airflow obstruction as a marker of adverse prognosis in rheumatoid arthritis. Front Med (Lausanne) 2023; 10:1063012. [PMID: 36968825 PMCID: PMC10033600 DOI: 10.3389/fmed.2023.1063012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/16/2023] [Indexed: 03/12/2023] Open
Abstract
ObjectivesIn our study, we explored the specific subgroup of patients with rheumatoid arthritis (RA) suffering from obstructive lung disease (OLD) and its impact on morbi-mortality.MethodsOur retrospective study included 309 patients suffering from RA with either obstructive (O-RA) or non-obstructive patterns (non-O-RA). OLD was defined based on the Tiffeneau index at the first available pulmonary functional test (PFT). Survival was then calculated and represented by a Kaplan–Meier curve. The comparison between the populations considered was performed by the Log-Rank test.ResultsOut of the 309 RA patients, 102 (33%) had airway obstruction. The overall survival time was significantly lower in the O-RA group than in the non-O-RA group (n = 207) (p < 0.001). The median survival time was 11.75 years in the O-RA group and higher than 16 years in the non-O-RA group. Multivariate analysis identified OLD as an independent risk factor for mortality (HR 2.20; 95% CI 1.21–4.00, p < 0.01).ConclusionAirway obstruction can be an independent risk factor of mortality in RA and should be considered as an early marker of poor prognosis. Further prospective longitudinal studies are required in order to determine the best clinical management for O-RA patients.
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Affiliation(s)
- Julien Guiot
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
- *Correspondence: Julien Guiot,
| | - Monique Henket
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | - Marie Ernst
- Biostatistics and Research Method Center (B-STAT), CHU Liège, Liège, Belgium
| | - Laurence Seidel
- Biostatistics and Research Method Center (B-STAT), CHU Liège, Liège, Belgium
| | - Marie Winandy
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | - Anna Denis
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | | | - Fanny Gester
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | - Marie Thys
- Department of Medico-Economic and Data, CHU Liège, Liège, Belgium
| | - Laurie Giltay
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | - Omaima Garah
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
| | | | | | - Paul Meunier
- Department of Radiology, CHU Liège, Liège, Belgium
| | | | | | | | | | - Renaud Louis
- Department of Respiratory Medicine, CHU Liège, Liège, Belgium
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Guiot J, Henket M, Frix AN, Gester F, Thys M, Giltay L, Desir C, Moermans C, Njock MS, Meunier P, Corhay JL, Louis R. Combined obstructive airflow limitation associated with interstitial lung diseases (O-ILD): the bad phenotype ? Respir Res 2022; 23:89. [PMID: 35410260 PMCID: PMC8996531 DOI: 10.1186/s12931-022-02006-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/24/2022] [Indexed: 12/17/2022] Open
Abstract
Abstract
Background
Patients suffering from combined obstructive and interstitial lung disease (O-ILD) represent a pathological entity which still has to be well clinically described. The aim of this descriptive and explorative study was to describe the phenotype and functional characteristics of a cohort of patients suffering from functional obstruction in a population of ILD patients in order to raise the need of dedicated prospective observational studies and the evaluation of the impact of anti-fibrotic therapies.
Methods
The current authors conducted a retrospective study including 557 ILD patients, with either obstructive (O-ILD, n = 82) or non-obstructive (non O-ILD, n = 475) pattern. Patients included were mainly males (54%) with a mean age of 62 years.
Results
Patients with O-ILD exhibited a characteristic functional profile with reduced percent predicted forced expired volume in 1 s (FEV1) [65% (53–77) vs 83% (71–96), p < 0.00001], small airway involvement assessed by maximum expiratory flow (MEF) 25/75 [29% (20–41) vs 81% (64–108), p < 0.00001], reduced sGaw [60% (42–75) vs 87% (59–119), p < 0.01] and sub-normal functional residual capacity (FRC) [113% (93–134) vs 92% (75–109), p < 0.00001] with no impaired of carbon monoxide diffusing capacity of the lung (DLCO) compared to those without obstruction. Total lung capacity (TLC) was increased in O-ILD patients [93% (82–107) vs 79% (69–91), p < 0.00001]. Of interest, DLCO sharply dropped in O-ILD patients over a 5-year follow-up. We did not identify a significant increase in mortality in patients with O-ILD. Interestingly, the global mortality was increased in the specific sub-group of patients with O-ILD and no progressive fibrosing ILD phenotype and in those with connective tissue disease associated ILD especially in case of rheumatoid arthritis.
Conclusions
The authors individualized a specific functional-based pattern of ILD patients with obstructive lung disease, who are at risk of increased mortality and rapid DLCO decline over time. As classically those patients are excluded from clinical trials, a dedicated prospective study would be of interest in order to define more precisely treatment response of those patients.
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Zanella D, Guiot J, Stefanuto PH, Giltay L, Henket M, Guissard F, André B, Malaise M, Potjewijd J, Schleich F, Louis R, Focant JF. Breathomics to diagnose systemic sclerosis using thermal desorption and comprehensive two-dimensional gas chromatography high-resolution time-of-flight mass spectrometry. Anal Bioanal Chem 2021; 413:3813-3822. [PMID: 33903944 DOI: 10.1007/s00216-021-03333-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/11/2021] [Accepted: 04/08/2021] [Indexed: 11/29/2022]
Abstract
Systemic sclerosis is a rare autoimmune disease associated with rapidly evolving interstitial lung disease, responsible for the disease severity and mortality. Specific biomarkers enabling the early diagnosis and prognosis associated with the disease progression are highly needed. Volatile organic compounds in exhaled breath are widely available and non-invasive and have the potential to reflect metabolic processes occurring within the body. Comprehensive two-dimensional gas chromatography coupled to high-resolution mass spectrometry was used to investigate the potential of exhaled breath to diagnose systemic sclerosis. The exhaled breath of 32 patients and 30 healthy subjects was analyzed. The high resolving power of this approach enabled the detection of 356 compounds in the breath of systemic sclerosis patients, which was characterized by an increase of mainly terpenoids and hydrocarbons. In addition, the use of 4 complementary statistical approaches (two-tailed equal variance t-test, fold change, partial least squares discriminant analysis, and random forest) resulted in the identification of 16 compounds that can be used to discriminate systemic sclerosis patients from healthy subjects. Receiver operating curves were generated that provided an accuracy of 90%, a sensitivity of 92%, and a specificity of 89%. The chemical identification of eight compounds predictive of systemic sclerosis was validated using commercially available standards. The analytical variations together with the volatile composition of room air were carefully monitored during the timeframe of the study to ensure the robustness of the technique. This study represents the first reported evaluation of exhaled breath analysis for systemic sclerosis diagnosis and provides surrogate markers for such disease.
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Affiliation(s)
- Delphine Zanella
- Molecular System, Organic & Biological Analytical Chemistry Group, University of Liege, 11 Allee du Six Aout, 4000, Liege, Belgium.
| | - Julien Guiot
- Respiratory Medicine, GIGA I3, CHU Liege, 4000, Liege, Belgium
| | - Pierre-Hugues Stefanuto
- Molecular System, Organic & Biological Analytical Chemistry Group, University of Liege, 11 Allee du Six Aout, 4000, Liege, Belgium
| | - Laurie Giltay
- Respiratory Medicine, GIGA I3, CHU Liege, 4000, Liege, Belgium
| | - Monique Henket
- Respiratory Medicine, GIGA I3, CHU Liege, 4000, Liege, Belgium
| | | | - Béatrice André
- Rheumatology Department, CHU Liege, 4000, Liege, Belgium
| | - Michel Malaise
- Rheumatology Department, CHU Liege, 4000, Liege, Belgium
| | - Judith Potjewijd
- Department of Internal Medicine, Division of Clinical and Experimental Immunology, Maastricht University Medical Center, 6229 HX, Maastricht, The Netherlands
| | | | - Renaud Louis
- Respiratory Medicine, GIGA I3, CHU Liege, 4000, Liege, Belgium
| | - Jean-François Focant
- Molecular System, Organic & Biological Analytical Chemistry Group, University of Liege, 11 Allee du Six Aout, 4000, Liege, Belgium
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