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Hamada S, Ichiyasu H, Inaba M, Takahashi H, Sadamatsu T, Akaike K, Masunaga A, Tashiro Y, Hirata N, Yoshinaga T, Sakagami T. Prognostic impact of pre-existing interstitial lung disease in non-HIV patients with Pneumocystis pneumonia. ERJ Open Res 2020; 6:00306-2019. [PMID: 32391396 PMCID: PMC7196667 DOI: 10.1183/23120541.00306-2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/11/2020] [Indexed: 12/15/2022] Open
Abstract
Background The increasing incidence of life-threatening Pneumocystis pneumonia (PCP) in non-HIV immunocompromised patients is a global concern. Yet, no reports have examined the prognostic significance of pre-existing interstitial lung disease (ILD) in non-HIV PCP. Methods We retrospectively reviewed the medical records of non-HIV PCP patients with (ILD group) or without (non-ILD group) pre-existing ILD. The clinical features and outcomes of the ILD group were compared with those of the non-ILD group. Cox regression models were constructed to identify prognostic factors. Results 74 patients were enrolled in this study. The 90-day mortality was significantly higher in the ILD group than in the non-ILD group (62.5% versus 19.0%, p<0.001). In the ILD group, patients with a higher percentage of bronchoalveolar lavage fluid neutrophils had worse outcomes compared to those having a lower percentage (p=0.026). Multivariate analyses revealed that pre-existing ILD (p=0.002) and low levels of serum albumin (p=0.009) were independent risk factors for 90-day mortality. Serum levels of β-d-glucan were significantly reduced after treatment of PCP in both groups, whereas levels of Krebs von den Lungen-6 (KL-6) significantly increased in the ILD group. In the ILD group, the 90-day mortality of patients with increasing KL-6 levels after treatment was significantly higher than those with decreasing levels (78.9% versus 0%, p=0.019). Conclusion In non-HIV PCP patients, pre-existing ILD is associated with a poorer prognosis. Prophylaxis for PCP is needed in patients with pre-existing ILD under immunosuppression. Pre-existing interstitial lung disease (ILD) is an independent prognostic risk factor for non- HIV Pneumocystis pneumonia (PCP). Prophylaxis for PCP is needed in patients with pre-existing ILD under immunosuppression.http://bit.ly/37BGZuK
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Affiliation(s)
- Shohei Hamada
- Dept of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Hidenori Ichiyasu
- Dept of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Megumi Inaba
- Division of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Hiroshi Takahashi
- Dept of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomoki Sadamatsu
- Dept of Respiratory Medicine, Minamata City General Hospital and Medical Center, Minamata, Japan
| | - Kimitaka Akaike
- Dept of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Aiko Masunaga
- Dept of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasumasa Tashiro
- Dept of Respiratory Medicine, Minamata City General Hospital and Medical Center, Minamata, Japan
| | - Naomi Hirata
- Division of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Takeshi Yoshinaga
- Division of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Takuro Sakagami
- Dept of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Hamada S, Ichiyasu H, Ikeda T, Inaba M, Kashiwabara K, Sadamatsu T, Sato N, Akaike K, Okabayashi H, Saruwatari K, Tomita Y, Saeki S, Hirata N, Yoshinaga T, Fujii K. Protective effect of bevacizumab on chemotherapy-related acute exacerbation of interstitial lung disease in patients with advanced non-squamous non-small cell lung cancer. BMC Pulm Med 2019; 19:72. [PMID: 30940113 PMCID: PMC6446385 DOI: 10.1186/s12890-019-0838-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 03/24/2019] [Indexed: 12/22/2022] Open
Abstract
Background Acute exacerbation of interstitial lung disease (AE-ILD) is the most serious complication in lung cancer patients with pre-existing ILD receiving chemotherapy. The role of vascular endothelial growth factor (VEGF) in pathogenesis of AE-ILD is conflicting. The influence of bevacizumab (Bev), a monoclonal antibody against VEGF, on lung cancer patients with pre-existing ILD remains unclear. We examined the effect of Bev on reducing AE-ILD risk in non-squamous non-small cell lung cancer (NSCLC) patients receiving chemotherapy. Methods We analysed incidence of AE-ILD and outcomes of 48 patients with advanced non-squamous NSCLC with ILD who received first-line chemotherapy with (Bev group, n = 17) and without (non-Bev group, n = 31) Bev between July 2011 and July 2016. Gray’s test, which was competing risk analysis during the study period, was performed for both groups. Results The most common regimen used for first-line chemotherapy was the combination of carboplatin plus pemetrexed (PEM) in both groups. The incidences of chemotherapy-related AE-ILD 120 days after first-line chemotherapy initiation were significantly lower in the Bev than in the non-Bev groups (0% vs. 22.6%, p = 0.037, Gray’s test). However, there were no differences in development of progressive disease of lung cancer and other events as the competing risk factors of AE-ILD between the two groups. Only patients receiving PEM-containing regimens also showed a significant difference in the incidence of AE-ILD between the two groups (p = 0.044). The overall-cumulative incidence of AE-ILD during the first-line and subsequent chemotherapy was 29.2% (14 of the 48). The median progression-free survival was significantly longer in the Bev than in the non-Bev groups (8.0 vs. 4.3 months, p = 0.026). Conclusions The addition of Bev to chemotherapy regimens may reduce the risk of chemotherapy-related AE-ILD in patients with lung cancer. Electronic supplementary material The online version of this article (10.1186/s12890-019-0838-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shohei Hamada
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hidenori Ichiyasu
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Tokunori Ikeda
- Department of Clinical Investigation (Biostatistics), Kumamoto University Hospital, Kumamoto, Japan
| | - Megumi Inaba
- Division of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Kosuke Kashiwabara
- Department of Respiratory Medicine, Kumamoto Regional Medical Center, Kumamoto, Japan
| | - Tomoki Sadamatsu
- Department of Respiratory Medicine, Minamata City General Hospital and Medical Center, Minamata, Japan
| | - Nahoko Sato
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Kimitaka Akaike
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Hiroko Okabayashi
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Koichi Saruwatari
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yusuke Tomita
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Sho Saeki
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Naomi Hirata
- Division of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Takeshi Yoshinaga
- Division of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan
| | - Kazuhiko Fujii
- Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
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Sadamatsu T. [Production of monoclonal antibody to chicken epiphyseal cartilage matrix vesicle metalloprotease to determine its localization]. Nihon Seikeigeka Gakkai Zasshi 1991; 65:230-9. [PMID: 2056238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Previous reports demonstrated that metalloprotease was isolated from matrix vesicles (MVs) of chicken epiphyseal cartilage. In this study, we produced the monoclonal antibody against MV metalloprotease (MVPase) and its location was studied by immunohistochemical technique. Isolated MVs were injected into Balb/c mice and spleen cells were collected for fusion with myeloma cells. A monoclonal hybrid cell producing antibody against MVPase was isolated. The immunoglobulin isotype was IgG1. On western blots, this antibody reacted with a single band protein of 33KDa which corresponded with purified MVPase. In the light immunohistochemical study, immuno reactions were observed in the mesenchymal cells of bone marrow at the lowest area in hypertrophic zone of the epiphyseal cartilage. Ultrastructural immunolocalization of protein A-gold particles revealing MVPase showed that MVs contained this enzyme, and in the calcifying area, gold particles were observed at the apatite needles of ruptured MVs. According to these observations, it is suggested that MVPase was already synthesized in undifferentiated marrow bone cells and this enzyme promotes the initial MV calcification and relates closely to the growth crystalline needles of apatite.
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Affiliation(s)
- T Sadamatsu
- Department of Orthopaedic Surgery, Nagasaki University School of Medicine, Japan
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