Biomarkers: A potential prognostic tool for silicosis

Abstract

Long-term exposure to respirable dust containing silica leads to pneumoconiosis/silicosis. The disease is irreversible and incurable, and only preventive steps such as job rotation, use of personal protective equipment, etc., remain solutions to the problem. Under such a situation, early diagnosis or prediction may become very useful to control the disease. Biomarkers are biological parameters in blood serum that change their values with deposition of dust in the lung and onset of lung fibrosis. Since these biomarkers can help us to diagnose and in the prognosis of the disease before it is actually diagnosed by the conventional X-ray technique and lung function test used for diagnosis of silicosis. The present paper describes the various types of available biomarkers, their application and usefulness. The paper also suggests that further study of the behavior/level of these biomarkers on a specific subject with time may provide more useful information of a confirmatory nature for prevention of dust-linked diseases.

Differential gene expression associated with inflammation in peripheral blood cells of patients with pneumoconiosis

“…IL-6 protein level was elevated in the serum of CWP and silicosis 17 , 18 , 26) . However, IL-6 mRNA change has not been reported in patients with pneumoconiosis.…”

“…Among these deferentially expressed genes, IL6 mRNA and protein levels are elevated in alveolar macrophages and bronchial lavage fluid of fibrosis animal models, patients with idiopathic pulmonary fibrosis, nodular pulmonary fibrosis patients, and patients with silicosis [22][23][24][25] . IL-6 protein level was elevated in the serum of CWP and silicosis 17,18,26) . However, IL-6 mRNA change has not been reported in patients with pneumoconiosis.…”

The Evolution of Silicosis into Massive Pulmonary Fibrosis — Case Series

“…ACE levels can increase in other types of pneumoconiosis, including siderosis, anthracosis, or sarcoidosis. 10 It is noticeable that both patients presented multiple intercurrent infections in the medium-and long-term follow-up, and both required large-spectrum antibiotics in association to corticosteroids and the chronic treatment. All these infectious episodes can lead to a longer recovery period and decrease the overall clinical and respiratory status of such patients, leading to reserved prognosis after several infectious episodes.…”

“…In both cases, there were difficulties in establishing a proper diagnosis of silicosis, 9 for which supplementary investigations were needed, including fibrobronchoscopy, multiple thoracic CT scans, bronchoalveolar lavage, and even lung biopsy. 10 The first case illustrates an episode of acute progression of the existing lung pathology (an acute evolution of silicosis, probably in the context of the autoimmune condition under treatment with Methotrexate). Bronchoalveolar lavage might contribute to a proper diagnosis in a timely fashion, for initiating therapeutic measures that could lead to cessation of this rapid disease progression.…”

“…1,2,9 Several studies have confirmed that the serum activity of angiotensin-converting enzyme (ACE) is increased in patients with silicosis, coal worker's pneumoconiosis, and sarcoidosis, and its elevated serum levels can indicate disease progression and severity. 10…”