Fibrosing alveolitis in systemic sclerosis: increase in memory T-cells in lung interstitium

Wells, AU; Lorimer, S.; Majumdar, S. K.; Harrison, NK; Corrin, B.; Black, CM; Jeffery, P. K.; Bois, RM du

doi:10.1183/09031936.95.08020266

Cited by 59 publications

(39 citation statements)

References 30 publications

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“…Moreover, responsiveness to treatment in fibrosing alveolitis depends upon a predominance of inflammation over fibrosis, not the absolute severity of inflammation [1,2,28]. There is a positive correlation between the degree of inflammatory cell infiltration and the severity of fibrosis in fibrosing alveolitis [11,29,30]; despite the presence of extensive inflammation in some cases, CFA patients with "mixed" histological appearances at open lung biopsy have a prognosis little different from patients with fibrotic disease [2]. Thus, correlations between functional variables and the severity of either inflammation or fibrosis in isolation have little bearing on the putative use of pulmonary function tests to distinguish between reversible and irreversible fibrosing alveolitis.…”

Section: Discussionmentioning

confidence: 92%

Functional impairment in fibrosing alveolitis: relationship to reversible disease on thin section computed tomography

Wells

Rubens²,

Bois³

et al. 1997

Eur Respir J

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Thin-section computed tomography (CT) provides a reproducible method of quantifying global disease extent and can also discriminate between fibrotic disease, with predominance of reticular abnormalities, and reversible inflammatory cell infiltration, shown as ground-glass attenuation.The aim of this study was to determine whether functional impairment varied according to the presence of ground-glass attenuation on CT, independently of extent of disease on CT, demographic factors, smoking history, therapeutic status, and the type of fibrosing alveolitis (lone cryptogenic fibrosing alveolitis (CFA) versus fibrosing alveolitis associated with systemic sclerosis (FASSc)).Patients with concurrent emphysema on CT (n=16) and FASSc patients with end-stage pulmonary hypertension (n=5) were excluded. One hundred and eleven patients were studied (CFA, n=54; FASSc, n=57).The severity of functional impairment did not vary independently with the presence of predominant ground-glass attenuation, mixed appearance and predominant reticulation on CT. In 34 treated patients undergoing serial CT scanning, the severity of functional impairment did not differ independently between patients with and without regression of ground-glass attenuation at follow-up.We conclude that the severity of functional impairment does not discriminate between inflammatory and fibrotic disease in fibrosing alveolitis, as judged by initial and serial computed tomographic scanning, after adjustment for the morphological extent of disease on computed tomography.

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Section: Discussionmentioning

confidence: 92%

Functional impairment in fibrosing alveolitis: relationship to reversible disease on thin section computed tomography

Wells

Rubens²,

Bois³

et al. 1997

Eur Respir J

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“…T cells appear in perivascular areas along with macrophages ( Figure 1). T cells with memory phenotype were also found in lung biopsy specimens from patients with SSc and lung involvement (36).…”

Section: T Cells In Sscmentioning

confidence: 88%

Is systemic sclerosis an antigen‐driven T cell disease?

Sakkas¹,

Platsoucas²

2004

Arthritis & Rheumatism

113

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“…There is a cellular infiltration of the skin, consisting of T cells, macrophages, and mast cells, early in the course of the disease (4 -7). T cells are also found in lung tissues from SSc patients with lung involvement (8). Peripheral blood T cells in SSc exhibit signs of activation and express activation Ags, such as IL-2R (CD25), HLA-DR, and CD29 (9,10), and increased levels of protooncogenes (11).…”

Section: S Ystemic Sclerosis (Ssc)mentioning

confidence: 99%

Oligoclonal T Cell Expansion in the Skin of Patients with Systemic Sclerosis

Sakkas

Artlett

et al. 2002

The Journal of Immunology

194

169

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Fibrosis, microvascular fibroproliferative alterations, and autoantibody production are the main features of systemic sclerosis (SSc), and all of them can be explained by cytokine production by activated T cells. However, little is known about the role of T cells in the pathogenesis of SSc, and there is no information on the Ag(s) that elicits such activation. To determine whether T cells infiltrating the skin biopsies of patients with SSc are oligoclonal, β-chain TCR transcripts from T cells infiltrating the skin of five patients with SSc of recent onset were amplified by either Vβ-specific PCR or nonpalindromic adaptor PCR. The resulting PCR products were subsequently cloned and sequenced. High proportions of identical β-chain TCR transcripts ranging from 43 to 90% of those sequenced were found in five patients, strongly suggesting the presence of oligoclonal T cells in these infiltrates. A dominant T cell clone was found to be clonally expanded in skin biopsies obtained from a single patient with SSc at three different times (0, 8, and 13 mo earlier) and from three different skin regions. β-chain TCR transcripts from PBMC from normal donors (methodological control) were unique when compared with each other, typical for polyclonal populations of T cells. The finding of oligoclonal T cells infiltrating the skin of patients with SSc suggests that these T cells have undergone proliferation in situ in the skin and clonal expansion in response to as yet unidentified Ag(s). These results suggest that T cells are involved in the pathogenesis of the disease.

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Fibrosing alveolitis in systemic sclerosis: increase in memory T-cells in lung interstitium

Abstract: In conclusion, in fibrosing alveolitis of systemic sclerosis, most interstitial Tlymphocytes express the phenotype of memory cells; these cells are likely to be involved in the persistent inflammatory process.

Cited by 59 publications

References 30 publications

Functional impairment in fibrosing alveolitis: relationship to reversible disease on thin section computed tomography

Functional impairment in fibrosing alveolitis: relationship to reversible disease on thin section computed tomography

Is systemic sclerosis an antigen‐driven T cell disease?

Oligoclonal T Cell Expansion in the Skin of Patients with Systemic Sclerosis

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