Hyaluronate in bronchoalveolar lavage fluid: a new marker in sarcoidosis reflecting pulmonary disease.

Hällgren, Roger; Eklúnd, Anders; Engström‐Laurent, Anna; Schmekel, Birgitta

doi:10.1136/bmj.290.6484.1778

Cited by 105 publications

(53 citation statements)

References 17 publications

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“…Our measurements of PIIINP agree with previous studies indicating elevated PIIINP levels in BAL of patients with diffuse lung diseases, such as IPF, adult respiratory distress syndrome (ARDS), sarcoidosis and farmer's lung [5][6][7][8][10][11][12][13][14][15].…”

Section: Discussionsupporting

confidence: 81%

“…Thus, biochemical measurements of the balance between collagen synthesis and degradation would be helpful in monitoring the progress of fibrotic lung disease. In recent years, an assay for the procollagen type-III Nterminal propeptide (PIIINP) [3,4] has been used to assess collagen turnover both in serum and bronchoalveolar lavage fluid (BALF) from patients with idiopathic pulmonary fibrosis [5,6], sarcoidosis [7,8], adult respiratory distress syndrome [9,10], and farmer's lung [11][12][13]. Most of these studies have investigated PIIINP levels either in serum or BALF: In a few studies both PIIINP levels were investigated [10,14,15].…”

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confidence: 99%

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Simultaneous measurement of collagen type-VI-related antigen and procollagen type-III-N-propeptide levels in bronchoalveolar lavage

Schaberg¹,

Orzechowski²,

Oesterling³

et al. 1994

Eur Respir J

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S Si im mu ul lt ta an ne eo ou us s m me ea as su ur re em me en nt t o of f c co ol ll la ag ge en n t ty yp pe e--V VI I--r re el la at te ed d a an nt ti ig ge en n a an nd d p pr ro oc co ol ll la ag ge en n t ty yp pe e--I II II I--N N--p pr ro op pe ep pt ti id de e l le ev ve el ls s i in n b br ro on nc ch ho oa al lv ve eo ol la ar r l la av va ag ge e Biochemical parameters which are correlated with collagen synthesis and degradation may be helpful to monitor fibrosis. In this study, we compared the sensitivity and specificity of procollagen type-III-N-propeptide (PIIINP) and collagen type-VI (C-VI) related antigen levels, as well as a ratio of both parameters (PIIINP/C-VI), in bronchoalveolar lavage fluid (BALF) from patients with diffuse and localized lung disease. We investigated 45 patients with diffuse lung disease (idiopathic pulmonary fibrosis (IPF), n=21; sarcoidosis, n=13; and lymphangitic carcinomatosis (LC), n=11); 58 control subjects; and 92 patients with localized lung disease (bronchial carcinoma, n=37; pulmonary tuberculosis, n=31; and pneumonia, n=24). C-VI and PIIINP were measured by immunoassay in concentrated BALF.Although the PIIINP and C-VI levels were increased in diffuse lung disease, the sensitivity of the individual parameters PIIINP and C-VI was low ( Simultaneous measurement of C-VI and PIIINP in BALF from patients with diffuse chronic lung diseases may be a more sensitive approach to assess disturbances in collagen metabolism than the determination of each single parameter. Eur Respir J., 1994Respir J., , 7, 1221Respir J., -1226

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Section: Discussionsupporting

confidence: 81%

mentioning

confidence: 99%

Simultaneous measurement of collagen type-VI-related antigen and procollagen type-III-N-propeptide levels in bronchoalveolar lavage

Schaberg¹,

Orzechowski²,

Oesterling³

et al. 1994

Eur Respir J

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“…The connective tissue constituent hyaluronan has previously been reported to be increased in the circulation of patients with SSc (36) and in BAL fluid recovered from patients with various interstitial lung diseases (35,63,64). The increased concentrations of HA in these compartments are likely to reflect an enhanced synthesis of this glycosaminoglycan, and may reflect activated or expanded fibroblast populations.…”

Section: Discussionmentioning

confidence: 99%

Eosinophil activation in systemic sclerosis

Gustafsson

Hällgren

Fredens

et al. 1991

Arthritis & Rheumatism

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Circulating levels of eosinophil cationic protein (ECP) were increased 4-fold in patients with systemic sclerosis (SSc) compared with those in healthy control subjects. There was no correlation between the ECP concentrations and laboratory indices of inflammatory activity or visceral involvement. Mean ECP levels were higher in patients with a history of occupational exposure to silica, even though patients who had no such history also had ECP levels higher than normal. The patients had increased bronchoalveolar levels of ECP, which correlated with impaired lung functioning. Skin infiltration with activated eosinophils and extracellular deposits of ECP were present in skin biopsy samples from the SSc patients. We conclude that eosinophil activation is part of the inflammatory process in SSc.The etiology of systemic sclerosis (SSc) is unknown although an increased prevalence has been reported in workers exposed to gold and silica. Most pathogenic findings in patients with SSc involve alterations in the vascular system (1-5), immunologic abnormalities (I-3,6-9), and disturbances in the regula-

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“…The inflammatory injury to lung parenchymal cells is associated with fibroblast activation and may develop into deposition of increased amounts of collagen in the interstitial space. Analysis of the broncho-alveolar lavage (BAL) fluid from patients with sarcoidosis and idiopathic pulmonary fibrosis has demonstrated an increased broncho-alveolar recovery of HYA related to the intensity of the alveolitis and the clinical severity, as indicated by pulmonary function tests and radiological criteria [16,17,18,19]. During an acute episode of farmer's lung very high amounts of HYA are recovered which are related to the intensity of the alveolitis [20,21].…”

Section: Pulmonary Conditionsmentioning

confidence: 99%

Dynamic role of hyaluronan (HYA) in connective tissue activation and inflammation

Gerdin

Hällgren

1997

Journal of Internal Medicine

124

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Gerdin B, Hällgren R (University Hospital, Uppsala, Sweden). Dynamic role of hyaluronan (HYA) in connective tissue activation and inflammation (Minisymposium: Hyaluronan). J Intern Med 1997; 242: 49–55. An increased tissue accumulation of HYA occurs in several human and experimental inflammatory conditions. Such is the case in sarcoidosis, idiopathic pulmonary fibrosis and farmer's lung in man, and experimental bleomycin‐induced lung damage in rats. Graft rejection in man and rats, experimental myocarditis in mice and myocardial infarction in rats follow the same pattern. Increased amounts of HYA also appear in gut luminal perfusion fluid in human inflammatory bowel disease. A transient accumulation of HYA is seen in wound healing, which is more sustained in fetuses. An increased accumulation of water and presentation of ligands for receptors on inflammatory cells are two consequences of the HYA accumulation.

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Hyaluronate in bronchoalveolar lavage fluid: a new marker in sarcoidosis reflecting pulmonary disease.

Cited by 105 publications

References 17 publications

Simultaneous measurement of collagen type-VI-related antigen and procollagen type-III-N-propeptide levels in bronchoalveolar lavage

Simultaneous measurement of collagen type-VI-related antigen and procollagen type-III-N-propeptide levels in bronchoalveolar lavage

Eosinophil activation in systemic sclerosis

Dynamic role of hyaluronan (HYA) in connective tissue activation and inflammation

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