The role of infection in acute exacerbation of Idiopathic Pulmonary Fibrosis

Wu, Dong; Li, Huiping

doi:10.1183/13993003.congress-2018.pa2913

Cited by 4 publications

(8 citation statements)

References 31 publications

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“…Moreover, high and low concentrations of IL-8 in plasma are correlated with a median survival of 1.9 and 5.1 years, respectively 41 . And mortality was increased by 6.7% for each 1 pg/mL in serum concentrations of IL-8 38,39 .…”

Section: Interleukins and Pulmonary Fibrosis In Clinical Researchmentioning

confidence: 95%

“…Interleukin levels not only change between subjects with and without pulmonary fibrosis, but also between different stages of pulmonary fibrosis. For example, peripheral blood levels of IL-6 and IL-9 increased in patients with acute exacerbation IPF (AE-IPF), compared with those with stable IPF 38 , 39 .…”

Section: Interleukins and Pulmonary Fibrosis In Clinical Researchmentioning

confidence: 99%

“… Interleukin Group Sample Method Fold change Ref. IL-1β IPF vs. HC BALF ELISA ↑, 2.23 36 IL-2 IPF vs. HC Serum ELISA ↑, 10 37 IL-6 AE-IPF vs. HC Serum Protein microarray analysis ↑, 1.36 39 AE-IPF vs. stable IPF Serum ↑, 1.19 39 IL-8 IPF vs. HC Serum ELISA ↑, 2.67 37 IPF vs. HC Serum and BALF ELISA ↑, >10 40 IL-9 AE-IPF vs. stable IPF Serum Protein microarray analysis ↑, 1.50 39 IL-10 IPF vs. HC Serum ELISA ↑, 10.12 37 IL-12 IPF vs. HC Serum ELISA ↑, 6.92 37 IL-17A IPF vs. HC BALF ELISA ↑, 9.67 36 IL-33 IPF vs. HC BALF ELISA ↑, 3.59 42 AE-IPF acute exacerbation-idiopathic pulmonary fibrosis, BALF bronchoalveolar lavage fluid, HC healthy control, IPF idiopathic pulmonary fibrosis. …”

Section: Interleukins and Pulmonary Fibrosis In Clinical Researchmentioning

confidence: 99%

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Role of interleukins in the pathogenesis of pulmonary fibrosis

2021

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Interleukins, a group of cytokines participating in inflammation and immune response, are proved to be involved in the formation and development of pulmonary fibrosis. In this article, we reviewed the relationship between interleukins and pulmonary fibrosis from the clinical, animal, as well as cellular levels, and discussed the underlying mechanisms in vivo and in vitro. Despite the effects of interleukin-targeted treatment on experimental pulmonary fibrosis, clinical applications are lacking and unsatisfactory. We conclude that intervening in one type of interleukins with similar functions in IPF may not be enough to stop the development of fibrosis as it involves a complex network of regulation mechanisms. Intervening interleukins combined with other existing therapy or targeting interleukins affecting multiple cells/with different functions at the same time may be one of the future directions. Furthermore, the intervention time is critical as some interleukins play different roles at different stages. Further elucidation on these aspects would provide new perspectives on both the pathogenesis mechanism, as well as the therapeutic strategy and drug development.

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Section: Interleukins and Pulmonary Fibrosis In Clinical Researchmentioning

confidence: 95%

Section: Interleukins and Pulmonary Fibrosis In Clinical Researchmentioning

confidence: 99%

Section: Interleukins and Pulmonary Fibrosis In Clinical Researchmentioning

confidence: 99%

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Role of interleukins in the pathogenesis of pulmonary fibrosis

2021

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“…More recently, Weng et al examined the sputum cultures of 170 patients with AE-IPF [ 47 ]. Gram-negative bacteria were found to dominate, consisting the 89% of the 38 different strains that have been found.…”

Section: Lung Microbiome In Acute Exacerbation Of Ipfmentioning

confidence: 99%

“…Gram-negative bacteria were found to dominate, consisting the 89% of the 38 different strains that have been found. Specifically, Klebsiella pneumonia accounted for 26%, Mycobacteria tuberculosis for 21% and Acinetobacter baumannii for 10% of the total strains [ 47 ].…”

Section: Lung Microbiome In Acute Exacerbation Of Ipfmentioning

confidence: 99%

The Role of Microbiome and Virome in Idiopathic Pulmonary Fibrosis

et al. 2021

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The interest in the lung microbiome and virome and their contribution to the pathogenesis, perpetuation and progression of idiopathic pulmonary fibrosis (IPF) has been increasing during the last decade. The utilization of high-throughput sequencing to detect microbial and/or viral genetic material in bronchoalveolar lavage fluid or lung tissue samples has amplified the ability to identify and quantify specific microbial and viral populations. In stable IPF, higher microbial burden is associated with worse prognosis but no specific microbe has been identified to contribute to this. Additionally, no causative relation has been established. Regarding viral infections, although in the past they have been associated with IPF, causation has not been proved. Although in the past the diagnosis of acute exacerbation of IPF (AE-IPF) was not considered in patients with overt infection, this was amended in the last few years and infection is considered a cause for exacerbation. Besides this, a higher microbial burden has been found in the lungs of patients with AE-IPF and an association with higher morbidity and mortality has been confirmed. In contrast, an association of AE-IPF with viral infection has not been established. Despite the progress during the last decade, a comprehensive knowledge of the microbiome and virome in IPF and their role in disease pathogenesis are yet elusive. Although association with disease severity, risk for progression and mortality has been established, causation has not been proven and the potential use as a biomarker or the benefits of antimicrobial therapeutic strategies are yet to be determined.

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Utility of illness severity scores to predict mortality in patients hospitalized with respiratory deterioration of idiopathic pulmonary fibrosis

Hyams

Hettle

Bibby

et al. 2020

QJM: An International Journal of Medicine

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Abstract Introduction In the context of IPF, respiratory related admissions to hospital are associated with a high morbidity and short-term mortality with significant burden on secondary care services. It has yet to be determined how to accurately identify patients at risk of acute respiratory deterioration (ARD) or the prognosticating factors. Objective We sought to define the characteristics of hospitalised ARD-IPF patients in a real-world cohort and investigate factors associated with worse outcomes. Specifically, we wished to determine the association between baseline CURB-65 and NEWS2 and mortality in IPF, given illness severity scores have not previously been validated in this cohort. Methods Single-centre retrospective observational cohort study. Results Of 172 first hospitalisations for ARD, 27 admissions (15.7%) were due to an acute exacerbation of IPF (AE-IPF), 28 (16.3%) secondary to cardiac failure/fluid overload and 17 due to pneumonia (9.9%). Other admissions related to lower respiratory tract infection, extra-parenchymal causes and those without a specific trigger. Baseline patient characteristics were comparable for all underlying aetiologies of ARD-IPF. Treatment pathways did not differ significantly between AE-IPF and other causes of ARD-IPF. Short term mortality was high, with approximately 22% patients dying within 30 days. Illness severity scores (NEWS-2 and CURB-65) were independent predictors of mortality in multivariable logistic regression modelling. Conclusions Our findings suggest significant mortality related to hospitalisation with ARD-IPF of any underlying cause. Our data supports the use of CURB-65 and NEWS-2 scores as illness severity scores that can provide a simple tool to help future prognostication in IPF. Research should be aimed at refining the management of these episodes, to try to reduce mortality, where possible, or to facilitate palliative care for those with adverse prognostic characteristics.

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The role of infection in acute exacerbation of Idiopathic Pulmonary Fibrosis

Cited by 4 publications

References 31 publications

Role of interleukins in the pathogenesis of pulmonary fibrosis

Role of interleukins in the pathogenesis of pulmonary fibrosis

The Role of Microbiome and Virome in Idiopathic Pulmonary Fibrosis

Utility of illness severity scores to predict mortality in patients hospitalized with respiratory deterioration of idiopathic pulmonary fibrosis

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