1
|
Sánchez-Díez S, Munoz X, Ojanguren I, Romero-Mesones C, Espejo D, Villar A, Gómez-Olles S, Cruz MJ. YKL-40 and KL-6 Levels in Serum and Sputum of Patients Diagnosed With Hypersensitivity Pneumonitis. J Allergy Clin Immunol Pract 2022; 10:2414-2423. [PMID: 35788062 DOI: 10.1016/j.jaip.2022.06.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/16/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND YKL-40 (chitinase 3-like-1) and Krebs von den Lungen-6 (KL-6) are 2 promising biomarkers that may have an important role in the management of interstitial lung diseases (ILD). OBJECTIVE The aim of this study was to investigate the values of KL-6 and YKL-40 as biomarkers in the diagnosis and prognosis of patients with hypersensitivity pneumonitis (HP). METHODS A cross-sectional study conducted in 49 patients diagnosed with HP due to exposure to birds (n = 32) or fungi (n = 17), 48 patients with other ILD, and 67 healthy volunteers. Patients with HP were divided into fibrotic and nonfibrotic. Serum and sputum YKL-40 and KL-6 levels were determined using commercial enzyme-linked immunosorbent assay kits. Receiver operating characteristic (ROC) curves were used to determine the sensitivity and specificity of both biomarkers for the diagnosis of HP. Pulmonary function tests were performed in patients during follow-up. RESULTS KL-6 and YKL-40 levels were significantly higher in serum of patients with HP exposed to birds with a fibrotic pattern than in controls (P < .0001 and .0055, respectively). Serum KL-6 levels were also significantly higher in patients with fibrotic HP exposed to fungi compared with the control group (P = .0001). In patients with HP exposed to fungi, sputum KL-6 and YKL-40 levels were higher in those with a fibrotic pattern (P = .0289 and .016, respectively). ROC analysis showed that the range between 55-121 ng/mL for serum YKL-40 levels and 346-1441 U/mL for serum KL-6 levels had the best sensitivity and specificity for discriminating between patients with HP, healthy controls, and patients with idiopathic pulmonary fibrosis (IPF). In patients with HP, serum KL-6 levels correlated negatively with total lung capacity (r = -0.485; P = .0103) and diffusing capacity of the lungs for carbon monoxide (r = -0.534; P = .0002) at 12 months. CONCLUSIONS Both KL-6 and YKL-40 proteins seem to be capable of distinguishing patients with HP from healthy individuals and from patients with IPF. Their sensitivity and specificity confirm their potential role as biomarkers. KL-6 may also be a predictor of disease progression.
Collapse
Affiliation(s)
- Silvia Sánchez-Díez
- Pulmonology Service, Department of Medicine, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Xavier Munoz
- Pulmonology Service, Department of Medicine, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Department of Cell Biology, Physiology and Immunology, Autonomous University of Barcelona, Barcelona, Spain.
| | - Iñigo Ojanguren
- Pulmonology Service, Department of Medicine, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Christian Romero-Mesones
- Pulmonology Service, Department of Medicine, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - David Espejo
- Pulmonology Service, Department of Medicine, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Ana Villar
- Pulmonology Service, Department of Medicine, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain
| | - Susana Gómez-Olles
- Pulmonology Service, Department of Medicine, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - María-Jesús Cruz
- Pulmonology Service, Department of Medicine, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| |
Collapse
|
2
|
Ojanguren A, Santamaría M, Milla-Collado L, Fraile C, Gatius-Calderó S, Puy S, Boldó A, Gómez-Olles S, Boada-Pérez M, Esquinas C, Sáez-Giménez B, Ojanguren I, Barrecheguren M, Olsina-Kissler JJ. Pilot Trial of Extended Hypothermic Lung Preservation to Analyze Ischemia-reperfusion Injury in Pigs. Arch Bronconeumol 2021; 57:479-489. [PMID: 35698954 DOI: 10.1016/j.arbr.2021.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/03/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND In lung transplantation (LT), the length of ischemia time is controversial as it was arbitrarily stablished. We ought to explore the impact of extended cold-ischemia time (CIT) on ischemia-reperfusion injury in an experimental model. METHODS Experimental, randomized pilot trial of parallel groups and final blind analysis using a swine model of LT. Donor animals (n=8) were submitted to organ procurement. Lungs were subjected to 6h (n=4) or 12h (n=4) aerobic hypothermic preservation. The left lung was transplanted and re-perfused for 4h. Lung biopsies were obtained at (i) the beginning of CIT, (ii) the end of CIT, (iii) 30min after reperfusion, and (iv) 4h after reperfusion. Lung-grafts were histologically assessed by microscopic lung injury score and wet-to-dry ratio. Inflammatory response was measured by determination of inflammatory cytokines. Caspase-3 activity was determined as apoptosis marker. RESULTS We observed no differences on lung injury score or wet-to-dry ratio any given time between lungs subjected to 6h-CIT or 12h-CIT. IL-1β and IL6 showed an upward trend during reperfusion in both groups. TNF-α was peaked within 30min of reperfusion. IFN-γ was hardly detected. Caspase-3 immunoexpression was graded semiquantitatively by the percentage of stained cells. Twenty percent of apoptotic cells were observed 30min after reperfusion. CONCLUSIONS We observed that 6 and 12h of CIT were equivalent in terms of microscopic lung injury, inflammatory profile and apoptosis in a LT swine model. The extent of lung injury measured by microscopic lung injury score, proinflammatory cytokines and caspase-3 determination was mild.
Collapse
Affiliation(s)
- Amaia Ojanguren
- Thoracic Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain; Thoracic Surgery Department, Lausanne University Hospital, Lausanne, Switzerland.
| | - Maite Santamaría
- General Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain
| | - Lucía Milla-Collado
- Thoracic Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain
| | - Carlos Fraile
- Thoracic Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain
| | | | - Sara Puy
- Centre de Reserca Experimental Biomèdica Aplicada (CREBA), IRBLleida, Lleida, Spain
| | - Alba Boldó
- Centre de Reserca Experimental Biomèdica Aplicada (CREBA), IRBLleida, Lleida, Spain
| | - Susana Gómez-Olles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Meritxell Boada-Pérez
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Esquinas
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Berta Sáez-Giménez
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Iñigo Ojanguren
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Miriam Barrecheguren
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | |
Collapse
|
3
|
Ojanguren A, Santamaría M, Milla-Collado L, Fraile C, Gatius-Calderó S, Puy S, Boldó A, Gómez-Olles S, Boada-Pérez M, Esquinas C, Sáez-Giménez B, Ojanguren I, Barrecheguren M, Olsina-Kissler JJ. Pilot Trial of Extended Hypothermic Lung Preservation to Analyze Ischemia-reperfusion Injury in Pigs. Arch Bronconeumol 2021:S0300-2896(21)00106-X. [PMID: 33849720 DOI: 10.1016/j.arbres.2021.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/26/2021] [Accepted: 03/03/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND In lung transplantation (LT), the length of ischemia time is controversial as it was arbitrarily stablished. We ought to explore the impact of extended cold-ischemia time (CIT) on ischemia-reperfusion injury in an experimental model. METHODS Experimental, randomized pilot trial of parallel groups and final blind analysis using a swine model of LT. Donor animals (n=8) were submitted to organ procurement. Lungs were subjected to 6h (n=4) or 12h (n=4) aerobic hypothermic preservation. The left lung was transplanted and re-perfused for 4h. Lung biopsies were obtained at (i) the beginning of CIT, (ii) the end of CIT, (iii) 30min after reperfusion, and (iv) 4h after reperfusion. Lung-grafts were histologically assessed by microscopic lung injury score and wet-to-dry ratio. Inflammatory response was measured by determination of inflammatory cytokines. Caspase-3 activity was determined as apoptosis marker. RESULTS We observed no differences on lung injury score or wet-to-dry ratio any given time between lungs subjected to 6h-CIT or 12h-CIT. IL-1β and IL6 showed an upward trend during reperfusion in both groups. TNF-α was peaked within 30min of reperfusion. IFN-γ was hardly detected. Caspase-3 immunoexpression was graded semiquantitatively by the percentage of stained cells. Twenty percent of apoptotic cells were observed 30min after reperfusion. CONCLUSIONS We observed that 6 and 12h of CIT were equivalent in terms of microscopic lung injury, inflammatory profile and apoptosis in a LT swine model. The extent of lung injury measured by microscopic lung injury score, proinflammatory cytokines and caspase-3 determination was mild.
Collapse
Affiliation(s)
- Amaia Ojanguren
- Thoracic Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain; Thoracic Surgery Department, Lausanne University Hospital, Lausanne, Switzerland.
| | - Maite Santamaría
- General Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain
| | - Lucía Milla-Collado
- Thoracic Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain
| | - Carlos Fraile
- Thoracic Surgery Department, Arnau de Vilanova University Hospital, Lleida, Spain
| | | | - Sara Puy
- Centre de Reserca Experimental Biomèdica Aplicada (CREBA), IRBLleida, Lleida, Spain
| | - Alba Boldó
- Centre de Reserca Experimental Biomèdica Aplicada (CREBA), IRBLleida, Lleida, Spain
| | - Susana Gómez-Olles
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Meritxell Boada-Pérez
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Esquinas
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Berta Sáez-Giménez
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Iñigo Ojanguren
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | - Miriam Barrecheguren
- Pneumology Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
| | | |
Collapse
|
4
|
Mendoza-Valderrey A, Gómez-Olles S, Gonzalo R, Sánchez-Pla A, Hernández-Fuentes MP, Escobar R, Berastegui C, Sáez B, Solé A, Zurbano F, De La Torre M, Laporta R, Redel J, Román A. Integrated mRNA and miRNA expression profiling of long-term survivors with normal allograft function after lung transplantation. Transplantation 2019. [DOI: 10.1183/13993003.congress-2019.pa3354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
5
|
Mendoza-Valderrey A, Gómez-Olles S, Sánchez-Pla A, Gonzalo R, Hernández-Fuentes MP, Escobar R, Berastegui C, Sáez B, Solé A, Zurbano F, De La Torre M, Laporta R, Redel J, Román A. Immunophenotype and gene signature of long-term survivors with normal allograft function after lung transplantation. Transplantation 2019. [DOI: 10.1183/13993003.congress-2019.pa3355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
6
|
Mendoza-Valderrey A, Sáez B, Hernández-Fuentes M, Pereira-Veiga T, Escobar R, Berastegui C, Rebollo-Mesa I, Solé A, Zurbano F, de la Torre M, Laporta R, Redel J, Gómez-Olles S, Román A. Identification of Leukocyte Subpopulations as Potential Biomarkers of Long-term Survival With Normal Allograft Function After Lung Transplantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
7
|
Cruz MJ, Alvarez-Simón D, Gómez-Olles S, Muñoz X. Estudios inmunológicos y pruebas de provocación bronquial específicas, técnicas esenciales para el diagnóstico de neumonitis por hipersensibilidad. Med Clin (Barc) 2014; 143:328-9. [DOI: 10.1016/j.medcli.2013.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 09/22/2013] [Accepted: 09/26/2013] [Indexed: 11/15/2022]
|