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Bronchoalveoloar lavage fluid cytokines and chemokines as markers and predictors for the outcome of interstitial lung disease in systemic sclerosis patients
Arthritis Research & Therapy, 07/21/09

Schmidt K et al. – The association of bronchoalveolar fluids (BALF) cytokines with lung fibrosis and its progress suggests that cytokines contribute to the pathogenesis of interstitial lung disease (ILD) and hence could be regarded as potential therapeutic targets.

Methods

Aim was to identify specific changes in cytokine levels which may serve as disease markers and possible targets for therapy in pts with SSc
Cytokines were measured by bioplex analysis in 38 BALF from 32 SSc pts and 26 controls
In case of SSc pts, cytokines were correlated with the respective bronchoalveolar lavage (BAL) cell differentiation, lung function, and thoracic HR-CT score
For 35 BALF samples derived from 29 SSc pts, f/u investigations of clinical data, lung function parameter, or thoracic HR-CT scans were available to evaluate the predictive capacity of BALF cytokines and chemokines

Results

High IL-7 levels were characteristic for SSc-associated ILD
When compared to ILD-negative SSc pts, ILD-positive SSc pts revealed higher IL-4, IL-6, IL-8, and CCL2 (MCP-1) BALF levels
High CCL2 and IL-8 BALF concns were associated with neutrophilic and mixed alveolitis
Cytokine levels of IL-4, IL-8, and CCL2 correlated negatively with lung function parameters
CCL2 concns also correlated with HR-CT score
High concns of several cytokines were associated with the progress of ILD and end-stage ILD
Univariate analyses: high IL-2 and TNF-α levels as best predictors for progressive disease, together with lung function parameters, young age, and neutrophilic alveolitis
Multivariate analyses: confirmed these results but did not sufficiently converge due to the limited number of pts

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