TGF-β1、PDGF、VEGF评估吡非尼酮治疗特发性肺纤维化的临床疗效观察

目的TGF-β1、PDGF、VEGF作为评估吡非尼酮治疗特发性肺纤维化患者的可行性。方法选择2014年10月至2019年2月在我院呼吸内科收治的72例特发性肺纤维化患者,随机将患者分为观察组(36例)和对照组(36例),其中,观察组患者给予吡非尼酮治疗;对照组患者常规给予甲强龙治疗。比较两组患者治疗前后TGF-β1、PDGF、VEGF表达变化;观察两组治疗方案对肺功能、血氧分压及复发率影响;进一步分析观察组治疗前后TGF-β1、PDGF、VEGF与肺功能的相关性。结果对照组治疗前后血清中TGF-β1、PDGF、VEGF表达水平无明显变化,无统计学意义(P>0.05);观察组经吡非尼酮治疗后,血清中TGF-β1、PDGF、VEGF较治疗前表达水平下降且具有统计学意义(P<0.05)。对照组治疗前后肺功能检查结果FEV 1、FEV 1/FVC、DLCO%及血氧分压改善情况差异不大,且无统计学意义(P>0.05);观察组治疗前后上述检测结果明显改变,且治疗后效果明显优异于对照组,均具有统计学意义(P<0.05)。治疗半年后随访,观察组患者复发率为8.33%,对照组患者复发率为33.33%,两组患者复发率具有统计学意义(P<0.05)。观察组治疗前后TGF-β1、PDGF、VEGF表达水平与FEV 1、FEV 1/FVC、DLCO%呈负相关,具有统计学意义(P<0.05)。结论吡非尼酮治疗特发性肺纤维化患者效果显著,且血清TGF-β1、PDGF、VEGF表达水平可作为评估吡非尼酮治疗效果指标,值得临床推广使用。     

CXCL14、TGF-β1和CTGF水平与特发性肺纤维化的关系

目的探讨血清趋化因子配体14(CXCL14)、转化生长因子β1(TGF-β1)和结缔组织生长因子(CTGF)水平与特发性肺纤维化(IPF)的关系。 方法选取2018年4月至2020年6月我院收治的79例IPF患者作为观察组对象,另选取65例同期其他住院患者作为对照组。观察组患者于入院时、对照组患者住院当日清晨采集4 ml空腹静脉血,检测血清CXCL14TGF-β1和CTGF水平,记录患者肺功能指标,评估患者胸部高分辨率CT(HRCT)评分、改良呼吸困难量表mMRC评分。将肺功能指标、HRCT评分、mMRC评分作为评估患者病情严重程度。采用Pearson法分析血清趋化因子配体14、TGF-β1和CTGF水平与IPF患者病情严重程度的相关性。 结果观察组血清CXCL14、TGF-β1、CTGF水平均高于对照组(P<0.05);观察组FVC、TLC、FEV₁水平均低于对照组(P<0.05);IPF患者血清CXCL14、TGF-β1、CTGF水平与FVC、TLC、FEV1%呈负相关(P<0.05);IPF患者HRCT评分为(6.29±1.20)分,mMRC评分为(3.18±1.16)分;IPF患者血清CXCL14、TGF-β1、CTGF水平与HRCT评分、mMRC评分呈正相关(P<0.05)。 结论IPF患者血清CXCL14、TGF-β1、CTGF水平与HRCT评分、mMRC评分及肺功能指标均存在相关性。     

KL-6、IGFBP-4在特发性肺纤维化患者支气管肺泡灌洗液和血清中的表达及意义

目的探讨涎液化糖链蛋白6(KL-6)、胰岛素样生长因子结合蛋白4(IGFBP-4)在特发性肺纤维化(IPF)患者支气管肺泡灌洗液和血清中的表达水平及临床意义。方法选择2012年1月-2015年12月我院诊治的37例IPF患者作为IPF组,19例Ⅰ期肺结节病患者作为对照组,采用酶联免疫吸附法检测2组患者支气管肺泡灌洗液和血清中的KL-6与IGFBP-4水平,分析2组患者肺功能、细胞学计数的差异及KL-6与IGFBP-4水平与肺功能的相关性。结果 IPF患者肺支气管肺泡灌洗液(BLAF)中巨噬细胞百分数明显高于对照组(P0.05);淋巴细胞百分数明显少于对照组(P0.05);IPF组患者BALF中的KL-6、IGFBP-4水平均明显高于对照组(P0.05);IPF组患者血清中的KL-6水平明显高于对照组(P0.05),但IGFBP-4水平与对照组无明显差异(P0.05);IPF组患者血清KL-6水平与FVC%和DLCO%pred均呈负相关(r=-0.426,P0.05;r=-0.541,P0.05);IPF组患者BALF中IGFBP4水平与FEV_1%、FVC%呈显著负相关(r=-0.549,P0.05;r=-0.517,P0.05),血清中IGFBP4水平与FEV_1%呈显著正相关(r=0.461,P0.05)。IPF组患者的BLAF和血清KL-6、IGFBP-4水平与巨噬细胞百分比无明显相关性。结论 IPF患者BALF和血清中KL-6、IGFBP-4水平均增高,且与患者的肺功能相关,KL-6、IGFBP-4之间呈现正相关关系,可作为IPF患者病情监测及疗效判断的评价指标。     

孟鲁司特钠对老年支气管哮喘患者血清血管内皮生长因子、转化生长因子β1的影响

目的探讨孟鲁司特钠对老年支气管哮喘患者血清血管内皮生长因子(VEGF)、转化生长因子(TGF)-β1的影响。方法选择老年支气管哮喘患者140例,根据随机数字表法分为孟鲁司特钠组(观察组)和对照组,每组70例,对照组给予舒利迭治疗,观察组给予舒利迭+孟鲁司特钠治疗,共12 w。判定疗效,肺功能检测仪测量治疗前后肺功能,酶联免疫吸附法(ELISA)测定治疗前后血清VEGF、TGF-β1水平。结果观察组总有效率明显高于对照组(P0.05)。治疗前,观察组和对照组第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、呼气峰值流速(PEF)和血清VEGF、TGF-β1水平比较差异无统计学意义(P0.05);治疗后,观察组FVC、FEV1、PEF均明显高于对照组(P0.05),观察组血清VEGF、TGF-β1水平均明显低于对照组(P0.05)。血清VEGF、TGF-β1水平与FVC、FEV1、PEF均呈负相关(P0.05)。结论孟鲁司特钠通过降低血清VEGF、TGF-β1水平增强老年支气管哮喘的治疗效果。     

外周血IGF-1、PAI-1和TGF-β1在肺间质纤维化合并肺气肿患者中的表达及意义分析

目的探讨肺间质纤维化合并肺气肿(CPFE)患者血清胰岛素样生长因子-1(IGF-1)、纤溶酶原激活物抑制物-1(PAI-1)及转化生长因子-β1(TGF-β1)表达水平,探讨其在疾病诊治及病情评估等方面的临床意义。方法选取2018年6月—2019年6月四川省绵阳市中心医院呼吸科收治的CPFE患者40例(CPFE组),并选取同期特发性肺间质纤维化(IPF)患者40例(IPF组)和肺气肿患者40例(肺气肿组)作为对照,检测并比较三组血清IGF-1、PAI-1、TGF-β1表达水平的差异,并分析三种细胞因子浓度与吸烟指数、血气分析及肺功能指标的相关性。结果CPFE组、IPF组血清IGF-1、PAI-1、TGF-β1水平均明显高于肺气肿组(P0.05),CPFE组与IPF组之间比较差异无统计学意义(P0.05)。CPFE组与肺气肿组血清IGF-1、PAI-1、TGF-β1均与吸烟指数呈正相关(P0.05)。CPFE组血清IGF-1与第一秒用力呼气容积(FEV1%)、用力肺活量(FVC%)、一氧化碳弥散量(DLCO%)水平均呈负相关(P0.05),PAI-1与FEV1%、DLCO%呈负相关(P0.05),TGF-β1与DLCO%呈负相关(P0.05);IPF组血清IGF-1与FVC%、DLCO%呈负相关(P0.05),PAI-1与DLCO%呈负相关(P0.05);肺气肿组血清IGF-1、PAI-1、TGF-β1与肺功能指标均无明显相关性(P均0.05)。三组血清IGF-1、PAI-1、TGF-β1与PaO2均无明显相关性(P均0.05)。结论 CPFE患者血清IGF-1、PAI-1、TGF-β1表达水平升高,这三项指标有望成为疾病病情监测、疗效评估甚至是靶向治疗的客观指标。     

VEGF和IMT测定对OSAS的临床意义

目的探讨血管内皮生长因子(VEGF)、颈动脉内膜中层厚度(IMT)与OSAS患者的关系。方法选取男性OS-AS患者30例和体检正常者25例进行多导睡眠监测,评估呼吸暂停低通气指数(AHI)、夜间缺氧时间、最低血氧饱和度差异。同时,检测外周血中的VEGF水平和颈动脉内膜中层厚度(IMT),并分析其差异及与睡眠监测指标相关性。结果与对照组比较,OSAS患者呼吸暂停低通气指数(AHI)、夜间缺氧时间、IMT、VEGF较明显增高,最低血氧饱和度明显降低,差异有统计学意义(P均<0.05);相关性分析显示,血浆VEGF与AHI、夜间缺氧时间正相关(P<0.05),与最低血氧饱和度负相关(P<0.05)。颈动脉IMT与AHI正相关(P<0.05),与最低血氧饱和度负相关(P<0.05)。结论 VEGF可能在OSAS患者发病中起重要作用,为早期预防OSAHS患者心血管合并症提供新思路。     

成年烟雾病患者血清血管细胞黏附分子1、基质金属蛋白酶9、转化生长因子β、血管内皮生长因子水平变化及其临床意义研究

背景目前,烟雾病(MMD)的病因及发病机制尚不完全明确,此类患者通常在发生脑血管事件后才被确诊,因此探讨MMD的预测因子及评估其严重程度的指标具有重要的临床意义。目的探讨成年MMD患者血清血管细胞黏附分子1(VCAM-1)、基质金属蛋白酶9(MMP-9)、转化生长因子β(TGF-β)、血管内皮生长因子(VEGF)水平及其临床意义。方法选取2016年3月-2019年1月四川大学华西广安医院收治的成年MMD患者114例作为病例组,其中缺血型68例,出血型46例;另选取同期在本院门诊健康体检中心体检健康者30例作为对照组。比较对照组受试者体检当日与病例组患者入院第1天血清VCAM-1、MMP-9、TGF-β、VEGF水平,比较出血型与缺血型患者入院第1、7、14天血清VCAM-1、MMP-9、TGF-β、VEGF水平,并比较不同Suzuki分级成年MMD患者入院第1天血清VCAM-1、MMP-9、TGF-β、VEGF水平;成年MMD患者入院第1天血清VCAM-1、MMP-9水平与血清TGF-β、VEGF水平的相关性分析采用Pearson相关分析。结果病例组患者入院第1天血清VCAM-1、MMP-9、TGF-β、VEGF水平高于对照组(体检当日)(P<0.05)。时间与方法在血清VCAM-1、MMP-9水平上不存在交互作用(P>0.05),在血清TGF-β、VEGF水平上存在交互作用(P<0.05);时间在血清VCAM-1、MMP-9、TGF-β、VEGF水平上主效应显著(P<0.05);方法在血清VCAM-1、MMP-9水平上主效应不显著(P>0.05),在血清TGF-β、VEGF水平上主效应显著(P<0.05);出血型患者入院第1、7、14天血清TGF-β、VEGF水平高于缺血型患者(P<0.05)。Suzuki分级3级缺血型患者血清入院第1天MMP-9、VEGF水平高于Suzuki分级2级患者,Suzuki分级3级出血型患者入院第1天血清VEGF水平高于Suzuki分级2级患者(P<0.05);Suzuki分级4级缺血型、出血型患者入院第1天血清VCAM-1、MMP-9、TGF-β、VEGF水平分别高于Suzuki分级2、3级缺血型、出血型患者(P<0.05);Suzuki分级5、6级缺血型、出血型患者入院第1天血清VCAM-1、MMP-9、TGF-β、VEGF水平分别高于Suzuki分级2、3、4级缺血型、出血型患者(P<0.05);Suzuki分级6级缺血型、出血型患者入院第1天血清VEGF水平分别高于Suzuki分级5级缺血型、出血型患者(P<0.05)。Pearson相关分析结果显示,缺血型、出血型MMD患者入院第1天血清VCAM-1、MMP-9水平分别与血清TGF-β、VEGF水平呈正相关(P<0.05)。结论缺血型和出血型成年MMD患者血清VCAM-1、MMP-9、TGF-β、VEGF水平均异常升高,且均与患者病情严重程度相关;血清VCAM-1、MMP-9水平分别与缺血型、出血型MMD患者血清TGF-β、VEGF水平呈正相关,VCAM-1、MMP-9可能参与了成年MMD患者颅内出血过程。     

冰硝散治疗痔术后水肿患者疗效观察及对血清PDGF、bFGF、VEGF和肛肠动力学影响

目的:探讨冰硝散外敷治疗痔术后水肿患者疗效及对血清血小板源性生长因子(PDGF)、碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子(VEGF)和肛肠动力学的影响。方法:选择2019年12月—2021年3月混合痔术后水肿患者80例,依据随机数字表法分为观察组40例与对照组40例。对照组口服地奥司明片,观察组在对照组基础上给予冰硝散外敷治疗。比较2组治疗疗效,肛门下坠和便血缓解时间,术后第1天和术后第7天的水肿评分、视觉模拟评分法(VAS)评分、PDGF、bFGF、VEGF水平及肛肠动力学变化。结果:观察组治疗总有效率(95.00%)高于对照组(80.00%)(P<0.05)。2组术后第7天水肿、VAS评分低于手术后第1天(P<0.05);观察组术后第7天水肿、VAS评分值低于对照组(P<0.05)。观察组肛门下坠和便血缓解时间短于对照组(P<0.05)。2组术后第7天血清PDGF、bFGF、VEGF水平高于第1天(P<0.05);观察组术后第7天血清PDGF、bFGF、VEGF水平高于对照组(P<0.05)。2组术后第7天RRP、ARP和AMCP高...     

肿瘤生长因子β1及血小板衍生生长因子对肝窦内皮细胞整合素α631及黏着斑激酶表达的影响

目的观察肿瘤生长因子β1(TGFβ1)及血小板衍生生长因子(PDGF)对大鼠肝窦内皮细胞(sinusoidal endothelial cell,SEC)整合素α6β1表达及黏着斑激酶(focal adhesion kinase,FAK)活性的影响.方法用胶原酶原位灌注、Percoll不连续密度梯度离心法分离大鼠SEC,并进行体外培养.采用细胞-ELISA和免疫沉淀蛋白质酪氨酸激酶活性测定法,分别观察TGFβ1及PDGF对SEC表面整合素α6β1表达及FAK活性的影响.结果经TGFβ1及PDGF作用24 h后,α6β1蛋白表达明显强于对照组(P＜0.05),且呈剂量依赖性.作用至48 h,表达继续增强,细胞中FAK的活性也明显增高(P＜0.05),虽于48 h后回落,但仍明显高于对照组.结论 TGFβ1及PDGF可促进SEC表面整合素α6β1的表达及FAK活性增高,可能是它们参与肝纤维化发生的机制之一.     

非小细胞肺癌患者血清血管内皮生长因子、血小板衍生生长因子和表皮生长因子受体测定的临床意义

目的 探讨血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、血小板衍生生长因子(platelet-derived growth factor,PDGF)和表皮生长因子受体(epidermal growth factor receptor,EGFR)测定在非小细胞肺癌(non-small cell lung cancer,NSCLC)诊断和预后判定中的意义.方法 采用双抗体夹心ABC-ELISA法测定31例NSCLC患者及30名健康者血清VEGF、PDGF和EGFR的含量.结果 NSCLC患者血清VEGF、PDGF和EGFR测定值均高于健康对照组(P值均＜0.01).血清VEGF、PDGF和EGFR测定值与NSCLC病理分型无关(P值均＞0.05),与远处转移有关,远处转移组的测定值高于未转移组(P＜0.05～0.01).NSCLC患者血清VEGF与PDGF测定值之间呈显著正相关(r=0.641,P＜0.01),血清VEGF和EGFR测定值呈正相关(r=0.369,P＜0.05).结论 检测血清VEGF、PDGF和EGFR水平对NSCLC的诊断和预后判定具有一定价值.     

Serum levels of platelet-derived growth factor-BB and vascular endothelial growth factor as prognostic factors for patients with fulminant hepatic failure

Background and Aims: In animal models for acute liver injury, the administration of some angiogenic factors such as vascular endothelial growth factor (VEGF) and granulocyte‐colony stimulating factor (G‐CSF) are shown to reduce liver injury and improve liver proliferative capacity. The aim of the present study was to assess the role of angiogenic factors in fulminant hepatic failure (FHF). Methods: Serum levels of nine angiogenic factors (angiopoietin‐2, follistatin, G‐CSF, hepatocyte growth factor [HGF], interleukin‐8, leptin, platelet‐derived growth factor [PDGF]‐BB, platelet endothelial cell adhesion molecule‐1 and VEGF) were measured using the Bio‐Plex Protein Array System in 30 patients, 17 of whom were diagnosed with FHF, 13 with acute hepatitis (AH), and 20 controls. Results: Serum levels of PDGF‐BB and VEGF were lower in FHF patients than AH patients and controls (PDGF‐BB; 2050 ± 1572 pg/mL vs 4521 ± 2419 pg/mL vs 8506 ± 5500 pg/mL, VEGF; 39 ± 38 pg/mL vs 144 ± 122 pg/mL vs 205 ± 121 pg/mL). By using univariate logistic regression models, serum levels of PDGF‐BB and VEGF were associated with poor outcomes. Serum PDGF‐BB levels were strongly correlated with serum VEGF levels (r = 0.70). Furthermore, serum PDGF‐BB levels were significantly correlated with platelet counts (r = 0.79), PT activity (r = 0.37) and D.Bil/T.Bil ratio (r = 0.50), while serum VEGF levels were significantly correlated with platelet counts (r = 0.68) and PT activity (r = 0.38). Conclusions: We consider that serum levels of PDGF‐BB and VEGF are worth investigating as biomarkers for predicting outcomes of FHF patients.     

哮喘大鼠支气管肺泡灌洗液中血管内皮生长因子和血小板源性生长因子的变化及缬沙坦的干预

目的观察血管内皮生长因子（VEGF）和血小板源性生长因子（PDGF）在哮喘大鼠支气管肺泡灌洗液（BALF）中的变化，探讨两者与哮喘气道重塑的关系以及缬沙坦的干预作用。方法50只Wistar大鼠随机分成5组，每组10只：A组（正常对照组）、B组（哮喘组）、C组[15mg／（kg·d）缬沙坦]、D组[30mg／（kg·d）缬沙坦]和E组[50mg／（kg·d）缬沙坦]。分别观察各组肺组织切片的病理改变，用酶联免疫吸附法（EHSA）检测各组大鼠BALF中VEGF和PDGF的水平。结果哮喘大鼠肺组织出现了气道重塑的病理改变；与A组比，B组BALF中VEGF和PDGF水平显著增高（P〈0．01），与B组比，缬沙坦干预后的C组、D组和E组BALF中VEGF和PDGF均显著减少（P〈0．05或P〈0．01）。结论VEGF和PDGF在哮喘大鼠BALF中浓度增高，可能参与了哮喘发病和气道重塑过程。缬沙坦能明显降低哮喘大鼠BALF中VEGF和PDGF的水平，有助于改善哮喘大鼠气道重塑的病理生理过程，其作用机理还有待进一步研究。     

肝细胞癌患者肝动脉化疗栓塞术前后血清TGFβ1、VEGF、bFGF浓度变化

目的：观察肝细胞癌患者肝动脉化疗栓塞术（TACE）前后血清转化生长因子（TGFβ1）、血管内皮生长因子（VEGF）和碱性成纤维细胞生长因子（bFGF）的浓度变化。方法：随机选择64例经病理确诊的肝细胞癌（HCC）患者,按照单纯随机抽样法均分为实验组和对照组,两组患者治疗药物相同,实验组患者行TACE术,对照组患者静脉注射化疗药物。用双抗体夹心酶联免疫吸附试验法检测两组患者TACE术前3天和术后两周血清TGFβ1、VEGF、bFGF浓度。结果：治疗后两周患者血清TGFβ1、VEGF、bFGF浓度均升高;与治疗前比较,差异有显著性意义（P〈0.05）。结论：TACE的远期疗效欠佳,可能是其引起HCC患者血清TGFβ1、VEGF、bFGF过表达,导致肿瘤血管增生、侧枝循环形成以及机体的免疫反应被抑制。     

血管内皮生长因子水平与大鼠支气管哮喘模型发病机制关系的研究

目的 探讨大鼠支气管哮喘(简称哮喘)模型支气管肺泡灌洗液(BALF)中血管内皮生长因子(VEGF)水平与哮喘嗜酸粒细胞(EOS)炎症及气道血管通透性之间的关系,以及吸入性激素的作用.方法 SD大鼠18只,随机分为对照组,哮喘模型组和地塞米松干预组各6只.以腹腔注射1%卵蛋白致敏和2%卵蛋白雾化吸入激发复制哮喘模型,干预组在每次激发前给予地塞米松干预.检测大鼠气道反应性,BALF中EOS百分数,VEGF(酶联免疫吸附法)及气道血管渗透指数.结果 BALF中EOS百分数,VEGF水平,气道反应性及气道血管渗透指数哮喘组明显高于对照组(P<0.05或P<0.01);经过6周吸入性激素治疗后,地塞米松组BALF中VEGF水平,EOS百分数,气道反应性及气道血管渗透指数较哮喘组明显降低(P<0.05或P<0.01),与对照组比较差异无统计学意义.相关分析显示,BALF中VEGF水平与EOS百分数呈正相关(r=0.76,P<0.01);VEGF水平与气道血管渗透指数呈正相关(r=0.84,P<0.01);VEGF水平与PC50呈负相关(r=-0.68,P<0.01).结论 大鼠哮喘模型BALF中VEGF水平增高,并与气道EOS百分数,气道反应性和气道血管渗透指数密切相关.该结果提示VEGF可能在哮喘的发病机制中起着重要作用.     

血管内皮细胞生长因子在急性肺损伤大鼠中的表达及意义

目的探讨血管内皮细胞生长因子(VEGF)在脂多糖所致急性肺损伤大鼠中的表达及意义,为临床防治急性肺损伤提供参考依据。方法将40只SD大鼠随机分为LPS(脂多糖)组和NS(生理盐水)组,麻醉后气管插管,LPS组吸入LPS(3 mg/kg),NS组吸入等量NS。0h、2h、4h、6h时每组分别处死5只大鼠,抽血行血气分析,同时进行血浆VEGF水平、肺泡灌洗液(BALF)蛋白定量和VEGF水平、肺组织病理学、免疫组化以及VEGF mRNA表达水平检测。结果 LPS组2h、4h、6h时间点p H和Pa O2均明显低于NS组相应时间点,Pa CO2和肺损伤评分均明显高于NS组相应时间点(P0.05)。LPS组2h、4h、6h时间点BALF蛋白定量均明显高于NS组相应时间点(P0.05),LPS组2h、4h、6h时间点BALF和血浆VEGF定量均明显高于NS组相应时间点(P0.05)。LPS组BALF和血浆中VEGF水平与肺损伤评分均呈正相关(r=0.682和r=0.613,P0.001),BALF中VEGF水平与蛋白定量呈正相关(r=0.715,P0.001)。LPS组2h、4h、6h时间点肺组织中VEGF mRNA的表达均明显高于NS组相应时间点表达(P0.05)。结论 ALI大鼠血浆、BALF和肺组织中VEGF水平明显升高,血浆和BALF中VEGF水平与肺损伤程度呈正相关,BALF中VEGF水平与蛋白定量呈正相关,提示VEGF可能通过增加呼吸膜的通透性参与急性肺损伤发生过程。     

Association between transforming growth factor β1 and atrial fibrillation in essential hypertensive patients

Abstract

Background: Transforming growth factor β₁ (TGFβ₁) was one of the main factors for accelerating atrial fibrosis and has been reported with significantly higher level in plasma of the patients with essential hypertension (EH), especially in those with target organ damage. The contribution of TGFβ₁ in the pathogenesis of atrial fibrillation (AF) in EH patients remains unknown. Methods: 75 EH patients with documented AF were divided into the paroxysmal AF group (EH+pAF, n?=?44) or the chronic AF group (EH+cAF, n?=?31), and 37 EH patients with sinus rhythm (SR) were assigned into the EH+SR group. All data including EH duration, blood pressure, lipids, glucose and left atrial diameter (LAD) measured by ultrasonic cardiogram were recorded. The serum levels of TGFβ₁ and connective tissue growth factor (CTGF) were detected, and compared with normal controls (NC group, n?=?36). Results: The serum levels of TGFβ₁ and CTGF in all EH groups were significantly higher than those in the NC group (p?<?0.001, respectively). Among the EH groups, TGFβ₁ and CTGF levels were highest in the cAF group, followed by the pAF and the SR groups (p?<?0.005). However, no significant difference was observed in TGFβ₁ and CTGF levels between the cAF group and the pAF group. The serum TGFβ₁ in AF patients was independently correlated with LAD, the presence of AF, aldosterone, CTGF and age. Conclusion: The serum TGFβ₁ promotes CTGF synthesis and causes left atrial enlargement and remodeling, which is possibly involved in the pathogenesis of AF in EH patients.     

Clinical significance of MCP-1 levels in BALF and serum in patients with interstitial lung diseases.

It has previously been reported that the expression of monocyte chemoattractant protein-1 (MCP-1) in the lung tissues of patients with idiopathic pulmonary fibrosis (IPF) was different from that in the tissues of patients with other interstitial lung diseases (ILDs). The aim of this study was to determine whether this difference reflects the amount of MCP-1 in the bronchoalveolar lavage fluid (BALF) or serum of patients with ILD, and whether such a correlation, if it exists, is clinically useful. MCP-1 concentrations in the BALF and sera were evaluated in 86 patients with ILDs including IPF, acute interstitial pneumonia, interstitial pneumonia with collagen vascular disease (IP-CVD), chronic interstitial pneumonia (CIP), bronchiolitis obliterans-organizing pneumonia, sarcoidosis, hypersensitivity pneumonitis, and in 10 normal healthy volunteers who were controls (NC). BALF MCP-1 levels were significantly elevated in the IPF, IP-CVD, CIP and sarcoidosis groups compared with the NC group. The level in the IPF group was significantly higher than that in any other patient group. Serum MCP-1 levels in the IPF, IP-CVD, CIP and sarcoidosis groups were significantly higher than the NC group. No statistical difference was found in serum MCP-1 levels between the IPF, IP-CVD and CIP groups. BALF MCP-1 levels were significantly higher than serum MCP-1 levels in the IPF group and lower than in the IP-CVD and CIP groups. Serum MCP-1 levels correlated with the clinical course of ILD treated with corticosteroid therapy. These results show that measurement of monocyte chemoattractant protein-1 levels in both bronchoalveolar lavage fluid and serum may be helpful in discriminating idiopathic pulmonary fibrosis from other types of interstitial lung disease and that monitoring of serum monocyte chemoattractant protein-1 may be useful for predicting the clinical course of interstitial lung diseases.     

Increased serum level of vascular endothelial growth factor in Mycobacterium avium complex infection

OBJECTIVE: Pulmonary infection caused by Mycobacterium avium complex (MAC) is one of the granulomatous diseases which are associated with the expression of vascular endothelial growth factor (VEGF). The aim of the present study was to clarify the association of VEGF with the pathogenesis of MAC infection. METHODOLOGY: The serum VEGF levels in 46 patients with pulmonary MAC infection were compared with those in 16 normal control subjects. Pulmonary lesions were evaluated using chest CT. In 20 patients, after treatment, serum VEGF levels were measured and chest CT performed again to evaluate pulmonary response to treatment. RESULTS: Infected patients had higher serum VEGF levels than controls (435.2 +/- 29.1 vs. 167.0 +/- 10.6 pg/mL, P < 0.0001), and serum VEGF level correlated with the extent of disease. The serum VEGF levels in 14 patients who underwent treatment and exhibited an improvement in their pulmonary lesions decreased significantly compared with the results pretreatment (509.0 +/- 60.7 vs. 303.6 +/- 65.3 pg/mL, P = 0.0092). In infected patients, alveolar macrophages, epithelioid cells and multinucleated giant cells exhibited VEGF overexpression on immunohistochemical staining. CONCLUSIONS: This study suggests that VEGF may be associated with the pathogenesis of pulmonary MAC infection. Additionally, serum VEGF levels may be a useful surrogate marker for evaluating the extent of disease and of the response to treatment.