Correlation of C-reactive protein with disease severity in CT diagnosed emphysema

Background and objective:   Recent studies suggest that CRP levels are related to airflow obstruction. However, limited data exist on the relevance of CRP levels in individuals with or without emphysema. The aim of this study was to assess the relationship between the extent of emphysema, COPD severity and serum CRP levels.
Methods:   Lung function tests and high-sensitivity CRP were examined in 651 males with stable disease who underwent CT screening for lung cancer. CRP levels were examined cross-sectionally in individuals with various degrees of emphysema and in those without emphysema.
Results:   Emphysema was detected in 179 (34.7%) of 516 current smokers. Airflow obstruction was observed in 47 (28.8%) of 163 smokers with mild emphysema, in eight (57.1%) of 14 smokers with moderate emphysema, and in two of two individuals with severe emphysema. CRP levels were not higher in individuals with mild or moderate emphysema compared with individuals without emphysema. Among 98 individuals with airflow obstruction (19.0% of the 516 current smokers), there was a modest correlation between CRP levels and FEV₁%.
Conclusions:   The severity of COPD varied in individuals with similar degrees of emphysema. CRP levels were not significantly higher in individuals with mild or moderate emphysema compared with individuals without emphysema but CRP levels were modestly correlated with FEV₁% among individuals with airflow obstruction.     

A superfemale with primary Sjögren's syndrome which involved systemic organs

Miyakawa H, Iyonaga K, Arima S, Yonekawa Y, Suga M, Ando M (First and Third Departments of Internal Medicine, Kumamoto University School of Medicine, Kumamoto, Japan). A superfemale with primary Sjögren's syndrome which involved systemic organs (Case report). J Intern Med 1997; 242 : 261–5.
A 52-year-old Japanese woman complicated by a sex chromosomal anomaly as a superfemale, a mosaic of XXXXX/XXXX/XXX/XX/XO, with mild mental retardation, was hospitalized for dry mouth, dry eyes, and proteinuria. The sialography of the right parotid gland showed a globular-type gland enlargement. A definite diagnosis of primary Sjögren's syndrome (SS) was made, and further examinations revealed not only typical sicca syndrome but also systemic extraglandular lymphocytic infiltration; interstitial pneumonitis, glomerular- and interstitial nephritis, superficial gastritis, thyroiditis, and a severe excitation conductive impairment of heart. We report a very rare case of superfemale with primary SS which involved systemic organs.     

ALTERATIONS IN CYTOKERATIN EXPRESSION BY THE ALVEOLAR LINING EPITHELIAL CELLS IN LUNG TISSUES FROM PATIENTS WITH IDIOPATHIC PULMONARY FIBROSIS

It is generally recognized that epithelial cytokeratins (CKs) are expressed in tissue-specific patterns and reflect differentiation, functional specialization, and pathological alterations of the cells. Differential epithelial cell types can thus be distinguished from each other by their selective expression of particular sets of CKs. To determine the characteristics of metaplastic and hyperplastic changes of alveolar-lining epithelial cells in the lungs of idiopathic pulmonary fibrosis (IPF), the expression of individual CKs was studied immunohistochemically using monospecific anti-CK monoclonal antibodies (anti-CKs 7, 8, 10, 13, 14, 16, 17, 18, 19). Biopsy specimens from 17 patients with IPF and normal lung tissues (NL) from seven patients with lung cancer were studied. In the IPF specimens, several kinds of altered epithelial cells were observed, which showed characteristic changes in CK expression compared with NL, especially CKs 8, 14, and 17. Hyperplastic type II cells expressed increased CKs 7, 8, and 19, but not CK 17; flattened or stratified squamous metaplastic cells expressed increased CKs 17 and 14, co-expressed with CKs 7, 8, and 19; bronchiolar metaplastic cells expressed increased CKs 7, 8, and 19, co-expressed with CKs 14 and 17; cuboidal metaplastic cells expressed increased CKs 7, 8, 17, and 19. The quantification of individual CKs in the tissues by enzyme-linked immunosorbent assay revealed increased expression of CKs 8, 14, and 17 in IPF lung tissues compared with NL. These results were consistent with the immunohistochemical observations. The hyperplastic and bronchiolar metaplastic phenotypes were characterized by their increased expression of simple CKs without CK alteration. The squamous metaplastic phenotype showed CK alterations, with the appearance of CKs 17 and 14. Epithelial cells are thus altered not only in shape, but possibly also in differentiation and function, with potential implications for the pathogenesis of IPF. © 1997 John Wiley & Sons, Ltd.