The Role of Infection in Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Dong Weng; Xian-Qiu Chen; Hui Qiu; Yuan Zhang; Qiu-Hong Li; Meng-Meng Zhao; Qin Wu; Tao Chen; Yang Hu; Liu-Sheng Wang; Ya-Ru Wei; Yu-Kui Du; Shan-Shan Chen; Ying Zhou; Fen Zhang; Li Shen; Yi-Liang Su; Martin Kolb; Hui-Ping Li

doi:10.1155/2019/5160694

Mediators of Inflammation (Jan 2019)

The Role of Infection in Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Dong Weng,
Xian-Qiu Chen,
Hui Qiu,
Yuan Zhang,
Qiu-Hong Li,
Meng-Meng Zhao,
Qin Wu,
Tao Chen,
Yang Hu,
Liu-Sheng Wang,
Ya-Ru Wei,
Yu-Kui Du,
Shan-Shan Chen,
Ying Zhou,
Fen Zhang,
Li Shen,
Yi-Liang Su,
Martin Kolb,
Hui-Ping Li

Affiliations

Dong Weng: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Xian-Qiu Chen: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Hui Qiu: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Yuan Zhang: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Qiu-Hong Li: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Meng-Meng Zhao: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Qin Wu: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Tao Chen: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Yang Hu: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Liu-Sheng Wang: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Ya-Ru Wei: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Yu-Kui Du: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Shan-Shan Chen: School of Medicine, Suzhou University, Suzhou, China
Ying Zhou: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Fen Zhang: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Li Shen: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Yi-Liang Su: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China
Martin Kolb: McMaster University Hamilton, Department of Medicine and Pathology/Molecular Medicine, ON, Canada
Hui-Ping Li: Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China

DOI: https://doi.org/10.1155/2019/5160694
Journal volume & issue: Vol. 2019

Abstract

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Background. Acute exacerbation of IPF (AE-IPF) is associated with high mortality. We studied changes in pathogen involvement during AE-IPF and explored a possible role of infection in AE-IPF. Objectives. Our purpose is to investigate the role of infection in AE-IPF. Methods. Overall, we recruited 170 IPF patients (48 AE-IPF, 122 stable) and 70 controls at Shanghai Pulmonary Hospital. Specific IgM against microbial pathogens and pathogens in sputum were assessed. RNA sequences of pathogens in nasopharyngeal swab of IPF patients were detected by PathChip. A panel of serum parameters reflecting immune function were assessed. Results. Antiviral/bacterial IgM was higher in IPF vs. controls and in AE-IPF vs. stable IPF. Thirty-eight different bacterial strains were detected in IPF patient sputum. Bacteria-positive results were found in 9/48 (18.8%) of AE-IPF and in 26/122 (21.3%) stable IPF. Fifty-seven different viruses were detected in nasopharyngeal swabs of IPF patients. Virus-positive nasopharyngeal swabs were found in 18/30 (60%) of tested AE-IPF and in 13/30 (43.3%) of stable IPF. AE-IPF showed increased inflammatory cytokines (IL-6, IFN-γ, MIG, IL-17, and IL-9) vs. stable IPF and controls. Mortality of AE-IPF in one year (39.5%) was higher compared to stable IPF (28.7%).Conclusions. IPF patients had different colonization with pathogens in sputum and nasopharyngeal swabs; they also displayed abnormally activated immune response, which was exacerbated during AE-IPF.

Published in Mediators of Inflammation

ISSN: 0962-9351 (Print); 1466-1861 (Online)
Publisher: Wiley
Country of publisher: United Kingdom
LCC subjects: Medicine: Pathology
Website: https://onlinelibrary.wiley.com/journal/4792

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