Evidence for chronic inflammation as a component of the interstitial lung disease associated with progressive systemic sclerosis. Academic Article uri icon

Overview

MeSH

  • Adult
  • Bronchi
  • Chronic Disease
  • Female
  • Fibroblast Growth Factors
  • Fibronectins
  • Follow-Up Studies
  • Gallium Radioisotopes
  • Humans
  • Macrophages
  • Male
  • Middle Aged
  • Pulmonary Alveoli
  • Radionuclide Imaging
  • Therapeutic Irrigation

MeSH Major

  • Pulmonary Fibrosis
  • Scleroderma, Systemic

abstract

  • Progressive systemic sclerosis (PSS) is a generalized disorder characterized by fibrosis of many organs including the lung parenchyma. Unlike most other interstitial disorders, traditional concepts of the interstitial lung disease associated with PSS have held it to be a "pure" fibrotic disorder without a significant inflammatory component. To directly evaluate whether an active alveolitis is associated with this disorder, patients with chronic interstitial lung disease and PSS were studied by open lung biopsy, gallium-67 scanning, and bronchoalveolar lavage. Histologic evaluation of the biopsies demonstrated that the interstitial fibrosis of PSS is clearly associated with the presence of macrophages, lymphocytes, and polymorphonuclear leukocytes, both in the interstitium and on the alveolar epithelial surface. Gallium-67 scans were positive in 77% of the patients, showing diffuse, primarily lower zone uptake, suggestive of active inflammation. Consistent with the histologic findings, bronchoalveolar lavage studies demonstrated a mild increase in the proportions of neutrophils and eosinophils with occasional increased numbers of lymphocytes. Importantly, alveolar macrophages from patients with PSS showed increased release of fibronectin and alveolar-macrophage-derived growth factor, mediators that together stimulate lung fibroblasts to proliferate, thus suggesting at least one mechanism modulating the lung fibrosis of these patients. Thus, evidence from several different points of view together demonstrates that the interstitial lung disease associated with PSS is associated with chronic inflammation in the local milieu, leading to the hypothesis that the inflammation plays some role in the derangements to the alveolar structures that characterize this disorder.(ABSTRACT TRUNCATED AT 250 WORDS)

publication date

  • April 1985

has subject area

  • Adult
  • Bronchi
  • Chronic Disease
  • Female
  • Fibroblast Growth Factors
  • Fibronectins
  • Follow-Up Studies
  • Gallium Radioisotopes
  • Humans
  • Macrophages
  • Male
  • Middle Aged
  • Pulmonary Alveoli
  • Pulmonary Fibrosis
  • Radionuclide Imaging
  • Scleroderma, Systemic
  • Therapeutic Irrigation

Research

keywords

  • Journal Article

Identity

Language

  • eng

Digital Object Identifier (DOI)

  • 10.1164/arrd.1985.131.4.612

PubMed ID

  • 3994157

Additional Document Info

start page

  • 612

end page

  • 617

volume

  • 131

number

  • 4