支气管肺泡灌洗液和血清中TGF-β IFN-γ水平与特发性肺纤维化的关系

doi:10.3969/j.issn.1006-6233.2021.05.013

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Abstract Objective: To analyze the relationship between levels of transforming growth factor-β (TGF-β) and interferon-γ (IFN-γ) in bronchoalveolar lavage fluid (BALF) and serum and idiopathic pulmonary fibrosis (IPF). Methods: The clinical data of 135 patients with IPF from February 2016 to December 2019 were retrospectively analyzed. BALF and serum samples were collected within 24 h after admission. According to the modified Medical Research Council (mMRC) dyspnea score, the patients were divided into mild group and moderate-to-severe group, and the levels of TGF-β and IFN-γ in BALF and serum were compared between the two groups, and the correlation between levels of TGF-β and IFN-γ in BALF and serum and the severity of disease was analyzed. 135 patients with IPF were divided into effective group and ineffective group based on the clinical efficacy. Receiver operating characteristic curve (ROC curve) was used to assess the predictive value of levels of TGF-β and IFN-γ in BALF and serum on effective treatment. Results: There were no significant differences in gender, age and course of disease between the two groups (P>0.05). The scores of ground glass opacity and interstitial fibrosis in mild group were lower than those in moderate-to-severe group (P<0.05), and the levels of TGF-β in BALF and serum in mild group were lower than those in moderate-to-severe group (P<0.05) while the levels of IFN-γ in BALF and serum were higher than those in moderate-to-severe group (P<0.05). Pearson correlation analysis showed that TGF-β levels in BALF and serum were significantly positively correlated with scores of mMRC, ground glass opacity and interstitial fibrosis (P<0.05), and IFN-γ levels in BALF and serum were significantly negatively correlated with scores of mMRC, ground glass opacity and interstitial fibrosis (P<0.05). Among 135 patients with IPF, there were 29 cases (21.48%) with ineffective treatment and 106 cases (78.52%) with effective treatment. The levels of TGF-β in BALF and serum in ineffective group were higher than those in effective group (P<0.05) while the levels of IFN-γ in BALF and serum in ineffective group were lower than those in effective group (P<0.05). After ROC curve analysis, it was found that levels of TGF-β and IFN-γ in BALF and serum were effective and beneficial for the treatment and diagnosis of patients with IPF (AUC=0.733, 0.718, 0.735, 0.796, P<0.05), and the cut-off values were 958.42 ng/L, 229.14 ng/L, 1009.37 ng/L and 250.87 ng/L. Conclusion: The levels of early TGF-β and IFN-γ in BALF and serum after admission are not only related to the severity of IPF, but can also assist in predicting the effective treatment status of patients, and they are beneficial for guiding clinical treatment.

Key words： Idiopathic pulmonary fibrosis Bronchoalveolar lavage fluid Serum TGF-β IFN-γ

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.05.013 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I5/762

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