Research

Higher serum CCL17 may be a promising predictor of acute exacerbations in chronic hypersensitivity pneumonitis

Yasunari Miyazaki, Koji Unoura, Tomoya Tateishi, Takumi Akashi, Tamiko Takemura, Makoto Tomita, Naohiko Inase andYasuyuki Yoshizawa

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Respiratory Research 2013, 14:57 doi:10.1186/1465-9921-14-57

Published: 25 May 2013

Abstract (provisional)

Background

Recent research has suggested that the Th1 and Th2 chemokine/cytokine axis contributes to the development of chronic hypersensitivity pneumonitis (HP). Acute exacerbations (AE) are significant factors in the prognosis of chronic HP. Little is known, however, about these biomarkers in association with AE in chronic HP patients.

Methods

Fifty-six patients with chronic HP were evaluated, including 14 patients during episodes of AE. Th1 mediators (C-X-C chemokine ligand [CXCL]10 and interferon [IFN]-gamma), Th2 mediators (C-C chemokine ligand [CCL]17, interleukin-4, and interleukin-13), and pro-fibrotic mediator (transforming growth factor [TGF]-beta) were measured to evaluate the mediators as predictors of AE. C-C chemokine receptor (CCR)4 (receptor for CCL17)-positive lymphocytes were quantified in lung specimens.

Results

Serum CCL17 levels at baseline independently predicted the first episode of AE (HR, 72.0; 95% CI, 5.03-1030.23; p = 0.002). AE was significantly more frequent in the higher-CCL17 group (>=285 pg/ml) than in the lower-CCL17 group (<285 0.031="" 0.0="" 1-year="" 14.3="" ae="" and="" baseline="" ccl17="" ccr4-positive="" cells="" during="" episodes="" from="" higher="" incidence:="" increased="" levels="" log-rank="" lower="" ml="" of="" p="" pg="" serum="" test="" the="" vs.="" were="">

Conclusions

Higher serum concentrations of CCL17 at baseline may be predictive of AE in patients with chronic HP, and CCL17 may contribute to the pathology of AE by inducing the accumulation of CCR4-positive lymphocytes in the lungs.

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