Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis

Nevins W Todd,1,2 Rachel G Scheraga,1,3 Jeffrey R Galvin,1,4 Aldo T Iacono,1 E James Britt,1 Irina G Luzina,1,2 Allen P Burke,5,* Sergei P Atamas1,2,* 1Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; 2Baltimore VA Medical Center, Baltimore, MD, USA; 3Critical C...

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Autores principales:	Todd NW, Scheraga RG, Galvin JR, Iacono AT, Britt EJ, Luzina IG, Burke AP, Atamas SP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Pathology RB1-214 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/1053d49802d84915bc40400139518a33
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spelling	oai:doaj.org-article:1053d49802d84915bc40400139518a332021-12-02T00:21:00ZLymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis1178-7031https://doaj.org/article/1053d49802d84915bc40400139518a332013-03-01T00:00:00Zhttp://www.dovepress.com/lymphocyte-aggregates-persist-and-accumulate-in-the-lungs-of-patients--a12588https://doaj.org/toc/1178-7031Nevins W Todd,1,2 Rachel G Scheraga,1,3 Jeffrey R Galvin,1,4 Aldo T Iacono,1 E James Britt,1 Irina G Luzina,1,2 Allen P Burke,5,* Sergei P Atamas1,2,* 1Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; 2Baltimore VA Medical Center, Baltimore, MD, USA; 3Critical Care Medicine Department, National Institutes of Health, Bethesda, MD, USA; 4Department of Diagnostic Radiology, University of Maryland School of Medicine, Baltimore, MD, USA; 5Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA *These authors contributed equally to this work Background: Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease with no known effective therapy. It is often assumed, but has not been objectively evaluated, that pulmonary inflammation subsides as IPF progresses. The goal of this work was to assess changes in the degree of inflammatory cell infiltration, particularly lymphocytic infiltration, over the duration of illness in IPF. Methods: Sixteen patients with confirmed IPF were identified in patients whom surgical lung biopsy (SLB) was performed in early disease, and in patients whom lung transplantation was subsequently performed in end stage disease. A numerical scoring system was used to histologically quantify the amount of fibrosis, honeycomb change, fibroblastic foci, and lymphocyte aggregates in each SLB and lung explant tissue sample. Analyses of quantitative scores were performed by comparing paired, matched samples of SLB to lung explant tissue. Results: Median time [1st, 3rd quartiles] from SLB to lung transplantation was 24 [15, 29] months. Histologic fibrosis and honeycomb change were more pronounced in the explant samples compared with SLB (P < 0.001 and P < 0.01, respectively), and most notably, higher numbers of lymphocyte aggregates were observed in the explant samples compared to SLB (P = 0.013). Immunohistochemical analyses revealed abundant CD3+ (T lymphocyte) and CD20+ (B lymphocyte) cells, but not CD68+ (macrophage) cells, within the aggregates. Conclusion: Contrary to the frequent assumption, lymphocyte aggregates were present in greater numbers in advanced disease (explant tissue) compared to early disease (surgical lung biopsy). This finding suggests that active cellular inflammation continues in IPF even in severe end stage disease. Keywords: idiopathic pulmonary fibrosis, inflammation, lymphocyte aggregatesTodd NWScheraga RGGalvin JRIacono ATBritt EJLuzina IGBurke APAtamas SPDove Medical PressarticlePathologyRB1-214Therapeutics. PharmacologyRM1-950ENJournal of Inflammation Research, Vol 2013, Iss default, Pp 63-70 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Pathology RB1-214 Therapeutics. Pharmacology RM1-950
spellingShingle	Pathology RB1-214 Therapeutics. Pharmacology RM1-950 Todd NW Scheraga RG Galvin JR Iacono AT Britt EJ Luzina IG Burke AP Atamas SP Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis
description	Nevins W Todd,1,2 Rachel G Scheraga,1,3 Jeffrey R Galvin,1,4 Aldo T Iacono,1 E James Britt,1 Irina G Luzina,1,2 Allen P Burke,5,* Sergei P Atamas1,2,* 1Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA; 2Baltimore VA Medical Center, Baltimore, MD, USA; 3Critical Care Medicine Department, National Institutes of Health, Bethesda, MD, USA; 4Department of Diagnostic Radiology, University of Maryland School of Medicine, Baltimore, MD, USA; 5Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA *These authors contributed equally to this work Background: Idiopathic pulmonary fibrosis (IPF) is a fatal lung disease with no known effective therapy. It is often assumed, but has not been objectively evaluated, that pulmonary inflammation subsides as IPF progresses. The goal of this work was to assess changes in the degree of inflammatory cell infiltration, particularly lymphocytic infiltration, over the duration of illness in IPF. Methods: Sixteen patients with confirmed IPF were identified in patients whom surgical lung biopsy (SLB) was performed in early disease, and in patients whom lung transplantation was subsequently performed in end stage disease. A numerical scoring system was used to histologically quantify the amount of fibrosis, honeycomb change, fibroblastic foci, and lymphocyte aggregates in each SLB and lung explant tissue sample. Analyses of quantitative scores were performed by comparing paired, matched samples of SLB to lung explant tissue. Results: Median time [1st, 3rd quartiles] from SLB to lung transplantation was 24 [15, 29] months. Histologic fibrosis and honeycomb change were more pronounced in the explant samples compared with SLB (P < 0.001 and P < 0.01, respectively), and most notably, higher numbers of lymphocyte aggregates were observed in the explant samples compared to SLB (P = 0.013). Immunohistochemical analyses revealed abundant CD3+ (T lymphocyte) and CD20+ (B lymphocyte) cells, but not CD68+ (macrophage) cells, within the aggregates. Conclusion: Contrary to the frequent assumption, lymphocyte aggregates were present in greater numbers in advanced disease (explant tissue) compared to early disease (surgical lung biopsy). This finding suggests that active cellular inflammation continues in IPF even in severe end stage disease. Keywords: idiopathic pulmonary fibrosis, inflammation, lymphocyte aggregates
format	article
author	Todd NW Scheraga RG Galvin JR Iacono AT Britt EJ Luzina IG Burke AP Atamas SP
author_facet	Todd NW Scheraga RG Galvin JR Iacono AT Britt EJ Luzina IG Burke AP Atamas SP
author_sort	Todd NW
title	Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis
title_short	Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis
title_full	Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis
title_fullStr	Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis
title_full_unstemmed	Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis
title_sort	lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/1053d49802d84915bc40400139518a33
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Lymphocyte aggregates persist and accumulate in the lungs of patients with idiopathic pulmonary fibrosis

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