Granulocyte colony-stimulating factor in bronchoalveolar lavage fluid is a potential biomarker for prognostic prediction of idiopathic pulmonary fibrosisopen access
- Authors
- Lee, Jong-Uk; Choi, Jae Sung; Kim, Min Kyung; Min, Sun A.; Park, Jong-Sook; 박춘식
- Issue Date
- Sep-2022
- Publisher
- 대한내과학회
- Keywords
- Granulocyte colony-stimulating factor; Neutrophils; Idiopathic pulmonary fibrosis; Survival
- Citation
- The Korean Journal of Internal Medicine, v.37, no.5, pp 979 - 988
- Pages
- 10
- Journal Title
- The Korean Journal of Internal Medicine
- Volume
- 37
- Number
- 5
- Start Page
- 979
- End Page
- 988
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/21457
- DOI
- 10.3904/kjim.2021.442
- ISSN
- 1226-3303
2005-6648
- Abstract
- Background/Aims: Neutrophilia is frequently observed in bronchoalveolar lavage fluid (BALE) of idiopathic pulmonary fibrosis (IPF) patients. Granulocyte colony-stimulating factor (G-CSF) is a potent neutrophil-activating glycoprotein. However, the clinical implications of G-CSF remain poorly understood.in patients with IPF. Therefore, we evaluated the relationship between the G-CSF concentration in BALF and the progression of fibrosis, including in terms of the decline in lung function and long-term survival rate. Methods: G-CSF concentrations were measured in BALF using enzyme-linked immunosorbent assay (ELISA). The survival rate was estimated using Kaplan-Meier survival analyses. Results: G-CSF protein levels were significantly higher in IPF (n = 87; 1.88 [0 to 5.68 pg/mL]), nonspecific interstitial pneumonia (n = 22; 0.58 [0 to 11.64 pg/mL]), and hypersensitivity pneumonitis (n = 19; 2.48 [0.46 to 5.71 pg/mL]) patients than in normal controls (n = 33; 0 [0 to 0.68 pg/mL]) (all p < 0.01). A receiver operating characteristic curve showed a difference in G-CSF levels between IPF and NC (area under the curve, 0.769): The G-CSF cut-off of 0.96 pg/mL indicated 84.9% specificity and 63.2% sensitivity for IPF. The survival rate was significantly lower in the group with G-CSF > 2.872 pg/mL than in the group with <= 2.872 pg/mL (hazard ratio, 2.69; p = 0.041). The annual decline in diffusing capacity of the lung for carbon monoxide was positively correlated with the G-CSF level (p = 0.018). Conclusions: G-CSF may participate in the development of IPF and be useful for predicting the prognosis of IPF. Therefore, G-CSF should be analyzed in BALF, in addition to differential cell counts.
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