PITTSBURGH, Feb. 3 A simple blood test could predict which patients with the lung-scarring disease known as idiopathic pulmonary fibrosis (IPF) are soon to get far worse, an indicator that could one day influence their treatment, according to researchers at the University of Pittsburgh School of Medicine. Their findings, published online last week in PLoS One, indicate that the body's immune cells attack healthy lung tissue, suggesting that IPF is in fact an immunologic disease.
In IPF, lung tissue gets progressively scarred, making it hard for patients to breathe, explained Steven R. Duncan, M.D., an associate professor in the Division of Pulmonary, Allergy and Critical Care Medicine at Pitt. The prognosis is grim; median survival is three years after diagnosis.
"If we knew who was in the gravest danger from this illness, we could direct them to lung transplantation or experimental therapy immediately," he said. "Also, we could possibly avoid prescribing grueling treatments for people whose disease is fairly stable."
Dr. Duncan and his colleagues may have found a way to test for that information. For their study, they collected blood samples from 89 IPF patients at various stages of disease severity, as well as 32 healthy individuals for comparison, and examined certain immune cells called CD4 T-cells. The cells, which typically respond to infectious threats, normally carry a surface protein called CD28.
The CD4 T-cells still bore their CD28 markers among patients whose disease was relatively stable. But, as a patient's disease got worse, the CD4 T-cells lost their CD28 protein markers and the cells were unusually "revved up," as Dr. Duncan put it. The greater the proportion of these distinctly abnormal cells in the blood, the greater the likelihood that the patient would quickly become gravely ill. In the study group, these patients were the ones who were most likely to require a lung transplant or to die within 1
|Contact: Anita Srikameswaran|
University of Pittsburgh Schools of the Health Sciences