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Elevated CXCL-8 expression in bronchoalveolar lavage correlates with disease severity in patients with acute respiratory distress syndrome resulting from tuberculosis.

Hashemian SM, Mortaz E, Tabarsi P, Jamaati H, Maghsoomi Z, Khosravi A, Garssen J, Masjedi MR, Velayati AA, Folkerts G, Barnes PJ, Adcock IM - J Inflamm (Lond) (2014)

Bottom Line: CXCL8 levels in BAL were significantly higher in the ARDS + TB group compared to TB and ARDS alone groups.In addition, CXCL8 levels and neutrophils were increased in non-miliary TB versus miliary TB.This further suggests that CXCL8 inhibitors or blockers may be useful to control the onset and/or development of these combined diseases.

View Article: PubMed Central - HTML - PubMed

Affiliation: Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Tuberculosis (TB) is a rare but known cause of acute respiratory distress syndrome (ARDS). The role of inflammatory cytokines in the progression of ARDS in TB patients is unknown.

Objectives: In this study we investigated the possible link between the levels of inflammatory cytokines in bronchoalveolar lavage (BAL) in patients with TB or ARDS alone or in patients with TB-induced ARDS (ARDS + TB).

Methods: 90 patients were studied: 30 with TB alone, 30 with ARDS alone and 30 with ARDS + TB. BAL was collected by fiberoptic bronchoscopy and the concentrations of interleukin(IL)-6, CXCL8, TNF-α and IL-1β and the amounts of total protein were measured by ELISA and bicinchoninic acid assay (BCA) methods respectively. The correlation between disease severity measured by Murray scores, SOFA and APACHE II analysis and BAL mediators and cells was also determined.

Results: CXCL8 levels in BAL were significantly higher in the ARDS + TB group compared to TB and ARDS alone groups. Disease severity in the ARDS + TB group as determined by Murray score correlated with BAL CXCL8 and neutrophils but not with IL-6, IL-1β and TNF-α concentrations. In addition, CXCL8 levels and neutrophils were increased in non-miliary TB versus miliary TB. This difference in CXCL8 was lost in the presence of ARDS.

Conclusions: BAL CXCL8 levels were significantly higher in patients with ARDS induced by TB and could suggest an important role of CXCL8 in the pathogenesis of this form of ARDS. This further suggests that CXCL8 inhibitors or blockers may be useful to control the onset and/or development of these combined diseases.

No MeSH data available.


Related in: MedlinePlus

CXCL8 levels and neutrophil numbers in bronchoalveolar lavage (BAL) of patients with miliary and non-miliary tuberculosis (TB). BAL CXCL8 levels (A) and the percentage BAL neutrophils (B) in patients with miliary (n=11) and non-miliary TB (n=19) were measured by ELISA as described in the materials and methods. The effect of the presence of acute respiratory distress syndrome (ARDS) on CXCL8 (C) and BAL neutrophils (D) was also assessed. Control (CONT) subjects are age-matched with a negative PPD (purified protein derivative) test. Data are presented as mean±SEM. *p≤0.05, **p≤0.01 and ***p≤0.01.
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Figure 4: CXCL8 levels and neutrophil numbers in bronchoalveolar lavage (BAL) of patients with miliary and non-miliary tuberculosis (TB). BAL CXCL8 levels (A) and the percentage BAL neutrophils (B) in patients with miliary (n=11) and non-miliary TB (n=19) were measured by ELISA as described in the materials and methods. The effect of the presence of acute respiratory distress syndrome (ARDS) on CXCL8 (C) and BAL neutrophils (D) was also assessed. Control (CONT) subjects are age-matched with a negative PPD (purified protein derivative) test. Data are presented as mean±SEM. *p≤0.05, **p≤0.01 and ***p≤0.01.

Mentions: Macrophages were much less numerous than neutrophils in all these samples (7.8 ± 3%, 7.8% ± 4.1% and 5.9 ± 4% in BAL, respectively), and lymphocytes comprised only about 2-3% of the total cells found in BAL. The remaining cells were epithelial cells (data not shown). There were no significant differences between the groups for any of these cell types.When we analysed the data according to whether the subjects had milary or non-milary disease there was a significant increase in BAL CXCL-8 (385.1 ± 14.8 vs 598 ± 22.6 pg/ml, p < 0.05) (Figure 4A) and neutrophilia (46.7 ± 4.1 vs 68.9 ± 2.5%, p < 0.001) (Figure 4B) in the patients with non-milary TB compared to those with milary TB. The significant increase in BAL CXCL-8 (608.6 ± 21.8 vs 686.5 ± 16.4 pg/ml, p = ns) (Figure 4C) was not observed in those patients with ARDS. In contrast, the difference in BAL neutrophils remained significant (72.0 ± 1.7 vs 85.1 ± 1.6%, p < 0.01) (Figure 4D).


Elevated CXCL-8 expression in bronchoalveolar lavage correlates with disease severity in patients with acute respiratory distress syndrome resulting from tuberculosis.

Hashemian SM, Mortaz E, Tabarsi P, Jamaati H, Maghsoomi Z, Khosravi A, Garssen J, Masjedi MR, Velayati AA, Folkerts G, Barnes PJ, Adcock IM - J Inflamm (Lond) (2014)

CXCL8 levels and neutrophil numbers in bronchoalveolar lavage (BAL) of patients with miliary and non-miliary tuberculosis (TB). BAL CXCL8 levels (A) and the percentage BAL neutrophils (B) in patients with miliary (n=11) and non-miliary TB (n=19) were measured by ELISA as described in the materials and methods. The effect of the presence of acute respiratory distress syndrome (ARDS) on CXCL8 (C) and BAL neutrophils (D) was also assessed. Control (CONT) subjects are age-matched with a negative PPD (purified protein derivative) test. Data are presented as mean±SEM. *p≤0.05, **p≤0.01 and ***p≤0.01.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4126912&req=5

Figure 4: CXCL8 levels and neutrophil numbers in bronchoalveolar lavage (BAL) of patients with miliary and non-miliary tuberculosis (TB). BAL CXCL8 levels (A) and the percentage BAL neutrophils (B) in patients with miliary (n=11) and non-miliary TB (n=19) were measured by ELISA as described in the materials and methods. The effect of the presence of acute respiratory distress syndrome (ARDS) on CXCL8 (C) and BAL neutrophils (D) was also assessed. Control (CONT) subjects are age-matched with a negative PPD (purified protein derivative) test. Data are presented as mean±SEM. *p≤0.05, **p≤0.01 and ***p≤0.01.
Mentions: Macrophages were much less numerous than neutrophils in all these samples (7.8 ± 3%, 7.8% ± 4.1% and 5.9 ± 4% in BAL, respectively), and lymphocytes comprised only about 2-3% of the total cells found in BAL. The remaining cells were epithelial cells (data not shown). There were no significant differences between the groups for any of these cell types.When we analysed the data according to whether the subjects had milary or non-milary disease there was a significant increase in BAL CXCL-8 (385.1 ± 14.8 vs 598 ± 22.6 pg/ml, p < 0.05) (Figure 4A) and neutrophilia (46.7 ± 4.1 vs 68.9 ± 2.5%, p < 0.001) (Figure 4B) in the patients with non-milary TB compared to those with milary TB. The significant increase in BAL CXCL-8 (608.6 ± 21.8 vs 686.5 ± 16.4 pg/ml, p = ns) (Figure 4C) was not observed in those patients with ARDS. In contrast, the difference in BAL neutrophils remained significant (72.0 ± 1.7 vs 85.1 ± 1.6%, p < 0.01) (Figure 4D).

Bottom Line: CXCL8 levels in BAL were significantly higher in the ARDS + TB group compared to TB and ARDS alone groups.In addition, CXCL8 levels and neutrophils were increased in non-miliary TB versus miliary TB.This further suggests that CXCL8 inhibitors or blockers may be useful to control the onset and/or development of these combined diseases.

View Article: PubMed Central - HTML - PubMed

Affiliation: Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

ABSTRACT

Background: Tuberculosis (TB) is a rare but known cause of acute respiratory distress syndrome (ARDS). The role of inflammatory cytokines in the progression of ARDS in TB patients is unknown.

Objectives: In this study we investigated the possible link between the levels of inflammatory cytokines in bronchoalveolar lavage (BAL) in patients with TB or ARDS alone or in patients with TB-induced ARDS (ARDS + TB).

Methods: 90 patients were studied: 30 with TB alone, 30 with ARDS alone and 30 with ARDS + TB. BAL was collected by fiberoptic bronchoscopy and the concentrations of interleukin(IL)-6, CXCL8, TNF-α and IL-1β and the amounts of total protein were measured by ELISA and bicinchoninic acid assay (BCA) methods respectively. The correlation between disease severity measured by Murray scores, SOFA and APACHE II analysis and BAL mediators and cells was also determined.

Results: CXCL8 levels in BAL were significantly higher in the ARDS + TB group compared to TB and ARDS alone groups. Disease severity in the ARDS + TB group as determined by Murray score correlated with BAL CXCL8 and neutrophils but not with IL-6, IL-1β and TNF-α concentrations. In addition, CXCL8 levels and neutrophils were increased in non-miliary TB versus miliary TB. This difference in CXCL8 was lost in the presence of ARDS.

Conclusions: BAL CXCL8 levels were significantly higher in patients with ARDS induced by TB and could suggest an important role of CXCL8 in the pathogenesis of this form of ARDS. This further suggests that CXCL8 inhibitors or blockers may be useful to control the onset and/or development of these combined diseases.

No MeSH data available.


Related in: MedlinePlus