Abstract
BackgroundInterstitial lung disease (ILD) is a prognostic indicator of poor outcome in myositis. Although the pathogenesis of myositis-associated ILD is not well understood, neutrophils are thought to play a pivotal role. Neutrophils store azurophil granules that contain defensins, which are antimicrobial peptides that regulate the inflammatory response. Here, we evaluated levels of the human neutrophil peptides (HNPs) α-defensin 1 through 3 in patients with myositis-associated ILD to determine whether HNPs represent disease markers and play a role in the pathogenesis of myositis-associated ILD.MethodsHNP levels were measured in the plasma and bronchoalveolar lavage fluid (BALF) of 56 patients with myositis-associated ILD and 24 healthy controls by enzyme-linked immunosorbent assay.ResultsAnalysis revealed significantly higher HNP levels in plasma and BALF samples from patients with myositis-associated ILD as compared to those of healthy controls; however, plasma HNPs were significantly correlated with total cell counts in BALF. Additionally, BALF HNP levels were positively correlated with serum surfactant protein-A and the percentage of neutrophils in BALF, and BALF HNP levels correlated with the percentage of reticular opacities in high-resolution computed tomography results for patients with anti-aminoacyl-tRNA synthetase (ARS) antibody positive myositis-associated ILD. Survival did not differ between patients with higher and lower levels of plasma and BALF HNPs.ConclusionsPlasma and BALF HNPs might reflect the disease activities of myositis-associated ILD, especially in patients with anti-ARS antibody positive myositis-associated ILD. However further studies are necessary to clarify whether HNPs represent disease markers and play roles in disease pathogenesis.
Highlights
Interstitial lung disease (ILD) is a prognostic indicator of poor outcome in myositis
We previously identified elevated plasma and bronchoalveolar lavage fluid (BALF) human neutrophil peptides (HNPs) levels in patients with various inflammatory lung diseases, including systemic sclerosis-associated ILD, with these levels correlated with neutrophils in BALF [12,13,14,15,16,17,18,19]
In line with these reports, the present results showed that increased HNP levels in the plasma and BALF from patients with myositis-associated ILD suggested that neutrophils are likely to release Neutrophil extracellular trap (NET), including HNPs, which are difficult to degrade in patients with myositisassociated ILD
Summary
Interstitial lung disease (ILD) is a prognostic indicator of poor outcome in myositis. The pathogenesis of myositis-associated ILD is not well understood, neutrophils are thought to play a pivotal role. We evaluated levels of the human neutrophil peptides (HNPs) α-defensin 1 through 3 in patients with myositis-associated ILD to determine whether HNPs represent disease markers and play a role in the pathogenesis of myositis-associated ILD. Interstitial lung disease (ILD) is a common pulmonary manifestation considered a common cause of morbidity and mortality in myositis [2, 3]. Some reports suggest that the presence of neutrophils in BALF correlates with poor clinical course [2, 7, 8]
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