Fibrosis and Damage Markers in Occupational Interstitial Lung Diseases

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Abstract

The investigation of biomarkers for fibrosis and lung tissue damage is very important for the diagnosis and prognosis of interstitial lung disease, as well as treatment strategies. The biomarkers secreted by Type II pneumocytes and cells of the bronchiolar epithelium are most reflective of the formation of pulmonary fibrosis and the degree of damage to the lung tissue. The levels of Krebs von den Lungen-6 (KL-6), alveolomucin (mucin-antigen 3EG5), and Clara cell secretory protein in occupational interstitial lung diseases (e.g., exogenous alveolitis, pneumoconiosis), caused by exposure to organic and inorganic factors, were analysed in dependence of disease activity phase. The level of alveolomucin in pneumoconiosis and in occupational alveolitis remission may reflect the extent of pulmonary fibrosis, which is a prognostic sign of the outcome of the disease. Higher specificity and lower sensitivity of alveolomucin compared to KL-6 can be used as a screening test for exogenous alveolitis. KL-6 and alveolomucin are more useful biomarkers than Clara cell secretory protein for diagnosis, exacerbation, and progression of occupational alveolitis.
职业性肺间质性疾病的纤维化和损伤标志物
研究纤维化和肺组织损伤的生物标志物对间质性肺疾病的诊断和预后以及治疗策略具有重要意义。II型肺细胞和细支气管上皮细胞分泌的生物标志物最能反映肺纤维化的形成和肺组织的损伤程度。分析了职业性间质性肺病(如外源性肺泡炎、尘肺病)中克雷伯氏菌-6 (KL-6)、肺泡蛋白(黏液抗原3EG5)和Clara细胞分泌蛋白水平与疾病活动期的相关性。尘肺病和职业性肺泡炎缓解期的肺泡吸积素水平可能反映肺纤维化的程度,这是疾病结局的预后标志。与KL-6相比,alveolomucin特异性较高,敏感性较低,可作为外源性肺泡炎的筛查试验。在职业性肺泡炎的诊断、恶化和进展方面,KL-6和肺泡蛋白是比Clara细胞分泌蛋白更有用的生物标志物。
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