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The Role of Infection in Acute Exacerbation of Idiopathic Pulmonary Fibrosis
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A1662 - The Role of Infection in Acute Exacerbation of Idiopathic Pulmonary Fibrosis
Author Block: D. Weng1, L. Huiping2; 1Respiratory Medicine, Shanghai Pulmonary Hospital, Shanghai, China, 2Shanghai Pulmonary, Shanghai, China.
Background: Acute exacerbation of IPF (AE-IPF) is associated with high mortality and its etiology is not clear until now, We studied changes in pathogen involvement during AE-IPF and explored a possible role of infection in AE-IPF. Methods: 170 IPF patients (48 AE-IPF, 122 stable) and 70 controls were recruited at Shanghai Pulmonary Hospital. Specific IgM against microbial pathogens and pathogens in sputum were assessed. RNA sequences of pathogens in nasopharyngeal swab of IPF patients were detected by PathChip. A panel of serum parameters reflecting immune function were assessed.Results: Anti-viral/bacterial IgM was higher in IPF vs. controls and in AE-IPF vs. stable-IPF. 38 different bacterial strains were detected in IPF patient sputum. Bacteria-positive results were found in 9/48 (18.8%) of AE-IPF and in 26/122 (21.3%) stable IPF. 57 different viruses were detected in nasopharyngeal swabs of IPF patients. Virus-positive nasopharyngeal swabs were found in 18/30 (60%) of tested AE-IPF and in 13/30 (43.3%) of stable-IPF. AE-IPF showed increased inflammatory cytokines (IL-6, IFN-γ, MIG, IL-17, and IL-9) vs. stable-IPF and controls. Mortality of AE-IPF in one year (39.5%) was higher compared to stable-IPF (28.7%).Conclusions: IPF patients had different colonization with pathogens in sputum and nasopharyngeal swabs, they also displayed abnormally activated immune responses, which was exacerbated during AE-IPF.
Author Block: D. Weng1, L. Huiping2; 1Respiratory Medicine, Shanghai Pulmonary Hospital, Shanghai, China, 2Shanghai Pulmonary, Shanghai, China.
Background: Acute exacerbation of IPF (AE-IPF) is associated with high mortality and its etiology is not clear until now, We studied changes in pathogen involvement during AE-IPF and explored a possible role of infection in AE-IPF. Methods: 170 IPF patients (48 AE-IPF, 122 stable) and 70 controls were recruited at Shanghai Pulmonary Hospital. Specific IgM against microbial pathogens and pathogens in sputum were assessed. RNA sequences of pathogens in nasopharyngeal swab of IPF patients were detected by PathChip. A panel of serum parameters reflecting immune function were assessed.Results: Anti-viral/bacterial IgM was higher in IPF vs. controls and in AE-IPF vs. stable-IPF. 38 different bacterial strains were detected in IPF patient sputum. Bacteria-positive results were found in 9/48 (18.8%) of AE-IPF and in 26/122 (21.3%) stable IPF. 57 different viruses were detected in nasopharyngeal swabs of IPF patients. Virus-positive nasopharyngeal swabs were found in 18/30 (60%) of tested AE-IPF and in 13/30 (43.3%) of stable-IPF. AE-IPF showed increased inflammatory cytokines (IL-6, IFN-γ, MIG, IL-17, and IL-9) vs. stable-IPF and controls. Mortality of AE-IPF in one year (39.5%) was higher compared to stable-IPF (28.7%).Conclusions: IPF patients had different colonization with pathogens in sputum and nasopharyngeal swabs, they also displayed abnormally activated immune responses, which was exacerbated during AE-IPF.
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