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      Associations between peripheral blood eosinophil counts in patients with systemic sclerosis and disease severity

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          Abstract

          Increased levels of serum pro-fibrotic cytokines have been reported in patients with systemic sclerosis (SSc). Some of these cytokines also play an important role in the differentiation and migration of eosinophils. The aim of this study was to determine whether eosinophilic inflammation is caused in SSc. We retrospectively reviewed the peripheral blood eosinophil counts in 70 untreated patients with SSc and compared them with those in patients with other major collagen diseases. We additionally evaluated a possible association with disease severity. Eosinophil counts were significantly higher levels in patients with SSc than in those with other collagen diseases, whereas total leukocyte counts were not. Eosinophil counts correlated positively with both severe interstitial lung disease (ILD; r = 0.255, p = 0.033) and modified Rodnan total skin thickness score (m-Rodnan TSS) in SSc (r = 0.347, p = 0.003), but did not correlate with ILD severity in other collagen diseases. In conclusion, peripheral eosinophil counts were higher in patients with SSc than in those with other collagen diseases and were correlated with increased disease severity. Our data suggest that eosinophilic inflammation is involved in the pathogenesis and progression of SSc.

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          Most cited references28

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          Histopathologic subsets of fibrosing alveolitis in patients with systemic sclerosis and their relationship to outcome.

          Fibrosing alveolitis associated with systemic sclerosis (FASSc) has a better prognosis than idiopathic pulmonary fibrosis. In view of recent reports that idiopathic nonspecific interstitial pneumonia (NSIP) has a better prognosis than idiopathic usual interstitial pneumonia (UIP), we classified histologic appearances of surgical lung biopsies performed in 80 patients with FASSc. NSIP (n = 62, 77.5%), subcategorized as cellular NSIP (n = 15) and fibrotic NSIP (n = 47) was much more prevalent than UIP (n = 6), end-stage lung disease (ESL, n = 6), or other patterns (n = 6). There were 25 deaths (NSIP 16/62, 26%; UIP/ESL 6/12, 50%). Five-year survival differed little between NSIP (91%) and UIP/ESL (82%); mortality was associated with lower initial carbon monoxide diffusing capacity (DL(CO)) and FVC levels (p = 0.004 and p = 0.007, respectively). Survival and serial FVC and DL(CO) trends did not differ between cellular and fibrotic NSIP. Increased mortality in NSIP was associated with lower initial DL(CO) levels (p = 0.04), higher BAL eosinophil levels (p = 0.03), and deterioration in DL(CO) levels during the next 3 years (p < 0.005). We conclude that NSIP is the histopathologic pattern in most patients with FASSc. However, outcome is linked more strongly to disease severity at presentation and serial DL(CO) trends than to histopathologic findings.
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            Clinical advances in the diagnosis and therapy of the interstitial lung diseases.

            The last century experienced remarkable advances in the classification, diagnosis, and understanding of the pathogenesis of the interstitial lung diseases. Technological advances, particularly physiologic testing, lung imaging studies, bronchoalveolar lavage, surgical lung biopsy, and histopathologic assessment, improved our understanding of these entities. In particular, the advent of high-resolution computed tomography, the narrowed pathologic definition of usual interstitial pneumonia, and recognition of the prognostic importance of separating usual interstitial pneumonia from other idiopathic interstitial pneumonia patterns have profoundly changed the approach to these processes. Most recently, genetic medicine, the use of new technologies (e.g., microarrays, mass spectroscopic analysis of proteins, and laser capture microdissection), and the development of animal models have had a major impact on understanding the pathogenesis and potential molecular targets for interfering with fibrogenesis. This article highlights some of the advances and changes in clinical practice that took place in the management of patients with interstitial lung diseases over the last century.
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              Elevated serum levels of interleukin 4 (IL-4), IL-10, and IL-13 in patients with systemic sclerosis.

              To determine whether serum interleukin 4 (IL-4), IL-10, and IL-13 levels in patients with systemic sclerosis (SSc) are elevated and whether they correlate with the clinical or serologic features of this disease. Serum samples from patients with limited cutaneous SSc (ISSc) (n = 45), diffuse cutaneous SSc (dSSc) (n = 28), and control subjects (n = 30) were examined by ELISA. Serum IL-4 and IL-13 levels were significantly higher in patients with ISSc and dSSc than in the controls. Serum IL-10 levels were significantly higher in the patients with dSSc compared with controls. Elevated IL-10 levels were detected frequently in patients with arthralgia. Serum IL-13 levels correlated with erythrocyte sedimentation rates and C-reactive protein levels in patients. We suggest that IL-4, IL-10, and IL-13 may be some of the cytokines that contribute to the disease process, and that IL-13 may be a serologic indicator of systemic inflammation in patients with SSc.
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                Author and article information

                Contributors
                +81-3-5802-1063 , kando@juntendo.ac.jp
                kuzuk77777@yahoo.co.jp
                nkaneko@kameda.jp
                kztakaha@juntendo.ac.jp
                motojima@kameda.jp
                Journal
                Springerplus
                Springerplus
                SpringerPlus
                Springer International Publishing (Cham )
                2193-1801
                23 August 2016
                23 August 2016
                2016
                : 5
                : 1
                : 1401
                Affiliations
                [1 ]Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo 113-8421 Japan
                [2 ]Department of Rheumatology, Kameda Medical Center, 929 Higashi-Cho, Kamogawa-City, Chiba 296-8602 Japan
                [3 ]Respiratory Internal Medicine, Kameda Medical Center, 929 Higashi-Cho, Kamogawa-City, Chiba 296-8602 Japan
                Article
                3106
                10.1186/s40064-016-3106-4
                4994817
                27610320
                ac75e7b6-a542-4f86-80f1-e344c834855d
                © The Author(s) 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 1 June 2015
                : 19 August 2016
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Uncategorized
                eosinophil,interstitial lung disease,systemic sclerosis,treatment
                Uncategorized
                eosinophil, interstitial lung disease, systemic sclerosis, treatment

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