Article Text

PDF
AB0677 Individual immunological predictorsof the risk of lung damage in patients with systemic sclerosis
  1. V Hayevska,
  2. V Chopyak,
  3. V Hayevskyy,
  4. on behalf of Chopyak Valentyna, Hayevskyy Volodymyr
  1. Department of clinical immunology and allergology, Lviv National Medical University named by Danylo Halytskyy, Lviv, Ukraine

Abstract

Background A significant role in the formation and development of systemic sclerosis (SSc) belongs to immunogenetic factors and immunopathological mechanisms, so nowadays become important to find immunological predictors of early diagnosis of the disease. An urgent task is timely diagnosing the pulmonary complications as the main causes of high mortality and appointment of adequate therapy and objective assessment of its effectiveness.

Objectives The main purpose was to develop a personal way of forecasting the risk of damage of the lungs, including its subtype – pneumofibrosis (PF) and pulmonary hypertension (PH) in patients with SSc.

Methods To address this goal, the following studies performed: clinical, general laboratory, instrumental, immunological, molecular genetics, statistical methods. Adequacy and reliability of the results of mathematical model of the risk of damage the lungs were using criteria Wald and Xi-square. The results show that our model is correct with a probability of error less than 1% (p=0.001).

Results We found that among the analyzed complex interrelated factors in the development of lung damage in patients with SSc significantly influenced: the duration of the disease, miRNA29b, expression levels in the blood concentration of IL17 in serum and blood, neutrophil phagocytic index t that we include in the predictive model.

We know that the most significant complications associated with damage to their lungs are pneumofibrosis and pulmonary hypertension, which threatened the rapid development of respiratory failure and a high mortality of these patients. In this regard analyzed immunological and molecular genetic parameters of patients with SSc depending on the development of PF and LH.

We found that among the complex of interrelated factors of the development of PF in patients with SSc significantly influenced the following factors: patient age, miRNA 29b, MCP-1, IFN-γ, TGF-β in serum, oxidative indicator “explosion” of neutrophils, which we have included in the predictive model.

At the same time, the development of PH in patients with SSc significantly affected other clinical and immunological factors: patient age, levels of endothelin-1, IL17 in serum, the number of CD4 + CD25 + Fox P3 + -lymphocytes, CD3 +/CDHLA-DR + -lymphocytes, CD4 + IL17 + -lymphocytes in peripheral blood, which we have included the following predictive model.

Conclusions The application withdrawn prognostic clinical and immunological and molecular genetic criteria of lungs damage (pulmonary hypertension and pneumofibrosis) will enable medical practitioners to verify early visceral lesions in patients with SSc in time and justified the appointment of basic therapy.

References

  1. Stern EP, Denton CP The Pathogenesis of Systemic Sclerosis. Rheum Dis Clin North Am. 2015 Aug;41(3):367–82.

  2. Meijs J, Anne A Schouffoer, et all A prediction model for progressive disease in systemic sclerosisRMD Open. 2015; 1(1) Published online.

  3. Peter A. Ward, M.D. Risk Prediction in Idiopathic Pulmonary Fibrosis American journal of respiratory and critical Care Medicine 2012 Vol 185: 6–7.

  4. Hanna M., Minna K. Et all Are risk predicting models useful for estimating survival of patients with rheumatoid arthritis-associated interstitial lung disease? BMC Pulmonary Medicine (2017), Published online.

References

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.