Inflammatory activity is still present in the advanced stages of idiopathic pulmonary fibrosis

• Published in: Respirology (Carlton, Vic.) Vic.), 2005-11, Vol.10 (5), p.609-614
• Main Authors: MURA, Marco, BELMONTE, Gelorma, Fanti, Stefano, CONTINI, Paola, PACILLI, Angela Maria Grazia, FASANO, Luca, ZOMPATORI, Maurizio, SCHIAVINA, Mario, FABBRI, Mario
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; alveolitis; Biomarkers - blood; Citrates; Disease Progression; Female; Follow-Up Studies; Gallium; gallium-67 citrate; Humans; idiopathic pulmonary fibrosis; inflammation; Inflammation - blood; Inflammation - diagnostic imaging; Male; Middle Aged; Predictive Value of Tests; Prognosis; Pulmonary Fibrosis - diagnosis; Pulmonary Fibrosis - diagnostic imaging; Pulmonary Fibrosis - immunology; Radionuclide Imaging; Radiopharmaceuticals
• ISSN: 1323-7799; 1440-1843
• DOI: 10.1111/j.1440-1843.2005.00757.x

Objective:  The role of active inflammation in idiopathic pulmonary fibrosis (IPF) is controversial. A gallium‐67 citrate (Ga67 scan) is a sensitive indicator of inflammatory activity. The aim of this study was to assess the Ga67 uptake and other markers of inflammation at different stages of IPF and to investigate its prognostic role. Methodology:  Twenty‐two patients (aged 66 ± 11 years, 18 males) with IPF were monitored for a period of 6–20 months (mean 13 months). At presentation (T0), high resolution CT (HRCT) scans showed reticular opacities and traction bronchiectasis with bi‐basilar and peripheral distribution in all cases. At both T0 and follow‐up (T1), we measured pulmonary function (PaO2, FVC, DLco), overall radiographic extent of fibrosis (HRCT visual score), Ga67 uptake, serum concentrations of lactate dehydrogenase (LDH) and C‐reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Results:  All parameters showed a significant deterioration during the T0–T1 interval, though the increase in Ga67 uptake and serum markers was not significant. Patients with Ga67 uptake indices graded as normal or mildly increased (group I), and graded as considerably or severely increased (group II) at presentation, were compared. There was no significant difference with respect to lung function or HRCT score between the two groups at T1. Ga67 uptake, LDH, CRP and ESR at presentation did not correlate significantly with the interval change in pulmonary function and disease extent. Conclusions:  Our findings indicate that inflammatory activity in the advanced stage of IPF is still relevant, although a Ga67 scan is not predictive of the clinical course.