Transforming growth factor-beta 1 in humidifier disinfectant-associated children's interstitial lung disease

Yoon Hee Kim, Kyung Won Kim, Kyung Eun Lee, MiJung Lee, Sang Kyum Kim, SeHoon Kim, Hyo Sup Shim, Chang Young Lee, Myung Joon Kim, Myung Hyun Sohn, Kyu Earn Kim

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Summary Background Humidifier disinfectant-associated children's interstitial lung disease has an unpredictable clinical course with a high morbidity and mortality. Objectives To evaluate the differences in clinical findings between survivors and non-survivors of humidifier disinfectant-associated children's interstitial lung disease. To evaluate dynamic changes in serum cytokines related to inflammation and fibrosis in lung injury, and to determine whether these changes are predictive of survival in this disease. Methods We evaluated 17 children with humidifier disinfectant-associated children's interstitial lung disease, from whom serum samples were obtained weekly during hospitalization. The severity of chest tomographic and lung pathologic findings was scored. Levels of several cytokines were measured in the serial serum samples. Results Seven of the 17 children were survivors. Compared to survivors, non-survivors had greater ground-glass attenuation on follow-up chest tomography, higher admission neutrophil counts, and more macrophages on pathologic findings. Transforming growth factor-beta 1 persisted at an elevated level (1,000-1,500 pg/ml) in survivors, whereas it decreased abruptly in non-survivors. At the time of this decrease, non-survivors had clinical worsening of their respiratory failure. Transforming growth factor-beta 1 was positively correlated with PaO2/FiO2 (r = 0.481, P < 0.0001). Conclusions Non-survivors exhibited more inflammatory clinical findings than survivors. Transforming growth factor-beta 1 remained elevated in survivors, suggesting that it affected the clinical course of humidifier disinfectant-associated children's interstitial lung disease. The prognosis of this lung disease may depend more on controlling excessive inflammation and repairing damaged lung than on fibrosis, and transforming growth factor-beta 1 may play a key role in this process.

Original languageEnglish
Pages (from-to)173-182
Number of pages10
JournalPediatric Pulmonology
Volume51
Issue number2
DOIs
Publication statusPublished - 2016 Feb 1

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Disinfectants
Interstitial Lung Diseases
Transforming Growth Factor beta
Survivors
Fibrosis
Thorax
Serum
Cytokines
Inflammation
Lung
Lung Injury
Respiratory Insufficiency
Lung Diseases
Glass
Humidifiers
Hospitalization
Neutrophils
Macrophages
Tomography
Morbidity

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Kim, Yoon Hee ; Kim, Kyung Won ; Lee, Kyung Eun ; Lee, MiJung ; Kim, Sang Kyum ; Kim, SeHoon ; Shim, Hyo Sup ; Lee, Chang Young ; Kim, Myung Joon ; Sohn, Myung Hyun ; Kim, Kyu Earn. / Transforming growth factor-beta 1 in humidifier disinfectant-associated children's interstitial lung disease. In: Pediatric Pulmonology. 2016 ; Vol. 51, No. 2. pp. 173-182.
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abstract = "Summary Background Humidifier disinfectant-associated children's interstitial lung disease has an unpredictable clinical course with a high morbidity and mortality. Objectives To evaluate the differences in clinical findings between survivors and non-survivors of humidifier disinfectant-associated children's interstitial lung disease. To evaluate dynamic changes in serum cytokines related to inflammation and fibrosis in lung injury, and to determine whether these changes are predictive of survival in this disease. Methods We evaluated 17 children with humidifier disinfectant-associated children's interstitial lung disease, from whom serum samples were obtained weekly during hospitalization. The severity of chest tomographic and lung pathologic findings was scored. Levels of several cytokines were measured in the serial serum samples. Results Seven of the 17 children were survivors. Compared to survivors, non-survivors had greater ground-glass attenuation on follow-up chest tomography, higher admission neutrophil counts, and more macrophages on pathologic findings. Transforming growth factor-beta 1 persisted at an elevated level (1,000-1,500 pg/ml) in survivors, whereas it decreased abruptly in non-survivors. At the time of this decrease, non-survivors had clinical worsening of their respiratory failure. Transforming growth factor-beta 1 was positively correlated with PaO2/FiO2 (r = 0.481, P < 0.0001). Conclusions Non-survivors exhibited more inflammatory clinical findings than survivors. Transforming growth factor-beta 1 remained elevated in survivors, suggesting that it affected the clinical course of humidifier disinfectant-associated children's interstitial lung disease. The prognosis of this lung disease may depend more on controlling excessive inflammation and repairing damaged lung than on fibrosis, and transforming growth factor-beta 1 may play a key role in this process.",
author = "Kim, {Yoon Hee} and Kim, {Kyung Won} and Lee, {Kyung Eun} and MiJung Lee and Kim, {Sang Kyum} and SeHoon Kim and Shim, {Hyo Sup} and Lee, {Chang Young} and Kim, {Myung Joon} and Sohn, {Myung Hyun} and Kim, {Kyu Earn}",
year = "2016",
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Kim, YH, Kim, KW, Lee, KE, Lee, M, Kim, SK, Kim, S, Shim, HS, Lee, CY, Kim, MJ, Sohn, MH & Kim, KE 2016, 'Transforming growth factor-beta 1 in humidifier disinfectant-associated children's interstitial lung disease', Pediatric Pulmonology, vol. 51, no. 2, pp. 173-182. https://doi.org/10.1002/ppul.23226

Transforming growth factor-beta 1 in humidifier disinfectant-associated children's interstitial lung disease. / Kim, Yoon Hee; Kim, Kyung Won; Lee, Kyung Eun; Lee, MiJung; Kim, Sang Kyum; Kim, SeHoon; Shim, Hyo Sup; Lee, Chang Young; Kim, Myung Joon; Sohn, Myung Hyun; Kim, Kyu Earn.

In: Pediatric Pulmonology, Vol. 51, No. 2, 01.02.2016, p. 173-182.

Research output: Contribution to journalArticle

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T1 - Transforming growth factor-beta 1 in humidifier disinfectant-associated children's interstitial lung disease

AU - Kim, Yoon Hee

AU - Kim, Kyung Won

AU - Lee, Kyung Eun

AU - Lee, MiJung

AU - Kim, Sang Kyum

AU - Kim, SeHoon

AU - Shim, Hyo Sup

AU - Lee, Chang Young

AU - Kim, Myung Joon

AU - Sohn, Myung Hyun

AU - Kim, Kyu Earn

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Summary Background Humidifier disinfectant-associated children's interstitial lung disease has an unpredictable clinical course with a high morbidity and mortality. Objectives To evaluate the differences in clinical findings between survivors and non-survivors of humidifier disinfectant-associated children's interstitial lung disease. To evaluate dynamic changes in serum cytokines related to inflammation and fibrosis in lung injury, and to determine whether these changes are predictive of survival in this disease. Methods We evaluated 17 children with humidifier disinfectant-associated children's interstitial lung disease, from whom serum samples were obtained weekly during hospitalization. The severity of chest tomographic and lung pathologic findings was scored. Levels of several cytokines were measured in the serial serum samples. Results Seven of the 17 children were survivors. Compared to survivors, non-survivors had greater ground-glass attenuation on follow-up chest tomography, higher admission neutrophil counts, and more macrophages on pathologic findings. Transforming growth factor-beta 1 persisted at an elevated level (1,000-1,500 pg/ml) in survivors, whereas it decreased abruptly in non-survivors. At the time of this decrease, non-survivors had clinical worsening of their respiratory failure. Transforming growth factor-beta 1 was positively correlated with PaO2/FiO2 (r = 0.481, P < 0.0001). Conclusions Non-survivors exhibited more inflammatory clinical findings than survivors. Transforming growth factor-beta 1 remained elevated in survivors, suggesting that it affected the clinical course of humidifier disinfectant-associated children's interstitial lung disease. The prognosis of this lung disease may depend more on controlling excessive inflammation and repairing damaged lung than on fibrosis, and transforming growth factor-beta 1 may play a key role in this process.

AB - Summary Background Humidifier disinfectant-associated children's interstitial lung disease has an unpredictable clinical course with a high morbidity and mortality. Objectives To evaluate the differences in clinical findings between survivors and non-survivors of humidifier disinfectant-associated children's interstitial lung disease. To evaluate dynamic changes in serum cytokines related to inflammation and fibrosis in lung injury, and to determine whether these changes are predictive of survival in this disease. Methods We evaluated 17 children with humidifier disinfectant-associated children's interstitial lung disease, from whom serum samples were obtained weekly during hospitalization. The severity of chest tomographic and lung pathologic findings was scored. Levels of several cytokines were measured in the serial serum samples. Results Seven of the 17 children were survivors. Compared to survivors, non-survivors had greater ground-glass attenuation on follow-up chest tomography, higher admission neutrophil counts, and more macrophages on pathologic findings. Transforming growth factor-beta 1 persisted at an elevated level (1,000-1,500 pg/ml) in survivors, whereas it decreased abruptly in non-survivors. At the time of this decrease, non-survivors had clinical worsening of their respiratory failure. Transforming growth factor-beta 1 was positively correlated with PaO2/FiO2 (r = 0.481, P < 0.0001). Conclusions Non-survivors exhibited more inflammatory clinical findings than survivors. Transforming growth factor-beta 1 remained elevated in survivors, suggesting that it affected the clinical course of humidifier disinfectant-associated children's interstitial lung disease. The prognosis of this lung disease may depend more on controlling excessive inflammation and repairing damaged lung than on fibrosis, and transforming growth factor-beta 1 may play a key role in this process.

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