背景:“间质性肺病”(ILD)是一个广泛的术语,涵盖了不同背景的疾病。“具有自身免疫特征的间质性肺炎”(IPAF)是一个最新术语,暗示存在自身免疫。
目的:本研究旨在确定波兰IPAF患者的特征,将它们与其他间质性肺炎患者进行比较,并在血清和支气管肺泡灌洗液(BALF)中寻找IPAF的预后和诊断生物标志物。
方法:这项多中心前瞻性研究计划招募240名参与者,分为1个研究组和2个对照组。将根据波兰呼吸学会管理指南收集生物流体样品,并将其储存在-80°C下进行进一步测试。计划对60名新诊断的个体进行为期5年的前瞻性观察。这项研究将分为几个小节。首先,我们计划描述波兰IPAF患者(研究组)与其他ILD患者(2个对照组)的关系.对照组1将包括特发性ILD患者,主要包括特发性肺纤维化和非特异性间质性肺炎。对照组2将包括结缔组织疾病相关的间质性肺病患者,比如类风湿性关节炎,系统性硬化症,多发性肌炎,皮肌炎,干燥综合征,混合性结缔组织病,和系统性红斑狼疮.将分析放射学和功能参数。将根据高分辨率计算机断层扫描结果对患者进行比较,6分钟的步行测试表现,和肺功能测试参数。IPAF的诊断将通过多学科讨论定期重新评估,以确定其临床稳定性。在实验室里,将评估炎症和纤维化途径。细胞因子水平(白细胞介素8,转化生长因子β1,趋化因子C-C基序配体[CXCL]18,CXCL1,表面活性蛋白[SP]-A,SP-D,KrebsvondenLungen-6蛋白,和几丁质酶1)将在血清和BALF中进行测量。将进行血清和BALF细胞因子水平的比较分析,以建立全身和局部炎症途径之间的潜在差异。在研究的生活质量(QoL)方面,将评估呼吸困难和咳嗽及其对QoL各个方面的影响。抑郁和焦虑将用医院焦虑和抑郁改良量表和9项患者健康问卷进行测量,并评估与症状患病率的潜在相关性。
结果:这项研究将于2023年10月开始招募患者进入第一阶段。最终结果将于2028年公布。我们计划在第一阶段开始2-3年后发布初步结果。
结论:这项研究将为更好地了解IPAF的病因和结果迈出一步。
■PRR1-10.2196/44802。
BACKGROUND: \"Interstitial lung disease\" (ILD) is a broad term encompassing diseases of different backgrounds. \"Interstitial pneumonia with autoimmune features\" (IPAF) is a recent term that implies the presence of autoimmunity.
OBJECTIVE: This study aims to determine the characteristics of Polish patients with IPAF, compare them with patients with other interstitial pneumonias, and search for the prognostic and diagnostic biomarkers of IPAF in serum and bronchoalveolar lavage fluid (BALF).
METHODS: This multicenter prospective study plans to recruit 240 participants divided into 1 study group and 2 control groups. Biological fluid samples will be collected according to Polish Respiratory Society management guidelines and stored at -80°C for further tests. Prospective 5-year observations of 60 newly diagnosed individuals are planned. The study will be divided into subsections. First, we plan to characterize Polish patients with IPAF (study group) against their peers with other ILDs (2 control groups). Control group 1 will comprise patients with idiopathic ILDs, including mainly idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia. Control group 2 will comprise patients with connective tissue disease-associated interstitial lung diseases, such as rheumatoid arthritis, systemic sclerosis, polymyositis, dermatomyositis, Sjögren\'s syndrome, mixed connective tissue disease, and systemic lupus erythematosus. Radiological and functional parameters will be analyzed. Patients will be compared in terms of high-resolution computed tomography results, the 6-minute walking test performance, and pulmonary function test parameters. The diagnosis of IPAF will be reassessed on a regular basis through multidisciplinary discussion in order to determine its clinical stability. In the laboratory arm, inflammation and fibrosis pathways will be assessed. Cytokine levels (interleukin 8, transforming growth factor beta 1, chemokine C-C motif ligand [CXCL]18, CXCL1, surfactant protein [SP]-A, SP-D, Krebs von den Lungen-6 protein, and chitinase 1) will be measured in serum and BALF. A comparative analysis of serum and BALF cytokine levels will be performed in order to establish potential differences between systemic and local inflammatory pathways. In the quality of life (QoL) arm of the study, dyspnea and cough and their impact on various aspects of the QoL will be assessed. Depression and anxiety will be measured with the Hospital Anxiety and Depression Modified Scale and the 9-item Patient Health Questionnaire, and potential correlations with symptom prevalence will be assessed.
RESULTS: This study will start recruiting patients to phase 1 in October 2023. The final results will be available in 2028. We plan to publish preliminary results after 2-3 years from the start of phase 1.
CONCLUSIONS: This study will be a step toward a better understanding of IPAF etiopathogenesis and outcomes.
UNASSIGNED: PRR1-10.2196/44802.