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Suboptimal Erythropoietic Response to Hypoxemia in Idiopathic Pulmonary Fibrosis*
- Source :
- Chest. 124:548-553
- Publication Year :
- 2003
- Publisher :
- Elsevier BV, 2003.
-
Abstract
- Idiopathic pulmonary fibrosis (IPF) is a chronic inflammatory process characterized by severe derangement of gas exchange in the advanced stages of disease. However, erythrocytosis is infrequent in IPF. The aim of this study was to investigate the potential relation between the blunted erythropoietic response and the chronic inflammation.Nine patients (6 men and 3 women) with IPF and profound hypoxemia (PO(2)65 mm Hg) and 34 sex- and age-matched healthy volunteers participated in the study.We evaluated the hematologic parameters, serum erythropoietin, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and IL-8 levels. We also studied the development of burst-forming unit-erythroid (BFU-E)-derived colonies in semisolid methylcellulose cultures in blood samples from all patients.Hemoglobin and serum erythropoietin levels were almost comparable between the two studied groups. On the contrary, serum TNF-alpha, IL-6, and IL-8 values were significantly higher in patients with IPF (p0.05, p0.01, and p0.001, respectively). IPF sera induced a significant growth inhibition of erythroid bursts arising from mononuclear cells of either patients or control subjects compared with heat-inactivated AB serum (p0.05 and p0.01, respectively). Moreover, there was an apparent increment in the number of BFU-E colonies when patients' mononuclear cells were cultured in comparison with those of healthy subjects (p0.05).Our findings suggest that in IPF there is an increased number of primitive erythroid progenitors, which fail to proliferate and differentiate in vivo, suggesting a kind of ineffective erythropoiesis. As a consequence, hemoglobin levels do not rise in proportion to the severity of hypoxemia. Cytokines released from alveolar macrophages seem to have not only local but also systemic effects, since the serum of these patients directly suppressed erythropoiesis; however, the suboptimal erythropoietic response to hypoxia cannot be entirely attributed to this suppression. It is possible that several other factors interfere, synergistically or additively.
- Subjects :
- Male
Pulmonary and Respiratory Medicine
Ineffective erythropoiesis
medicine.medical_specialty
Pulmonary Fibrosis
Inflammation
Critical Care and Intensive Care Medicine
medicine.disease_cause
Hypoxemia
Idiopathic pulmonary fibrosis
Internal medicine
medicine
Humans
Erythropoiesis
Erythropoietin
Aged
Erythroid Precursor Cells
Interleukin-6
Tumor Necrosis Factor-alpha
business.industry
Interleukin-8
Interleukin
Middle Aged
Hypoxia (medical)
medicine.disease
Endocrinology
Case-Control Studies
Immunology
Female
medicine.symptom
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 00123692
- Volume :
- 124
- Database :
- OpenAIRE
- Journal :
- Chest
- Accession number :
- edsair.doi.dedup.....6fcbcc5e12c144c5ae58a4afec9a0ba0