간질성 폐질환 환자의 기관지폐포세척액 및 혈청에서의 Type 3 Procollagen N - terminal Peptide 측정 = Type 3 Procollagen N - terminal Peptides Level in Serum and Bronchoalveolar Lavage Fluids of Interstitial Lung Disease Patients

다국어 초록 (Multilingual Abstract)

Objectives: Idiopathic pulmonary fibrosis(IPF) is characterized by varying degree of chronic inflammation and fibrosis. A hallmark of this disease is the abnormal deposition of collagen, which is a prime determinant of clinical course. The deposition of collagen is a multiple step process involving intracelluar synthesis by connective tissue cells. such as fibbroblast, secretion into the extracellular space, extracellular enzymatic processing, and subsequent cross-liking. Part of the extracellular processing of collagen involves the cleavage of procollagen peptides from the C-terminal and N-terminal ends of the molecule. Type III N-terminal procollagen peptide (N-PIIIP) is a peptide released during the conversion of type III procollagen to type III collagen and are known to be a useful marker for collagen metabolism. The purpose of the present study was to exlpore the relationship between N-PIIIP levels in the serum, bronchoalveolar lavage fluid(BALF) and various physiologic parameters and course of the diseases in IPF patients. Methods: The level of N-PIIIP in bronchoalveolar lavage fluid(BALF) and serum from patients with IPF, sarcoidosis and collagen lung disease and healthy controls were measured by radioimmunoassay. Results: The results obtained were as follows: 1) The N-PIIIP in BALF of the patients with IPF was higher than that of controls(p<0.05), but there were no difference between sarcoidosis, collagen lung disease and control groups(p>0,05), 2) In patients with IPF, the N-PIIIP in BALF was higher than that in serum(p<0.05) 3) There were no significant differences in the serum N-PIIIP among the interstitial lung diseases and control groups(p>0.05) 4) In patients with IPF, the N-PIIIP in serum correlated positively with difference of alveolar-arterial oxygen gradient between rest and exercise (r=0.65 p<0.05), but did not correlate with total lung capacity or diffusion capacity(respectively, r=－0.205, r=－0.102, p>0.05). 5) In patients with IPF, the N-PIIIP in serum decreased remarkably within 3 months after beginning steroid treatment and didn't change thereafter. Conclusion: These finding suggest that in patients with IPF, the N-PIIIP in BALF can be used as a marker for collagen deposition and the measurement of N-PIIIP in serum may be useful in assessing the response to treatment