Session Information
Date: Tuesday, November 10, 2015
Title: Systemic Sclerosis, Fibrosing Syndromes and Raynaud's - Clinical Aspects and Therapeutics Poster III
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose:
Induced sputum (IS) is a noninvasive tool, aimed at collecting cellular and soluble materials from lung airways. IS is well accepted by patients, safer than bronchoalveolar lavage (BAL) and easily repeated. IS sampling has been validated in chronic obstructive as well as in various interstitial lung disorders (ILD). Very few studies have evaluated the role of IS analysis in SSc.
Purpose
To evaluate IS cellular analysis in SSc patients compared to healthy controls and its possible relationship with disease manifestations.
Methods:
Twenty consecutive SSc patients and 16 healthy controls underwent pulmonary Function testing (PFT) (Jaeger Masterlab spirometer), single breath diffusion capacity of carbon monoxide (DLCO) and analysis of induced sputum (IS) cytology. IS was recovered after 20 min inhalation of 3% saline with an ultrasonic nebulizer by the selecting plugs method.
Results:
Group 1(SSc) : 13 (65%) with diffuse type,7 ( 35%) with CREST syndrome, 19 (95%) women, mean age 52.25+17.08, disease duration 8.69+7.56 years, Raynaud duration 10.3+9.22 years , eight (40%) patients had a history of ILD and none had pulmonary artery hypertension .
.Group 2 (controls): 16 healthy volunteers: 13 women (81.25%), mean age 57.93 ± 10.4years.
Lung tests:
TLC, FVC and DLCoVA were significantly lower within Group 1 vs controls . Seven patients in Group1 had a restrictive pattern.
SSc patients IS contained higher neutrophils count (p=0.091) and lower lymphocytes count (p=0.045) compared to the control group. No difference in IS cytology was found between types of SSc.
Within Group 1, a statistically significant positive correlation was
found among several clinical, PFT and IS findings (mRss score – CD3 (p=0.044); mRss –CD4 (p=0.04); mRss – % neutrophils (0.059); FVC-% neutrophils (0.002)). Neutrophils counts in IS were significantly inversely associated with TLC and FVC.
IS samples from SSc patients with PFT restrictive pattern contained a significantly lower percentage of lymphocytes (p=0.004) and CD4/CD8 ratio (0.028) compared with controls.
Among SSc, the statically significant high CD4/CD8 ratio was associated with restrictive PFT pattern (p=0.05).
A positive correlation was found between restrictive subtype of Group 1 IS cytology count and several clinical, laboratory PFT parameters ( disease duration- CD4/CD8 ratio(p=0.033), TLC- CD3(p=0.053), TLC and FVC – % macrophages (p=0.033,p=0.052 respectively), DLCoVA – % macrophages (p=0.032), CRP – % lymphocytes ,% macrophages and neutrophils (p=0.019 and p= 0.008 and p= 0.006 respectively). A Negative correlation was shown between TLC and neutrophils count (p=0.043).
Conclusion:
IS analysis of SSc patients, including patients with restrictive lung disease, shows changes in cellular pattern in comparison to healthy controls and correlation with several clinical and PFT parameters.
To cite this abstract in AMA style:
Litinsky I, Fireman E, Polachek A, Broyde A, Sharabi A, Anouk M, Paran D, Elkayam O. Induced Sputum Analysis in Systemic Sclerosis Patients [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/induced-sputum-analysis-in-systemic-sclerosis-patients/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/induced-sputum-analysis-in-systemic-sclerosis-patients/