The online version of this article (doi:10.1186/s12890-015-0122-z) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
Study conceptualization and design: Dr. JHS. Dr. JHS takes responsibility for the content of the manuscript, including the data and analysis. Data collection: Drs LQ, and WZW. Pathological review and immunohistochemical analysis: Drs HRL and WZW. Statistical analyses: Dr. LQ. Manuscript preparation: Drs. JHS and YX. Advice on rheumatologic disease: Dr. WJZ. Advice on radiology: Dr. MWQ. All authors read and approved the final version.
Nonspecific interstitial pneumonia (NSIP) is characterized by interstitial infiltration of T lymphocytes, and subpopulations of these cells may be associated with the progression of fibrosis. However, few studies evaluate the correlation of prognosis with this characteristic. Therefore, we performed morphological and quantitative analyses of T lymphocytes in patients with NSIP and evaluated the relationship between T lymphocytes and prognosis.
Immunohistochemistry was used to detect the presence of CD4+ and CD8+ T lymphocytes in 55 biopsies of patients with NSIP to determine the numbers of these T cell subpopulations in lymphoid follicles as well as in perivascular, interstitial, and peribronchial anatomical compartments. The relationship between CD4+ and CD8+ T lymphocyte populations and prognosis was analyzed.
The mean age of 55 patients was 48.9 ± 10.5 years, and 36 (65 %) of patients were women. All patients were followed for a mean duration of 46 ± 25 months. Thirteen (23.6 %) patients died during follow-up. Perivascular CD4+ lymphocyte infiltration (HR, 0.939; 95 % CI, 0.883–0.999; p = 0.048) was an independent risk factor for survival. Perivascular infiltrates of CD4+ T lymphocytes correlated with survival time (r = 0.270, p = 0.046). Patients with improved forced vital capacity survived longer and had higher numbers of CD4+ T lymphocytes that infiltrated perivascular tissue. The densities of CD4+ and CD8+ T lymphocytes infiltrating other tissues were not significantly associated with survival time.
Perivascular infiltration of CD4+ T lymphocytes in patients with NSIP correlated with prognosis. The underlying mechanisms are unknown and require further studies.
Additional file 1: Table S1. The prognostic factors study with multivariate analysis. (DOCX 406 kb)12890_2015_122_MOESM1_ESM.docx
Additional file 2: Figure S1. The relationship between perivascular CD4 infiltration and DLCO (p = 0.642, r = −0.064). (PPT 98 kb)12890_2015_122_MOESM2_ESM.ppt
Additional file 3: Figure S2.The relationship between perivascular CD4 infiltration and 12 months follow-up DLCO (p = 0.134, r = −0.205). (PPT 43 kb)12890_2015_122_MOESM3_ESM.ppt
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- Prognosis of nonspecific interstitial pneumonia correlates with perivascular CD4+ T lymphocyte infiltration of the lung
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