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Immunohistochemical and morphometric evaluation of COX 1 and COX-2 in the remodeled lung in idiopathic pulmonary fibrosis and systemic sclerosis / Avaliacao imuno-histoquimica e morfometrica de COX-1 e COX-2 no remodelamento pulmonar na fibrose pulmonar idiopatica e na esclerose sistemica
Parra, Edwin Roger; Lin, Flavia; Martins, Vanessa; Rangel, Maristela Peres; Capelozzi, Vera Luiza.
  • Parra, Edwin Roger; University of Sao Paulo. School of Medicine. Sao Paulo. BR
  • Lin, Flavia; University of Sao Paulo. School of Medicine. Sao Paulo. BR
  • Martins, Vanessa; University of Sao Paulo. School of Medicine. Sao Paulo. BR
  • Rangel, Maristela Peres; University of Sao Paulo. School of Medicine. Sao Paulo. BR
  • Capelozzi, Vera Luiza; University of Sao Paulo. School of Medicine. Sao Paulo. BR
J. bras. pneumol ; 39(6): 692-700, Nov-Dec/2013. tab, graf
Article in English | LILACS | ID: lil-697779
ABSTRACT

OBJECTIVE:

To study the expression of COX-1 and COX-2 in the remodeled lung in systemic sclerosis (SSc) and idiopathic pulmonary fibrosis (IPF) patients, correlating that expression with patient survival.

METHODS:

We examined open lung biopsy specimens from 24 SSc patients and 30 IPF patients, using normal lung tissue as a control. The histological patterns included fibrotic nonspecific interstitial pneumonia (NSIP) in SSc patients and usual interstitial pneumonia (UIP) in IPF patients. We used immunohistochemistry and histomorphometry to evaluate the expression of COX-1 and COX-2 in alveolar septa, vessels, and bronchioles. We then correlated that expression with pulmonary function test results and evaluated its impact on patient survival.

RESULTS:

The expression of COX-1 and COX-2 in alveolar septa was significantly higher in IPF-UIP and SSc-NSIP lung tissue than in the control tissue. No difference was found between IPF-UIP and SSc-NSIP tissue regarding COX-1 and COX-2 expression. Multivariate analysis based on the Cox regression model showed that the factors associated with a low risk of death were younger age, high DLCO/alveolar volume, IPF, and high COX-1 expression in alveolar septa, whereas those associated with a high risk of death were advanced age, low DLCO/alveolar volume, SSc (with NSIP), and low COX-1 expression in alveolar septa.

CONCLUSIONS:

Our findings suggest that strategies aimed at preventing low COX-1 synthesis will have a greater impact on SSc, whereas those aimed at preventing high COX-2 synthesis will have a greater impact on IPF. However, prospective randomized clinical trials are needed in order to confirm that. .
RESUMO

OBJETIVO:

Estudar a expressão de COX-1 e COX-2 em áreas pulmonares remodeladas em pacientes com esclerose sistêmica (ES) ou fibrose pulmonar idiopática (FPI) e correlacioná-la com a sobrevida desses pacientes.

MÉTODOS:

Examinamos espécimes de biópsia pulmonar a céu aberto de 24 pacientes com ES e de 30 pacientes com FPI, utilizando-se tecido pulmonar normal como controle. Os padrões histológicos incluíram pneumonia intersticial não específica (PINE) fibrótica em pacientes com ES e pneumonia intersticial usual (PIU) nos pacientes com FPI. Imuno-histoquímica e histomorfometria foram usadas para avaliar a expressão celular de COX-1 e COX-2 em septos alveolares, vasos e bronquíolos, sua correlação com provas de função pulmonar e seu impacto na sobrevida.

RESULTADOS:

A expressão de COX-1 e COX-2 em septos alveolares foi significativamente maior em FPI-PIU e ES-PINE do que no tecido controle. Não houve diferença entre FPI-PIU e ES-PINE quanto à expressão de COX-1 e COX-2. A análise multivariada baseada no modelo de regressão de Cox mostrou que os fatores associados a baixo risco de morte foram ter idade menor, valores elevados de DLCO/volume alveolar, FPI, e alta expressão de COX-1 em septos alveolares, ao passo que os fatores associados a alto risco de morte foram ter idade maior, valores baixos de DLCO/volume alveolar, ES (com PINE) e baixa expressão de COX-1 em septos alveolares.

CONCLUSÕES:

Nossos resultados sugerem que estratégias de prevenção de baixa síntese de COX-1 terão maior impacto sobre a ES, ao passo que as de prevenção de alta síntese de COX-2 terão maior impacto sobre a FPI. Porém, são necessários ensaios clínicos randomizados prospectivos para confirmar essa hipótese. .
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Scleroderma, Systemic / Cyclooxygenase 1 / Idiopathic Pulmonary Fibrosis / Airway Remodeling Type of study: Controlled clinical trial / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: J. bras. pneumol Journal subject: Pulmonary Disease (Specialty) Year: 2013 Type: Article Affiliation country: Brazil Institution/Affiliation country: University of Sao Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Scleroderma, Systemic / Cyclooxygenase 1 / Idiopathic Pulmonary Fibrosis / Airway Remodeling Type of study: Controlled clinical trial / Observational study / Prognostic study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: J. bras. pneumol Journal subject: Pulmonary Disease (Specialty) Year: 2013 Type: Article Affiliation country: Brazil Institution/Affiliation country: University of Sao Paulo/BR