[Interstitial Lung Disease]. / Enfermedad pulmonar intersticial difusa.

Diffuse interstitial lung diseases (ILD) are a heterogeneous group of respiratory disorders that are usually classified together because they have similar clinical, radiological, physiological or pathological manifestations. In the last decade there have been important scientific advances in the study of these entities, which has led to a better understanding of their pathophysiology and to the appearance of treatments that have brought about a paradigm shift in the disease. This document presents a series of questions and answers on ILD, with special emphasis on the most relevant changes in terms of pathophysiology, diagnosis, and treatment.

Factor de necrosis tumoral como marcador de inflamación precoz en fumadores sanos / Tumor necrosis factor as an early marker of inflammation in healthy smokers

Fundamento y objetivo: El tabaco produce una inflamación que conduce a pérdida de función pulmonar. El tumoral necrosis factor α (TNF-α, «factor de necrosis tumoral α») es una citocina implicada en la patogenia de la enfermedad pulmonar obstructiva crónica. Necesitamos desarrollar métodos que permitan detectar precozmente a los fumadores en riesgo de pérdida de función pulmonar. Los objetivos de este trabajo fueron: demostrar que los fumadores tienen valores más elevados de TNF-α en suero y condensado de aire exhalado (CAE); valorar la influencia de sexo, edad y peso en dichos valores; conocer la relación entre consumo de tabaco y función pulmonar con los valores de TNF-α. Pacientes y método: Grupo estudio y control sin patología. Realización de espirometría con test broncodilatador, recogida de CAE y extracción sanguínea previa al abandono del tabaco. Análisis estadístico con SPSS 11.0. Resultados: Se incluyeron 51 pacientes (60,8% fumadores), un 56,9% mujeres, con una edad media de 39,88 años. Los fumadores tenían un consumo medio de 21,68 cigarrillos/día y una edad media de inicio de 15,77 años. Los fumadores tenían valores significativamente más elevados de TNF-α en suero (p<0,043); los valores en CAE no mostraban diferencias. De los parámetros de consumo de tabaco, solo la edad de inicio y el TNF-α plasmático guardaban correlación. De la función pulmonar, solo la capacidad vital forzada y el volumen espirado durante el primer segundo guardaban relación con el TNF-α plasmático. Conclusiones: Los fumadores tienen valores más elevados de TNF-α en suero. La cuantía de años de consumo de tabaco influye en los valores de TNF-α plasmáticos. Existe una discreta relación de la función pulmonar con los valores de TNF-α en suero. Los valores de TNF en CAE no muestran diferencias ni correlaciones significativas (AU)

Background and objectives: Smoking creates an inflammation that leads to lose of lung function. Tumor necrosis factor alpha (TNF-α) is a cytokine that plays an important role in the pathogenesis of chronic obstructive pulmonary disease. There is a need to develop methods for an early detection of an impaired lung function in smokers. We aimed to show that smokers have higher levels of TNF-α in serum and exhaled breath condensate (EBC). We also analysed the influence of sex, age and weight on TNF-α, and determined the association between smoking, pulmonary function and TNF-α.Patients and methods: Prospective study of smokers and non-smokers without any known disease. Respiratory function tests, EBC and blood samples were performed before smoking cessation. Statistical analysis: SPSS 11.0. Results: Fifty-one patients (60.8% smokers), 56.9% females, mean age 39.88 years old. Smokers initiated at an age of 15.77 years; the mean of cigarettes/day was 21.68. Significant differences in TNF-α serum levels between smokers and non-smokers were observed (P<.043). Differences did not reach significance for EBC. For tobacco consumption data, only age at smoking initiation and serum TNF-α levels had a correlation. A significant relation between TNF-α serum levels and forced expiratory volume in one second and forced vital capacity was found. Conclusions: Smokers show higher TNF-α levels in serum. Number of years of smoking has an influence on TNF-α levels. There is a modest corelation between pulmonary function and plasma TNF-α levels, but not for EBC (AU)

[Tumor necrosis factor as an early marker of inflammation in healthy smokers]. / Factor de necrosis tumoral como marcador de inflamación precoz en fumadores sanos.

BACKGROUND AND OBJECTIVES: Smoking creates an inflammation that leads to lose of lung function. Tumor necrosis factor alpha (TNF-α) is a cytokine that plays an important role in the pathogenesis of chronic obstructive pulmonary disease. There is a need to develop methods for an early detection of an impaired lung function in smokers. We aimed to show that smokers have higher levels of TNF-α in serum and exhaled breath condensate (EBC). We also analysed the influence of sex, age and weight on TNF-α, and determined the association between smoking, pulmonary function and TNF-α. PATIENTS AND METHODS: Prospective study of smokers and non-smokers without any known disease. Respiratory function tests, EBC and blood samples were performed before smoking cessation. STATISTICAL ANALYSIS: SPSS 11.0. RESULTS: Fifty-one patients (60.8% smokers), 56.9% females, mean age 39.88 years old. Smokers initiated at an age of 15.77 years; the mean of cigarettes/day was 21.68. Significant differences in TNF-α serum levels between smokers and non-smokers were observed (P<.043). Differences did not reach significance for EBC. For tobacco consumption data, only age at smoking initiation and serum TNF-α levels had a correlation. A significant relation between TNF-α serum levels and forced expiratory volume in one second and forced vital capacity was found. CONCLUSIONS: Smokers show higher TNF-α levels in serum. Number of years of smoking has an influence on TNF-α levels. There is a modest correlation between pulmonary function and plasma TNF-α levels, but not for EBC.