Increased Expression of CC16 in Patients with Idiopathic Pulmonary Fibrosis

PLoS One. 2016 Dec 15;11(12):e0168552. doi: 10.1371/journal.pone.0168552. eCollection 2016.

Abstract

Idiopathic pulmonary fibrosis (IPF) is a devastating disease of unknown etiology. The pathogenic mechanisms are unclear, but evidence indicates that aberrantly activated alveolar epithelial cells secrete a variety of mediators which induce the migration, proliferation and activation of fibroblasts and finally the excessive accumulation of extracellular matrix with the consequent destruction of the lung parenchyma. CC16 (approved symbol SCGB1A1), a putative anti-inflammatory protein produced by "club" cells in the distal airways, has not been evaluated in IPF lungs. In this study, we determined the serum and bronchoalveolar lavage (BAL) levels as well as the lung cell localization of this protein. Also, we explored the usefulness of serum levels of CC16 for the differential diagnosis of IPF (n = 85), compared with non-IPF interstitial lung diseases [chronic hypersensitivity pneumonitis (cHP; n = 85) and connective tissue diseases (CTD-ILD; n = 85)]. CC16 was significantly increased in serum and BAL fluids of IPF patients and was found not only in club cells but also in alveolar epithelial cells. When compared with non-IPF patients and controls, serum levels were significantly increased (p<0.0001). Sensitivity and specificity for CC16 (cut-off 41ng/mL) were 24% and 90%, positive predictive value 56% and negative predictive value 69%. These findings demonstrate that CC16 is upregulated in IPF patients suggesting that may participate in its pathogenesis. Although higher than the serum levels of non-IPF patients it shows modest sensitivity to be useful as a potential biomarker for the differential diagnosis.

MeSH terms

  • Aged
  • Biomarkers / blood*
  • Biomarkers / metabolism
  • Bronchi / cytology
  • Bronchi / metabolism
  • Bronchoalveolar Lavage Fluid / chemistry*
  • Epithelial Cells / metabolism
  • Female
  • Humans
  • Idiopathic Pulmonary Fibrosis / blood*
  • Idiopathic Pulmonary Fibrosis / diagnosis*
  • Idiopathic Pulmonary Fibrosis / metabolism
  • Lung Diseases, Interstitial / blood
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / metabolism
  • Male
  • Middle Aged
  • Pulmonary Alveoli / cytology
  • Pulmonary Alveoli / metabolism
  • Sex Factors
  • Uteroglobin / blood*
  • Uteroglobin / metabolism*

Substances

  • Biomarkers
  • SCGB1A1 protein, human
  • Uteroglobin

Grants and funding

This study was supported by CONACYT SALUD-2011-1-162010 and by the National Institute of Respiratory Diseases, Mexico. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. There was no additional external funding received for this study.