Different cytokine profiles in cryptogenic fibrosing alveolitis and fibrosing alveolitis associated with systemic sclerosis

ABSTRACT: Differences in the inflammatory,response and prognosis of cryptogenic fibrosing alveolitis (CFA) and,that associated with systemic,sclerosis (FASSc) are beginning,to emerge. It is hypothesized,that these differences may,be reflected in a distinct pattern of T-helper (Th)-1 and Th-2-type cytokines. Open lung biopsies were obtained,from,clinically well-documented,cases of CFA and FASSc and, as a control, compared with grossly and histologically normal paren- chyma,obtained,from,smokers,whose,lungs were,resected for cancer,(n=5 in each group). In situ hybridization,(ISH) was applied to the samples,using anti-sense and sense,, in CFA and control subjects, respectively. Whereas the proportions of the four cytokines in FASSc were similar to the control subjects, IL-4 and IL-5 pre- dominated significantly in CFA (p<0.001). For example, the ratio of IL-5 to IFN-c was 22:1 in CFA, significantly higher than in the cases with FASSc (2:1) or the control subjects (4:1) (p<0.05). In conclusion, cryptogenic fibrosing alveolitis is an inflammatory condition which is characterized, like asthma, by a predominance of gene expression for T-helper-2- type regulatory cytokines, whereas cryptogenic fibrosing alveolitis associated with systemic sclerosis appears,to have a distinct mixed,T-helper-1/T-helper-2 functional phenotype,and a greater number,of cells expressing each of these pro-inflammatory cytokines. Eur Respir J 1999; 14: 251‐257.