Adiposity and Interstitial Lung Abnormalities in Community-Dwelling Adults

Anderson, Michaela R.; Kim, John S.; Allison, Matthew; Giles, Jon T.; Hoffman, Eric A.; Ding, Jingzhong; Barr, R. Graham; Podolanczuk, Anna J.

doi:10.1016/j.chest.2021.03.058

Cited by 20 publications

(22 citation statements)

References 46 publications

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“…The association between obesity and pulmonary diseases, including ILD, can be related to TNF-α -, MCP-1 -, and TGF-β1-dependent pathways, insulin resistance, or altered lung microbiota [ 43 , 44 , 45 ]. Greater amounts of visceral adipose tissue predispose to a higher prevalence of interstitial lung abnormalities [ 46 ]. It was suggested that this association mightbe partially mediated by IL-6 and leptin [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

Interstitial Lung Disease in Primary Biliary Cholangitis: A Cohort Prospective Study

Kalashnikov

Akulkina

Brovko

et al. 2023

Life

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Interstitial lung disease (ILD) has been recognized as an extrahepatic manifestation ofprimary biliary cholangitis (PBC), althoughlimited data are available on its prevalence and clinical significance. Therefore, we evaluated the occurrence and clinical features of ILD in a cohort of PBC patients. Ninety-three individuals without concomitant rheumatic diseases were enrolled in our prospective cohort study. All patients underwent chest high-resolution computed tomography (HRCT). Liver-related and lung-related survival wereassessed. A lung-related outcome was defined as death from ILD complications; a liver-related outcome was defined as liver transplantation or death from liver cirrhosis complications. HRCT findings suggestive ofILD were detected in 38 patients (40.9%). A sarcoid-like pattern of PBC-associated ILD was the most frequent, followed by subclinical ILD and organizing pneumonia. Patients with ILD were less likely to have liver cirrhosis and liver-related symptoms and presented with higher serum immunoglobulin M(IgM) and M2 subtype antimitochondrial antibodies (AMA-M2) positivity rates. In a multivariate analysis, the absence of liver disease symptoms at the disease presentation (OR 11.509; 95% CI 1.210–109.421; p = 0.033), the presence of hepatic non-necrotizing epithelioid cell granulomas (OR 17.754; 95% CI 1.805–174.631; p = 0.014), higher serum IgM (OR 1.535; 95% CI 1.067–2.208; p = 0.020) and higher blood leukocyte count (OR 2.356; 95% CI 1.170–4.747; p = 0.016) were independent risk factors associated with ILD in PBC. More than a third of patients with ILD showed no respiratory symptoms, and only one ILD-related death occurred during a follow-up of 29.0 months (IQR 11.5; 38.0). Patients with ILD had better liver transplant-free survival.ILD in PBC had a benign course and was associated with a lower liver disease severity. PBC-associated ILD should be included in a list of differential diagnoses of ILD.

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Section: Discussionmentioning

confidence: 99%

Interstitial Lung Disease in Primary Biliary Cholangitis: A Cohort Prospective Study

Kalashnikov

Akulkina

Brovko

et al. 2023

Life

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“…There are several possible effects of BMI on fibrotic ILDs. First, large amounts of pericardial and abdominal visceral adipose tissue have been reported to be associated with a higher prevalence of interstitial lung abnormalities associated with gastroesophageal reflux and a lower FVC 32 . Second, the association between obesity and immune balance may affect the pathogenesis of various lung diseases 33 .…”

Section: Discussionmentioning

confidence: 99%

Lung CCR6−CXCR3− type 2 helper T cells as an indicator of progressive fibrosing interstitial lung diseases

Tsukuda

Ohnishi

Fujimoto

et al. 2022

Sci Rep

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Progressive fibrosing interstitial lung diseases (PF-ILDs) have a poor prognosis and may be resistant to corticosteroids and/or immunosuppressants, but antifibrotic therapies such as nintedanib and pirfenidone have been shown to slow the deterioration of lung function. The aim of this study was to identify the characteristic cellular profile of bronchoalveolar lavage fluid at diagnostic bronchoscopy for predicting PF-ILDs, defined as fibrotic diseases on chest high-resolution computed tomography with more than a 5% relative decline in the percent predicted value of forced vital capacity (FVC) over 6 months. The proportions of inflammatory cells, CCR6−CXCR3− T helper type 2 (Th2) cells among conventional CD4+ T cells in bronchoalveolar lavage fluid (BALF) and peripheral blood, were measured by flowcytometry. The proportion of lymphocytes in BALF was significantly higher in non-PF-ILD patients than in PF-ILD patients. The proportion of Th2 cells in BALF, but not in peripheral blood, was significantly higher in PF-ILD patients than in non-PF-ILD patients. Multivariate analysis showed that a greater population of Th2 cells in BALF was the only indicator for PF-ILDs. An increased proportion of Th2 cells in BALF is associated with greater deterioration of lung function in fibrotic interstitial lung diseases.

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“…35 They concluded that increased pericardial and/or abdominal visceral adipose tissue were associated with early lung injury and thus, adipose tissue may represent a modifiable risk factor for ILAs and an early indicator of ILD risk. 35 Another large analysis of CT findings in the Framingham Heart Study found that lower pulmonary vascular volumes on CT were associated with greater odds of ILAs and restrictive spirometry, identifying another possible early predictor of significant ILD. 36 With the emergence of novel approaches, there remains the possibility that lung biopsy need can be further reduced in the diagnostic work up of ILDs.…”

Section: Screening and Early Diagnosismentioning

confidence: 99%

“…The Multi‐Ethnic Study of Atherosclerosis (MESA) is an ongoing prospective cohort study that enrolled 6814 adults aged 45–84 years between 2000 and 2002 with numerous subsequent follow‐up examinations. Anderson et al evaluated adipose tissue and the risk of ILD; while previous work examining the link between BMI and parenchymal lung disease had been inconsistent, the authors demonstrated that in the MESA cohort, for every doubling in pericardial adipose tissue volume there was 20% increase in the odds of ILAs and for visceral adipose tissue there was 30% increased odds and lower forced vital capacity (FVC) measures 35 . They concluded that increased pericardial and/or abdominal visceral adipose tissue were associated with early lung injury and thus, adipose tissue may represent a modifiable risk factor for ILAs and an early indicator of ILD risk 35 .…”

Section: Diagnosis and Prognosticationmentioning

confidence: 99%

“…Anderson et al evaluated adipose tissue and the risk of ILD; while previous work examining the link between BMI and parenchymal lung disease had been inconsistent, the authors demonstrated that in the MESA cohort, for every doubling in pericardial adipose tissue volume there was 20% increase in the odds of ILAs and for visceral adipose tissue there was 30% increased odds and lower forced vital capacity (FVC) measures 35 . They concluded that increased pericardial and/or abdominal visceral adipose tissue were associated with early lung injury and thus, adipose tissue may represent a modifiable risk factor for ILAs and an early indicator of ILD risk 35 . Another large analysis of CT findings in the Framingham Heart Study found that lower pulmonary vascular volumes on CT were associated with greater odds of ILAs and restrictive spirometry, identifying another possible early predictor of significant ILD 36 …”

Section: Diagnosis and Prognosticationmentioning

confidence: 99%

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Contemporary Concise Review 2021: Interstitial lung disease

McCarthy

Keane

2022

Respirology

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The last 2 years have presented previously unforeseen challenges in pulmonary medicine. Despite the significant impact of the SARS-CoV-2 pandemic on patients, clinicians and communities, advances in the care and understanding of interstitial lung disease (ILD) continued unabated. Recent studies have led to improved guidelines, better understanding of the role for antifibrotics in fibrosing ILDs, prognostic indicators and novel biomarkers. In this concise contemporary review, we summarize many of the important studies published in 2021, highlighting their relevance and impact to the management and knowledge of ILD.

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Adiposity and Interstitial Lung Abnormalities in Community-Dwelling Adults

Cited by 20 publications

References 46 publications

Interstitial Lung Disease in Primary Biliary Cholangitis: A Cohort Prospective Study

Interstitial Lung Disease in Primary Biliary Cholangitis: A Cohort Prospective Study

Lung CCR6−CXCR3− type 2 helper T cells as an indicator of progressive fibrosing interstitial lung diseases

Contemporary Concise Review 2021: Interstitial lung disease

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