Challenges in pulmonary fibrosis {middle dot} 2 : Bronchiolocentric fibrosis

Cordier, J

doi:10.1136/thx.2004.031005

Cited by 40 publications

(28 citation statements)

References 183 publications

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“…Pathological analysis of the lung biopsy available in nine out of 25 cases (a proportion possibly greater than that in current clinical practice) demonstrated bronchiolitis in all cases, predominantly with constrictive fibrotic bronchiolitis obliterans and peribronchiolar fibrosis (so-called bronchiolocentric fibrosis [39]), and occasionally follicular or mixed constrictive/ follicular bronchiolitis, in a similar manner to previous studies [5,6]. Both pathological patterns often coexist in patients with RA [6].…”

Section: Discussionsupporting

confidence: 59%

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Devouassoux

Cottin²,

Lioté³

et al. 2009

European Respiratory Journal

107

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The characteristics of patients with rheumatoid arthritis (RA) who develop obliterative bronchiolitis characterised by severe airflow obstruction have been hitherto poorly investigated.A retrospective study of 25 patients with RA and functional evidence of obliterative bronchiolitis (forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) ,50% and/or residual volume (RV)/total lung capacity (TLC) .140% predicted) was conducted.Patients (mean¡SD age 64¡11 yrs) included 17 never-smokers and eight ex-smokers (10.5¡5.4 pack-yrs). The diagnosis of RA preceded respiratory symptoms in 88% of cases. Dyspnoea on exertion was present in all patients and bronchorrhea in 44%. High-resolution computed tomography findings included: bronchial wall thickening (96%), bronchiectasis (40%), mosaic pattern (40%), centrilobular emphysema (56%), and reticular and/or ground-glass opacities (32%). Pulmonary function tests showed: FEV1 41¡12% pred, FEV1/FVC 49¡14%, FVC 70¡20% pred, RV 148¡68% pred and RV/TLC 142¡34% pred. Lung biopsy, available in nine patients, demonstrated constrictive, follicular and mixed bronchiolitis. Patients were followed for 48.2¡49 months. Treatment was poorly effective. Chronic respiratory failure occurred in 40% of patients, and four patients died.Obliterative bronchiolitis associated with rheumatoid arthritis is a severe and under-recognised condition leading to respiratory failure and death in a high proportion of patients.

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Section: Discussionsupporting

confidence: 59%

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Devouassoux

Cottin²,

Lioté³

et al. 2009

European Respiratory Journal

107

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“…Although a definitive diagnosis of bronchiolitis relies on biopsy, this invasive procedure is currently rarely performed in such a setting. The terms bronchiolitis obliterans and obliterative bronchiolitis are considered to be synonymous; however, we usually employ the term obliterative bronchiolitis to designate the clinical functional condition characterised by airflow obstruction resulting from bronchiolitis [10], while the pathological condition is usually designated bronchiolitis obliterans. The characteristic computed tomography direct features of bronchiolitis have been well established [8], with: 1) a pattern of ill-defined nodules of ground-glass attenuation (observed in sub-acute hypersensitivity pneumonitis and CSS) corresponding pathologically to peribronchiolar inflammation; and 2) a pattern of centrilobular nodules with a tree-in-bud appearance and bronchial wall thickening (as seen in Mycobacterium infection and ABPA), which correspond pathologically to the plugging of small airways or dilated bronchioles.…”

Section: Discussionmentioning

confidence: 99%

Hypereosinophilic obliterative bronchiolitis: a distinct, unrecognised syndrome

et al. 2012

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Biopsy-proven cases of eosinophilic bronchiolitis have only been reported in isolation, and all come from Japan.We present six patients with hypereosinophilic obliterative bronchiolitis (HOB), defined by the following criteria: 1) blood eosinophil cell count .1 G?L -1 and/or bronchoalveolar lavage eosinophil count .25%; 2) persistent airflow obstruction despite high-dose inhaled bronchodilators and corticosteroids; and 3) eosinophilic bronchiolitis at lung biopsy (n51) and/or direct signs of bronchiolitis (centrilobular nodules and branching opacities) on computed tomography (n56). Chronic dyspnoea and cough which was often severe, without the characteristic features of asthma, were the main clinical manifestations. Atopy and asthma were present in the history of three and two patients, respectively. One patient met biological criteria of the lymphoid variant of idiopathic hypereosinophilic syndrome. Mean blood eosinophil cell count was 2.7 G?L -1 and mean eosinophil differential percentage at bronchoalveolar lavage was 63%. Mean initial forced expiratory volume in 1 s/forced vital capacity ratio was 50%, normalising with oral corticosteroid therapy in all patients. HOB manifestations recurred when oral prednisone was decreased to 10-20 mg?day -1, but higher doses controlled the disease. HOB is a characteristic entity deserving to be individualised among the eosinophilic respiratory disorders. Thorough analysis is needed to determine whether unrecognised and/or smouldering HOB may further be a cause of irreversible airflow obstruction in chronic eosinophilic respiratory diseases.

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“…The other important histological finding was the bronchiolocentric interstitial inflammatory responses in the allergic and control mice exposed to the AgNP, which indicates the progression of bronchiolocentric fibrosis. Bronchiolocentric fibrosis is characterized by the pathological pattern of constrictive fibrotic bronchiolitis obliterans, 35 which is related Eosinophilic inflammation of the airways accompanied by an increase in activated and degranulated eosinophils is the phenotype of allergic and nonallergic asthma. 36 This study demonstrated a significant increase in the recruitment of eosinophils in the lungs of the allergic mice compared to the healthy controls under the same exposure conditions (FA/ AgNP).…”

Section: Discussionmentioning

confidence: 99%

Allergenicity and toxicology of inhaled silver nanoparticles in allergen-provocation mice models

Chuang¹,

Hsiao²,

Wu³

et al. 2013

IJN

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Silver nanoparticles (AgNP) have been associated with the exacerbation of airway hyperresponsiveness. However, the allergenicity and toxicology of AgNP in healthy and allergic individuals are unclear. We investigated the pathophysiological responses to AgNP inhalation in a murine model of asthma. Continuous and stable levels of 33 nm AgNP were maintained at 3.3 mg/m 3 during the experimental period. AgNP exposure concomitant with ovalbumin challenge increased the enhanced pause (Penh) in the control and allergic groups. AgNP evoked neutrophil, lymphocyte and eosinophil infiltration into the airways and elevated the levels of allergic markers (immunoglobulin E [IgE] and leukotriene E 4 [LTE 4 ]), the type 2 T helper (Th2) cytokine interleukin-13 (IL-13), and oxidative stress (8-hydroxy-2′-deoxyguanosine [8-OHdG]) in healthy and allergic mice. Bronchocentric interstitial inflammation was observed after AgNP inhalation. After inhalation, the AgNP accumulated predominantly in the lungs, and trivial amounts of AgNP were excreted in the urine and feces. Furthermore, the AgNP induced inflammatory responses in the peritoneum. The inhalation of AgNP may present safety concerns in healthy and susceptible individuals.

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Challenges in pulmonary fibrosis {middle dot} 2 : Bronchiolocentric fibrosis

Cited by 40 publications

References 183 publications

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Characterisation of severe obliterative bronchiolitis in rheumatoid arthritis

Hypereosinophilic obliterative bronchiolitis: a distinct, unrecognised syndrome

Allergenicity and toxicology of inhaled silver nanoparticles in allergen-provocation mice models

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