Factors associated with the relapse of cryptogenic and secondary organizing pneumonia

Onishi, Yasutaka; Kawamura, Tomohiro; Nakahara, Yasuharu; Kagami, Ryogo; Sasaki, Shin; Takahashi, Sayaka; Kominami, Ryota; Hirano, Katsuya; Hiraoka, Ryota; Hirata, Nobuya

doi:10.1016/j.resinv.2016.09.001

Cited by 21 publications

(27 citation statements)

References 21 publications

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“…However, the majority of the studies have focussed on cryptogenic OP, and until this study, no study has analysed the RA-OP recurrence. The identi ed predictors of OP recurrence in previous reports and this study are summarised in Table 4 [26][27][28][29][30][31][32]. This comparison emphasises the value of our data exclusively on RA-OP, and suggests the particularity of RA-OP compared with other forms of OP.…”

Section: Discussionsupporting

confidence: 56%

“…Three of them are related to the timing of OP onset: lower age at the rst OP onset (especially ≤66 years), shorter period from the RA onset to the rst OP onset (especially ≤4 years), and OP-preceding. However, the age at the rst OP onset has not been identi ed as a predictor of recurrence in previous studies focussing mainly on cryptogenic OP (Table 4) [ [26][27][28][29][30][31][32]. This discrepancy may indicate the specialty of RA-OP and re ect the difference of underlying immunological mechanisms between RA-OP and cryptogenic OP.…”

Section: Discussionmentioning

confidence: 99%

“…A history of smoking was the other predictor of RA-OP recurrence identi ed in this study. However, this characteristic has been previously reported as irrelevant to the recurrence of the other types of OP: cryptogenic OP [26,28] or cryptogenic and secondary OP [32]. It is well established that smoking is a strong risk factor for RA [36] and even for ILDs in patients with RA [37,38], and that smoking in uences the severity of RA [39,40].…”

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics and Predictors of the Recurrence of Organising Pneumonia Associated with Rheumatoid Arthritis

Kamei¹,

Yamashita²,

Takahashi³

et al. 2020

Preprint

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Background: Organizing pneumonia (OP) accounts for ~10% of the interstitial lung diseases in patients diagnosed with rheumatoid arthritis (RA). There are only a few published studies that have described RA-associated OP (RA–OP), each with comparatively few study participants. Furthermore, despite the high frequency of secondary flareups, no studies to date have identified factors that predict RA–OP recurrence. This study aimed to clarify the clinical characteristics of RA–OP, to determine the relationship between OP and RA exacerbations, and to identify predictors of RA–OP disease recurrence.Methods: The data of 33 patients with RA–OP admitted to our hospital between 2006 and 2016 were retrospectively analysed.Results: RA onset preceded OP in 82% of patients; OP preceded or co-occurred with RA in 9% each. The median [Q1, Q3] age at first OP onset was 64.0 [55.0, 68.0] years and 5.5 [1.0, 19.3] years after RA onset. At OP onset, 42% of events exhibited unilateral shadows and 76% had normal KL-6; RA disease control remained good in 52% and was exacerbate d in only 18%. Ten (30%) patients experienced OP recurrence with an interval of 13.0 [7.5, 22.5] months between events, with a rate of first recurrence of 127 per 1,000 person-years. Compared with 14 non-recurrent cases, 10 recurrent cases showed lower age at first OP (59.5 years vs. 67.1 years; p = 0.043) and shorter period from RA to first OP (6.4 vs. 14.2 years; p = 0.047) and included more OP-preceding patients (30% vs. 0%; p = 0.029) and more ever-smokers (80% vs. 36%; p = 0.032). OP-preceding patients showed shorter median recurrence-free survival time (15 vs. 136 months; p = 0.009) and higher recurrence risk (hazard ratio, 5.5; p = 0.021). Conclusions: RA–OP showed a high recurrence rate but no association with RA exacerbation. Four predictors of RA–OP recurrence were identified.

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics and Predictors of the Recurrence of Organising Pneumonia Associated with Rheumatoid Arthritis

Kamei¹,

Yamashita²,

Takahashi³

et al. 2020

Preprint

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“…Evidence on the participation of neutrophil in the pathogenesis of pneumonia has been accumulated in recent years. For example, the neutrophil percentage in BALF was higher in the relapse group of organizing pneumonias and may also be considered as a predictive factor of organizing pneumonia relapse as Onishi et al reported [124]. But, on the contrary, CAP had significant low neutrophil counts in peripheral blood [125].…”

Section: Neutrophils In Infectious Pneumoniamentioning

confidence: 99%

Advanced Role of Neutrophils in Common Respiratory Diseases

Liu

Pang

Wang

et al. 2017

Journal of Immunology Research

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Respiratory diseases, always being a threat towards the health of people all over the world, are most tightly associated with immune system. Neutrophils serve as an important component of immune defense barrier linking innate and adaptive immunity. They participate in the clearance of exogenous pathogens and endogenous cell debris and play an essential role in the pathogenesis of many respiratory diseases. However, the pathological mechanism of neutrophils remains complex and obscure. The traditional roles of neutrophils in severe asthma, chronic obstructive pulmonary diseases (COPD), pneumonia, lung cancer, pulmonary fibrosis, bronchitis, and bronchiolitis had already been reviewed. With the development of scientific research, the involvement of neutrophils in respiratory diseases is being brought to light with emerging data on neutrophil subsets, trafficking, and cell death mechanism (e.g., NETosis, apoptosis) in diseases. We reviewed all these recent studies here to provide you with the latest advances about the role of neutrophils in respiratory diseases.

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“…However, relapses can occur and some cases do not completely resolve, with the potential for severe or fulminant respiratory failure requiring mechanical ventilation, occasionally leading to death. Onishi et al reported that a high percentage of neutrophils in bronchoalveolar lavage (BAL) and the level of fibrin deposition in lung biopsy specimens were considered as predictors of OP relapse during tapering or after cessation of steroid therapy (5) . Lazor et al retrospectively studied 48 cases of COP and reported delayed treatment increased the risk of relapse (6) .…”

Section: Introductionmentioning

confidence: 99%

Organizing pneumonia with elevated surfactant protein-D needs attention to the possibility of relapse

Yamagishi

Kodaka

Watanabe

et al. 2019

Preprint

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Background and Objectives Organizing pneumonia (OP) usually responds spectacularly well to initial treatment, but relapses can occur and some cases run a fatal course. Still the issue of relapse has been addressed in relatively few studies and predictors have not been clarified. The purpose of this study was to examine the pattern of relapses in OP, to determine whether relapse affects morbidity and mortality and to identify possible predictors of relapse. Methods Blood sampling, pulmonary function testing, computed tomography (CT) of the chest and bronchofiberscopy were performed for all patients and were retrospectively reviewed along with clinical information. To determine relapse of OP, additional chest CT was performed regularly or when relapse of OP was clinically suspected. All patients were followed regarding treatment response, treatment duration and presence of relapse. Results were compared between two groups based on serum concentrations of surfactant protein (SP)-D: normal SP-D; and high SP-D. Results Twenty-two patients were analyzed in this study. SP-D showed a negative correlation with percutaneous oxygen saturation, and positive correlations with serum lactate dehydrogenase (LDH), Krebs von den Lungen (KL)-6 and percentage lymphocytes in bronchoalveolar lavage (BAL). Prognosis was good for all patients, but relapse was significantly more frequent in the high SP-D group (6 cases) than in the normal SP-D group (0 cases; p=0.049). Serum KL-6 and percentage monocytes in BAL were significantly higher and pulmonary vital capacity and forced expiratory volume in 1 s were significantly lower in the high SP-D group than in the low SP-D group. Conclusions When treating cases of OP with high serum concentrations of SP-D, attention should be paid to the possibility of relapse.

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Factors associated with the relapse of cryptogenic and secondary organizing pneumonia

Cited by 21 publications

References 21 publications

Clinical Characteristics and Predictors of the Recurrence of Organising Pneumonia Associated with Rheumatoid Arthritis

Clinical Characteristics and Predictors of the Recurrence of Organising Pneumonia Associated with Rheumatoid Arthritis

Advanced Role of Neutrophils in Common Respiratory Diseases

Organizing pneumonia with elevated surfactant protein-D needs attention to the possibility of relapse

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