Impaired lung epithelial permeability in hepatitis C virus antibody positive patients detected by 99mTc-DTPA aerosol scintigraphy

Abstract

Chronic hepatitis C virus (HCV) infection has been recently identified as an aetiological agent in idiopathic pulmonary fibrosis. The present study was designed to determine the pulmonary clearance rate of 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) in asymptomatic HCV antibody positive (HCV Ab+) patients and the role of 99mTc-DTPA aerosol scintigraphy in the early detection of lung involvement. Twenty-six non-smoker HCV Ab+ and HCV-RNA (+) patients (20 female, six male; aged 43+/-11 years), with no clinical pulmonary symptoms, and normal radiological findings, were studied. Thirty-one healthy non-smoker volunteers (24 female, seven male; aged 40+/-10 years) were taken as a control group. 99mTc-DTPA aerosol inhalation scintigraphy and pulmonary function tests were performed in all patients and in controls. On the basis of the scintigrams the percentage decline in activity per minute (Kep) was evaluated, which represented an accurate parameter of lung membrane permeability. The mean Kep values of healthy controls (0.78+/-0.13 for left lung, 0.79+/-0.14 for right lung) were significantly lower than HCV Ab+ patients (1.10+/-0.31 for left lung, 1.11+/-0.34 for right lung, P<0.001). But no significant change was observed in PFT (P>0.05). We conclude that subclinical alveolitis and/or interstitial lung disease may be present in patients with HCV Ab+, since it is known that an increase in the epithelial permeability of the lung is an early manifestation of interstitial disease.

Lung epithelial permeability and inhaled furosemide: added dimensions in asthmatics

“…Lung epithelial permeability is changed in different respiratory conditions [7][8][9][10][11][12][13]. It is now well accepted that there is an inflammatory process present in the airways of patients with asthma [14].…”

The complex interrelationships between chronic lung and liver disease: a review

“…Interestingly, the extent of these abnormalities does not correlate with liver disease severity [73]. Furthermore, patients with HCV exhibit a significantly increased epithelial permeability (as measured by technetium-99-labelled diethylenetriaminepentaacetic acid aerosol scintigraphy), suggestive of early interstitial lung disease compared with controls [74]. More recently, Arase et al [66] reported a much higher incidence of IPF than expected in HCV-positive patients (as assessed by anti-HCV antibodies determined using second-generation enzyme-linked immunosorbent assay and HCV RNA), but not in hepatitis B virus-positive patients.…”

“…Interestingly, the extent of these abnormalities does not correlate with liver disease severity [73]. Furthermore, patients with HCV exhibit a significantly increased epithelial permeability (as measured by technetium‐99‐labelled diethylenetriaminepentaacetic acid aerosol scintigraphy), suggestive of early interstitial lung disease compared with controls [74]. More recently, Arase et al.…”

Technetium-99mdiethylenetriaminepentaacetic acid radioaerosol scintigraphy in organophosphate induced pulmonary toxicity: Experimental study

“…Technetium-99m diethylenetriaminepentaacetic acid (Tc99m DTPA) radioaerosol scintigraphy has been used to detect functional defects of the alveolar-capillary barrier in different interstitial lung diseases or lung toxicity (8)(9)(10)(11)(12). To our knowledge, changes in alveolar-capillary membrane permeability and alveolar clearance due to OP poisoning using radioaerosol scintigraphy have not been established.…”