Pulmonary inflammation in asbestos-exposed subjects with borderline parenchymal changes on HRCT

Lehtimäki, Lauri; Oksa, Panu; Järvenpää, Ritva; Vierikko, Tuula; Nieminen, Riina; Kankaanranta, Hannu; Uitti, Jukka; Moilanen, Eeva

doi:10.1016/j.rmed.2010.01.019

« Previous Next »Respiratory Medicine
Volume 104, Issue 7 , Pages 1042-1049, July 2010

Pulmonary inflammation in asbestos-exposed subjects with borderline parenchymal changes on HRCT

Lauri Lehtimäki
- The Immunopharmacology Research Group, Medical School, University of Tampere, Finland
- The Research Unit, Tampere University Hospital, Finland
- Department of Respiratory Medicine, Tampere University Hospital, Finland
- Corresponding author at: Department of Pharmacology, Medical School, FIN-33014, University of Tampere, Tampere, Finland. Tel.: +358 3 35518081; fax: +358 3 35518082.
Panu Oksa
- Department of Occupational Medicine, Tampere University Hospital, Finland
- Finnish Institute of Occupational Health, Tampere, Finland
Ritva Järvenpää
- Department of Radiology, Tampere University Hospital, Finland
Tuula Vierikko
- Department of Radiology, Tampere University Hospital, Finland
Riina Nieminen
- The Immunopharmacology Research Group, Medical School, University of Tampere, Finland
- The Research Unit, Tampere University Hospital, Finland
Hannu Kankaanranta
- The Immunopharmacology Research Group, Medical School, University of Tampere, Finland
- Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
Jukka Uitti
- Department of Occupational Medicine, Tampere University Hospital, Finland
- Finnish Institute of Occupational Health, Tampere, Finland
Eeva Moilanen
- The Immunopharmacology Research Group, Medical School, University of Tampere, Finland
- The Research Unit, Tampere University Hospital, Finland

Received 23 June 2009; accepted 27 January 2010. published online 18 February 2010.

Summary

Many asbestos-exposed subjects have minor parenchymal changes on high resolution computed tomography (HRCT) that do not fulfil the diagnostic criteria for pulmonary fibrosis and asbestosis. We investigated if these borderline parenchymal changes in asbestos-exposed subjects are related to pulmonary inflammatory activity.

Exhaled nitric oxide was measured, exhaled breath condensate collected and HRCT scanned in 104 subjects with moderate to high occupational asbestos exposure. Forty-one healthy unexposed subjects served as a comparison group.

After excluding other pulmonary diseases, 35 asbestos-exposed subjects had normal parenchymal findings and 31 subjects had borderline parenchymal changes on HRCT. Lung function was poorer in the latter group, but there was no difference in the degree of asbestos exposure between these groups. As compared with the unexposed comparison group, asbestos-exposed subjects with borderline parenchymal changes had increased alveolar NO concentration (3.0 ± 0.2 vs. 2.3 ± 0.1 ppb, p = 0.008) and increased levels of leukotriene B₄ (12.2 ± 1.1 vs. 3.3 ± 0.8 pg/ml, p < 0.001) and 8-isoprostane (9.4 ± 0.7 vs. 7.3 ± 0.6 pg/ml, p = 0.021) in breath condensate. Asbestos-exposed subjects with normal parenchymal findings had only increased breath condensate levels of leukotriene B₄ (11.4 ± 0.9, p < 0.001).

Borderline parenchymal changes on HRCT in asbestos-exposed subjects are associated with increased markers of pulmonary inflammation. Such borderline parenchymal changes are likely a mild or early form of the same pathological process that leads to asbestosis.

Keywords: Asbestos, Breath tests, Computed tomography, Mediators of inflammation, Pulmonary fibrosis