CORRELATION BETWEEN CHEMICAL MEDIATORS AND HAEMORHEOLOGICAL - COAGULATIVE FACTORS IN THE PATHOGENESIS OF CHRONIC RESPIRATORY FAIL¬URE CAUSED BY INTERSTITIAL LUNG DISEASES (F.I.D)
Interstitial lung diseases are caused by deep lung inflammatory state, characterized by an increase of the immunocompetent cells and vascular compartment injury. To evaluate the physiopathological mechanics involved in the pathogenesis of chronic respiratory failure caused by interstitial lung diseases (F.I.D), we examined in six patients with F.I.D. (age: x ±sd = 55.5113.84) in comparison with three normal subjects (age: x ± sd = 52.66112.74) the levels of chemical mediators, cytokines both in BAL and in alveolar macrophages cultures (albumin; TxB2; LTB4; PAF: PGFl-a; PGE2; IL-la; IL-lp; IL-6; IL-8) and the levels of haemorheological parameters in the peripheral blood (V.E.; fibrinogen; P.T.; P.TT.; antithrombin III; beta- thromboglobulin). All patients have been tested to fibrobronchoscopy and BAL in order to study the immunocompetent cell activation by cytofluorimetry; chemical mediators and cytokins by radioimmunassay; haemorheological- coagulative parameters and haemogasanalysis by peripheral blood samples. In patients with F.I.D. the values of chemical mediators were increased significantly in comparison with normals subjects both in BAL (Albumin p=0.02; TxB2 p=0.02; LTB4 p=0.02) and in 24 h unstimulated A.M. culture (Albumin p=0.02; TXB2 p=0.05; LTB4 p=0.02; PAF p=0.02). Significant values of interleukin 1 (3-6-8 were obtained also in BAL (DL-lp p=0.09; IL-6 p=0.05; IL=8 p=0.05) and 24 h unstimulated A.M. culture (IL-lp p=0.05; IL- 6 p=0.05; IL-8 p=0.08). These results were confirmed “in vitro” LPS- stimulated macrophage culture at 12, 24, 48 and 72h. The immunocompetent cell activation shown by either the interleukins increase and by chemical mediators release, proves the presence of vascular phlogosis demonstrated by alterations of haemoreological-coagulative factors such as AP (p=0.05), Fibrin, (p=0.05), PT (p=0.09), PTT (p=0.09), beta-TG (p=0.02). The remarkable cellular activator induced by cytokines was well documented by multiple correlation test that showed a significant value between IL-1(3 vs VE (r=0.64); IL-lp vs AP (n=0.59) IL-lp vs p-TG (n=0.50); IL-8 vs AP (n=0.77); IL-8 vs Fibrin. (r=0.50)
